Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cellulitis due to Hemophilus influenzae type B is a rare but treatable event in adults. Herein is described a 67-year-old woman with anterior neck cellulitis caused by H. influenzae type B, documented by positive blood culture results. Six additional cases reported in the literature are reviewed. The following clinical syndrome emerges: the patient is usually older than 50 years of age, and pharyngitis develops first, followed by the onset of high fever and rapidly progressive anterior neck swelling, tenderness, and erythema associated with dysphagia. Because the causative organism may be resistant to ampicillin, the early use of chloramphenicol is recommended along with a beta-lactamase-resistant penicillin or cephalosporin (to cover other potential pathogens), or an appropriate third-generation cephalosporin that would also adequately cover all possible pathogens.
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PMID:Hemophilus influenzae type B cellulitis in adults. 376 1

We treated four adults whose upper airway was compromised due to acute epiglottitis. We also reviewed the English literature for all reports of this condition in adults (18 years and older). Among the 158 cases, the infectious etiology was identified in 29 (H. influenzae 20, Streptococcus pneumoniae six, H. parainfluenzae two, Streptococcus pyogenes one). In the remaining cases, the etiology was uncertain. Bacteremia was documented in 23/32 patients (71.9%), but extra-epiglottic infections were strikingly rare (X = six). The clinical manifestations were sore throat (100%), fever (88%), dyspnea (78%), dysphagia (76%), anterior neck cellulitis or tenderness (27%), hoarseness (21%), pharyngitis (20%) and anterior cervical lymphadenopathy (9%). Complete airway obstruction ensued in 23 out of the 119 subjects (18.3%) who had respiratory difficulty. Overall mortality rate was 17.6% but it was 6.4% among the patients who were semi-electively tracheostomized or endotracheally intubated. These findings illustrate that antibiotics therapy active against H. influenzae is required in the treatment of acute epiglottitis in adults. Additionally, airway patency should be established when inspiratory stridor appears assuring uncomplicated recovery.
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PMID:Acute epiglottitis in adults. 670 91

Post-tonsillectomy bacteremia is a well-recognized aetiological factor in streptococcal endocarditis, and prophylactic penicillin has been recommended to reduce its incidence in susceptible patients undergoing tonsillectomy. Recent studies have shown a change in the microflora and an increase in the number of penicillin-resistant organisms in the tonsils of patients undergoing tonsillectomy. The aim of this study was to assess the incidence of post-tonsillectomy bacteraemia, to identify the micro-organisms associated with it and to review the suitability of penicillin in prophylactic regimens. The relationship between positive blood cultures and several clinical parameters such as fever, vomiting, pharyngeal discomfort, or dysphagia was also analysed. Of the 102 patients included in the study, 41 (40.1%) had positive post-tonsillectomy blood cultures. Haemophilus influenzae were isolated from 23 (56%) of the positive cultures and Streptococcus viridans in 15 (36.5%). Twenty-five per cent of H. influenzae produced beta-lactamase and only 30% of streptococci of the viridans group were penicillin-sensitive. Positivity of the blood cultures was not related to fever, discomfort, surgical technique, type of tonsil, or any of the parameters studied. Bacteraemia seems to be related to traction of the tonsil before dissection rather than direct spread of bacteria into the opened vessels. Using a beta-lactamase stable antibiotic instead of penicillin for prophylaxis would be more appropriate.
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PMID:Bacteraemia during tonsillectomy: a study of the factors involved and clinical implications. 956 68