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Query: UMLS:C0031350 (pharyngitis)
 2,405 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fever is one of the main symptoms leading to medical evaluation. Not only infections cause fever but also inflammatory disorders. To distinguish one from another, a thorough medical history and clinical evaluation are needed. Sometimes, only the clinical course will reveal the diagnosis. PFAPA-Syndrome (periodic fever, aphthous stomatitis, pharyngitis, adenitis) is the most frequent periodic fever syndrome in Switzerland. No diagnostic test is available to support the diagnosis. Some important diseases have to be ruled out, such as Immunodeficiency, cyclic neutropenia, chronic viral infections and rheumatologic disorders. To know the diagnosis of the PFAPA-Syndrome can help avoiding antibiotic courses for febrile episodes in infants. There is a clinical overlap to hereditary periodic fever syndromes as familial Mediterranean fever (FMF), Hyper-IgD and fever syndrome (HIDS), Tumor-necrosis factor receptor associated periodic syndrome (TRAPS) and others, in which a genetic basis for the disease has already been found.
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PMID:[Recurrent febrile episodes--normal, periodic fever syndrome or immunodeficiency?]. 1704 86

Clinicians face a diagnostic challenge when a patient with the classic fever, pharyngitis, and lymphadenopathy triad of infectious mononucleosis has a negative "spot" heterophile antibody test. This screening test, although commonly considered sensitive for the presence of Epstein-Barr virus (EBV) infection, may be negative early after infection. A growing number of pathogens have been reported to cause heterophile-negative mononucleosis-like illnesses, including cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), human immunodeficiency virus (HIV), adenovirus, herpes simplex virus (HSV), Streptococcus pyogenes, and Toxoplasma gondii. Other infectious and noninfectious disorders also may present in ways that mimic mononucleosis, but fail to generate EBV's archetypal triad of clinical findings. A systematic approach to the diagnosis of mononucleosis-like illnesses ensures that conditions warranting specific therapy are distinguished from others requiring only supportive care.
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PMID:Diagnostic evaluation of mononucleosis-like illnesses. 1790 63

A 42-year-old bedridden patient suddenly became seriously ill with an unexplained fever (39 degrees C) and hypoxemia (pulse oximetry oxygen saturation: patient, 90%; normal, >98%). He had received the inactivated vaccine for pandemic 2009 H1N1-influenza (pH1N1) 41 days earlier. He had no cough, sore throat, or pharyngitis. Therefore, he did not satisfy the Centers for Disease Control criteria for an "influenza-like illness." Nevertheless, his nasopharyngeal swab was tested by rapid enzyme-linked immunosorbent assay for influenza A and found positive. He was promptly treated with supplemental oxygen and oseltamivir (75 mg twice daily) for 5 days. On day 6, reverse transcriptase-polymerase chain reaction test confirmed the virus to be pH1N1. A chest radiograph was normal on day 1 but revealed bilobar pneumonia on day 2. This was considered bacterial superinfection and empirically treated for 10 days with 3 g of piperacillin and 375 mg of tazobactam. The patient fully recovered. This case of pH1N1 vaccine failure occurred because no vaccine is 100% protective, and immune response may be poorer in patients with chronic medical problems. Vaccine failure was not due to immunodeficiency or improper vaccine handling. We credit this patient's recovery to our facility's heightened surveillance for influenza even among the vaccinated individuals, and also in those without classic influenza-like illness.
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PMID:Serious pH1N1 influenza illness and pneumonia despite inactivated vaccine: success of prompt diagnosis and treatment. 2105 11

Acute infection with human immunodeficiency virus (HIV) is infrequently diagnosed, owing in large part to vague or non-specific symptoms. Among the most common of these symptoms are fever, fatigue, pharyngitis, lymphadenopathy, anorexia, arthralgia, myalgia, rash, and headache. Some patients seek no medical attention for such symptoms, and others recall no symptoms whatsoever. Physicians in all healthcare environments must maintain a high index of suspicion for HIV in the setting of these symptoms. For suspected acute infection, rapid serologic tests should be supplemented with assays of p24 antigen and/or HIV RNA viral load. We report here a case of acute HIV infection in a young man who presented with a negative rapid serologic test, as well as pancytopenia and transaminitis. We also review the epidemiology, transmission, diagnosis, and management of acute HIV infection.
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PMID:A 23-year-old man with fever and malaise. 2286 58

Various sexual practices like fellatio, cunnilingus, or anilingus (rimming) can cause both symptomatic and asymptomatic oral infections in both sexes. Clinically apparent lesions are found in primary, secondary, and tertiary syphilis, in acute HIV infection and the subsequent stage of immunodeficiency (opportunistic infections), as well as in herpes and human papilloma virus infections. Genital candidiasis also can be transmitted to the oral cavity. Depending on the infective agent transmitted, ulcerative, inflammatory or papillomatous lesions of the lips, tongue, mucous membranes and pharynx occur. Oropharyngeal infections with Neisseria gonorrhoeae or Chlamydia trachomatis (Serovar D-K) can cause pharyngitis and tonsillitis with sore throat, but are completely asymptomatic in most cases. Asymptomatic infections are an important, but frequently overlooked reservoir for new infections. Systemic treatment of oral STI's usually is the same as that for anogenital infections. It can be accompanied by symptomatic topical therapy. When the tonsils and other difficult to reach tissues are infected, higher doses and an antibiotic with good tissue penetration are recommended.
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PMID:[Sexually transmitted infections of the oral cavity]. 2289 75

Basic knowledge concerning the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) is useful for ENT physicians. Although HIV patients are usually stably asymptomatic nowadays due to modern therapy, HIV often manifests in ENT symptoms, such as neck lumps, sore throat, difficulty swallowing and dysgeusia. After infection, an initial increase in viral load can cause, among other symptoms, oral ulcers and pharyngitis. Once the immune system is compromised by the attack on CD4 lymphocyte cells, HIV-related diseases can occur: oral mycoses (particularly candidosis) and viral infections (including warts), aphthous ulcers, gingivitis, salivary gland diseases and malignancies (e. g. intraoral Kaposi's sarcoma). Neck lymphadenopathy is frequent. Markers of disease severity are the clinical symptoms, viral load and CD4 helper cell count. HIV treatment (antiretroviral therapy, ART) is a combination of at least three antiviral drugs.
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PMID:[A practically orientated clinical HIV update for ENT physicians]. 2535 97


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