Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0031350 (pharyngitis)
 2,405 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acyclovir (ACV) has an ED50 of 0.3 microM against EBV replication in vitro. Based on these and other data we carried out a pilot, double-blind, placebo-controlled trial of ACV for treatment of infectious mononucleosis. Only patients with relatively severe illness requiring hospital management were enrolled. Ten subjects with proven infectious mononucleosis received placebo and 10 ACV. The drug was administered intravenously at 8-hourly intervals in a total daily dosage of 1500 mg/m2 for 5 days. Preliminary analyses of the results indicate that the drug interrupted virus excretion in the oropharynx transiently but had no effect on ability to generate lymphocytic lines from peripheral blood. Symptoms and signs unaffected by ACV were splenomegaly, lymphadenopathy, lethargy, fever and pharyngitis. There was significantly more rapid regain of weight in the ACV-treated group. On the basis of these results we have instituted an out-patient trial of orally administered ACV in patients with less severe illness earlier in its course. We have also begun in-vitro tests of other drugs that might prove to be effective against Epstein-Barr virus infection, and have shown that 9-1 (1,3-dihydroxy-2-propoxymethyl)guanine (BW759) has an ED50 of 0.05 microM.
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PMID:Acyclovir and Epstein-Barr virus infection. 631 91

A case of brachial plexus neuropathy (BPN) associated with infectious mononucleosis (IM) in a 13 year old boy is presented. The essential clinical picture of BPN is discussed and the main points are: acute pain at onset across the top of the shoulder-blade followed by weakness and atrophy on muscles supplied in most cases by superior brachial plexus. The prognosis is good and most patients began to note improvement within months. The main neurological complications of IM are lymphocytic meningitis, peripheral neuropathy and encephalomyelitis and they can occur without any classical findings as pharyngitis, adenopathy or splenomegaly. The association of BPN and IM was described previously in only 7 cases and as the present case all of them had a complete recovery.
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PMID:[Brachial plexus neuropathy (amyotrophic neuralgia) and infectious mononucleosis: report of a case]. 649 19

Angioimmunoblastic lymphadenopathy occurred in a 46-year-old man 16 months after an episode of infectious mononucleosis induced by Epstein-Barr (EB) virus. The features of infectious mononucleosis included fever, pharyngitis, lymph gland enlargement, hepatosplenomegaly, hyperbasophilic mononuclear cells, and IgM antibodies to EB virus, although heterophile antibodies were not detected. The illness was severe and prolonged and included an asymptomatic measles virus infection. Over a year later massive enlargement of the lymph nodes led to a biopsy, which showed a diffuse infiltration with lymphoid cells and a proliferation of arborising small vessels typical of angioimmunoblastic lymphadenopathy. In spite of corticosteroids, levamisole, chlorambucil, and radiotherapy, no remission occurred, and serious infections led to death 18 months after the onset. Viral infections with EB virus and measles virus associated with pre-existing or subsequent immunological changes probably resulted in the appearance of angioimmunoblastic lymphadenopathy.
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PMID:Angioimmunoblastic lymphadenopathy after infectious mononucleosis. 678 65

Sixteen patients with primary or secondary anaerobic infections of the maxillary sinus, mouth and throat were treated with tinidazole. The peak plasma concentration in eight patients given 2 g tinidazole initially followed by 1 g daily on the 5 subsequent days varied between 15 and 48 microgram/ml the first day and were only slightly lower during the following days. The mixed saliva/plasma concentration ratios ranged between 0.2 and 1.8 with a mean value of 0.85. In eight patients with anginose infectious mononucleosis, a rapid improvement was observed after the onset of treatment. Normal body temperature and well-being was restored within 3 to 5 days. No bacteria considered to be involved in the infection of the throat were isolated from these patients, and it, therefore, seems unlikely that the clinical benefit is attributable only to antibacterial activity of tinidazole. Anaerobic infections in five patients with purulent maxillary sinusitis, two patients with acute exacerbation of atrophic pharyngitis and one patient with a necrotic ulcer of the tongue, were treated successfully with tinidazole.
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PMID:Tinidazole in the treatment of infections of the upper respiratory tract. 694 50

Although almost always a benign, self-limiting disease, infectious mononucleosis accounts for considerable symptomatic illness in the young athlete and can, on occasion, be truly life-threatening. Recognition of the syndrome "glandular fever," vis-a-vis infectious mononucleosis--fever, pharyngitis, lymphadenopathy, and splenomegaly, with characteristic changes in the peripheral blood leukocytes--dates back over a half a century. However, seroepidemiologic studies have only recently established its viral causation and epidemiology. This acute infection by the Epstein-Barr virus is unique pathophysiologically--an acute, self-limiting, lymphoproliferative disorder with autoimmune features--and may well be the cause or one of the causes of several malignant neoplasms, Burkitt's lymphoma, and nasopharyngeal carcinoma. This review (1) describes infectious mononucleosis, pathophysiologically, clinically, and epidemiologically; and outlines its most frequent and serious complications; (2) discusses how to reliably diagnose infectious mononucleosis and evaluate the heterophile-negative case; and (3) addresses management, especially the thorny issues of the use of corticosteroids and restriction from athletic training and participation.
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PMID:Infectious mononucleosis in the athlete. Diagnosis, complications, and management. 711 52

