The microbial growing is suspected, by inconspicuous hemolytic zones at 24 hours (h) of incubation at 37[degrees]C on bovine blood agar, thereafter at 48 h and with an exhaustive macroscopic examination, it is possible to see white pin point colonies with 1-2 mm diameter, surrounded by a more prominent total ([beta]) hemolysis [9, 46, 57], it is partially acid-alcohol resistant and has a fermentative metabolism ; unlike clinical samples, cultures do not have a characteristic odor; CAMP test is helpful to confirm the identification [13,31] and differentiation from Arcanobacterium haemolyticum
, which inhibit Staphylococcus aureus [beta] haemolysin .
For example, pharyngitis caused by Arcanobacterium haemolyticum can have a similar clinical syndrome as group A strep, including fever, exudative pharyngitis, and accompanying rash.
Arcanobacterium haemolyticum and streptococcal pharyngitis.
Other causes include Mycoplasma, Epstein-Barr virus, Adenovirus, Influenza virus, Arcanobacterium haemolyticum
, gonococcal pharyngitis and others.
5,11] The predominance of diptheroids reflects the normal flora of the oral cavity, as does isolation of viridans streptococci and Arcanobacterium haemolyticum
Mancini reviewed common exanthems, and many that aren't so common, paying special attention to five of the newer or atypical exanthems: acute generalized exanthematous pustulosis (AGEP), Arcanobacterium haemolyticum, Gianotti-Crosti syndrome, papular-purPuric gloves and socks syndrome, and unilateral laterothoracic exanthem.
Often masquerading as scarlet fever, Arcanobacterium haemolyticum typically appears in adolescents and young adults as a sore throat with a scarlet fever-like rash.
4) Group A [beta]-hemolytic streptococci (GABHS) are responsible for most bacterial cases of acute pharyngotonsillitis, although other pathogens, such as Neisseria gonorrhoeae, Arcanobacterium haemolyticum
, Mycoplasma pneumoniae, and Chlamydia pneumoniae, may be the causative agents in sporadic cases.
4) Other bacterial agents that occasionally cause pharyngitis and are reported when recovered include group B and C beta-hemolynic streptococci, Neisseria gonorrhoeae, Arcanobacterium haemolyticum
, Corynebacterium diphtheriae, Chlamydia pneumoniae, and Mycoplasma spp.