In children with acute pharyngitis, which is the most common etiologic cause?

• A. S. pyogenes
• B. H. influenzae
• C. M. pneumoniae
• D. Respiratory viruses

Answer: (D)

Respiratory viruses are the most common cause of acute pharyngitis in children. Most sore throats in kids come from viral upper respiratory infections, with agents like rhinovirus, influenza, adenovirus, and others being typical culprits. Bacterial pharyngitis due to Streptococcus pyogenes is important but accounts for a smaller portion of cases overall. Clinically, viral pharyngitis often features cough, runny nose, or conjunctivitis, while strep pharyngitis tends to present with fever, sore throat without cough, tonsillar exudates, and tender anterior cervical nodes. Because viruses predominate, management is usually supportive, and antibiotics are reserved for confirmed streptococcal infection via rapid testing or throat culture. Age can shift risk somewhat, but the general pattern remains that viruses are the most common cause.