Arcanobacterium haemolyticum pharyngitis and exanthem. Three case reports and literature review.

BACKGROUND: Arcanobacterium haemolyticum is a bacterial pharyngeal pathogen that infects adolescents and young adults, frequently causing an exanthem that may mimic a viral exanthem, toxic erythema, or drug eruption. To our knowledge, the cutaneous manifestations of A haemolyticum infection have not previously been reported in the dermatologic literature.

OBSERVATIONS: The severity of this infection can range from mild pharyngitis to a diphtheria-like illness and even septicemia. We report three cases that demonstrate the spectrum of manifestations of this disease, including an unusual case with acral distribution of the associated exanthem.

CONCLUSIONS: Arcanobacterium haemolyticum infection should be considered in the differential diagnosis when evaluating a young adult with an exanthem. Antibiotic treatment is reliably efficacious, but the throat swab must be specifically cultured on 5% human blood agar in order to make the diagnosis.