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However, no guidelines exist on when to diagnose or treat it. We aimed to investigate associations between clinical criteria and <jats:italic>F. necrophorum-<\/jats:italic>positivity in pharyngotonsillitis and assess the predictive potential of a simple scoring system.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Pharyngotonsillitis patients who were tested for <jats:italic>F. necrophorum<\/jats:italic> (PCR) and presented to hospitals in the Sk\u00e5ne Region, Sweden, between 2013\u20132020 were eligible. Data were retrieved from electronic chart reviews and registries. By logistic regression we investigated associations between <jats:italic>F. necrophorum<\/jats:italic>-positivity and pre-specified criteria: age 13\u201330\u00a0years, symptom duration\u2009\u2264\u20093\u00a0days, absence of viral symptoms (e.g. cough, coryza), fever, tonsillar swelling\/exudate, lymphadenopathy and CRP\u2009\u2265\u200950\u00a0mg\/L. In secondary analyses, associated variables were weighted by strength of association into a score and its predictive accuracy of <jats:italic>F. necrophorum<\/jats:italic> was assessed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among 561 cases included, 184 (33%) had <jats:italic>F. necrophorum,<\/jats:italic> which was associated with the following criteria: age 13\u201330, symptom duration\u2009\u2264\u20093\u00a0days, absence of viral symptoms, tonsillar swelling\/exudate and CRP\u2009\u2265\u200950\u00a0mg\/L. Age 13\u201330 had the strongest association (OR5.7 95%CI 3.7\u20138.8). After weighting, these five variables had a sensitivity and specificity of 68% and 71% respectively to predict <jats:italic>F. necrophorum<\/jats:italic>-positivity at the proposed cut-off.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Our results suggest that <jats:italic>F. necrophorum<\/jats:italic> cases presenting to hospitals might be better distinguished from other pharyngotonsillitis cases by a simple scoring system presented, with age 13\u201330 being the strongest predictor for <jats:italic>F. necrophorum<\/jats:italic>. Prospective studies, involving primary care settings, are needed to evaluate generalisability of findings beyond cases presenting to hospitals.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s10096-024-04827-6","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T16:02:11Z","timestamp":1712937731000},"page":"1099-1107","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Symptoms predictive of Fusobacterium necrophorum pharyngotonsillitis \u2013 an observational study of cases presenting to hospitals in Southern Sweden"],"prefix":"10.1007","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2150-5173","authenticated-orcid":false,"given":"Josefina","family":"Pagels","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustav","family":"Torisson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Wasserstrom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarina","family":"Hedin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Holm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Nygren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,12]]},"reference":[{"issue":"12","key":"4827_CR1","doi-asserted-by":"publisher","first-page":"1903","DOI":"10.1007\/s10096-016-2757-y","volume":"35","author":"TE Klug","year":"2016","unstructured":"Klug TE, Rusan M, Fuursted K, Ovesen T, Jorgensen AW (2016) A systematic review of Fusobacterium necrophorum-positive acute tonsillitis: prevalence, methods of detection, patient characteristics, and the usefulness of the Centor score. 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