We reviewed the thirty cases of cytomegalovirus infections with occurred in previously healthy patients, hospitalised for fever from 1981 to 1992. Pregnant women, transplant recipients, HIV infected persons and all immunocompromised subjects were excluded. We observed 34 cases (18 women, 16 men) whose mean age was 34 years (17 to 79). Fever appeared progressively (73%), persisted more than 15 days (87%) and was well tolerated. The main functional symptoms were headaches, myalgia (53%), profuse sweat (50%), abdominal pain, diarrhea, recent loss of weight, dry cough (51%). Splenomegaly was present in 24% of the cases. Chest X ray was always normal. Differential blood count was always inverse and an authentic mononucleosis syndrome was present in 91%: it appeared mainly 13 days after onset of symptoms. Hepatic abnormalities were nearly constant, especially cytolytic (97%) (transaminases three or four times upper the normal limit) but also cholestatic (62%). Thrombopenia has been noticed once (48,000/mm3). Serological diagnosis was confirmed with Elisa test (anti CMV Ig M: 30 cases) or complement fixation test (seroconversion: one, significant increase of the titers: two). CMV viremia, studied in seven patients, was positive in three. Spontaneous or treated (NSAI in 30%) outcome was nearly always favourable (97%). Two patients presented severe complications: meningo encephalitis and spleen rupture. CMV infection in previously healthy patients has to be suspected, without waiting for the mononucleosis syndrome, in view of a prolonged, well tolerated febrile illness, without pharyngitis, associated with hyperlymphocytosis and mild cytolysis. A careful follow-up is needed to detect the rare but severe complications.
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PMID:[Clinical, biological and developmental aspects of cytomegalovirus infection in immunocompetent patients: apropos of 34 hospitalized patients]. 805 48

A 5 year old boy had a spiky fever accompanied by a mild pharyngitis, cervical lymphadenopathy and hepatosplenomegaly. Laboratory findings revealed leukocytosis with 26% atypical lymphocytes, and liver dysfunction. A chest X-ray showed pneumonia and a considerable amount of pleural effusion. Serum antibody titers for cytomegalovirus (CMV) were elevated significantly and CMV-DNA (polymerase chain reaction) was detected in the pleural effusion. Only 13 cases of pleural effusion associated with infectious mononucleosis have been reported previously in the literature, but there was no documentation that proved CMV infection. The case reported here suggests that the pleural effusion was caused by the infiltration of mononuclear cells to the pleura as a result of systemic inflammation, and the possible alternative of host immune response against CMV was related to recent Varicella zoster virus infection.
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PMID:A case of cytomegalovirus mononucleosis associated with pleural effusion. 809 78

Common causes of acute laryngotracheobronchitis (LTB) are viral infections. More rarely, bacterial germs, unspecific irritants, foreign bodies, rachitic laryngospasm, mild malformation, tumours, C1 esterase inhibitor deficiency, bilateral vocal cord paralysis, and psychogenic laryngospasm may be responsible for croup. Symptoms similar to epiglottitis may occur in pharyngitis based on common bacterial tonsillitis or infectious mononucleosis and peritonsillar abscess. It is decisively important to establish a precise diagnosis to provide for an appropriate therapy. Viral croup of mild degree is often sufficiently treated by cold and moistened air and--if necessary--prednisolone. In serious disease, oxygen insufflation and adrenaline (epinephrine) are useful. Recurrent croup is due to an unspecific hyperreactivity of tracheobronchial mucosa. It often leads to asthma. Consequently, preventive measures have to be considered similar to patients with bronchial hyperreactivity. Vaccination with haemophilus influenzae type b vaccine has proved effective and safe. The disease has therefore become impressively less frequent.
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PMID:[Croup syndrome]. 811 57

Infectious mononucleosis is caused by the Epstein-Barr virus (EBV) and most commonly affects young adults from 15 to 35 years of age. The diagnosis is made by accurate assessment of clinical, hematologic and serologic manifestations of the illness. Manifestations include the classic triad of fever, pharyngitis and cervical lymphadenopathy; lymphocytosis with a predominance of atypical lymphocytes; a positive heterophil (Monospot) antibody test; and in some cases, serologic evidence of EBV-specific antibodies produced against antigens related to the virus. The most valuable serologic finding is the presence of IgM antibody to EBV viral capsid antigen, which is found during acute primary EBV infection. Infectious mononucleosis is considered a self-limited illness, but it may result in serious complications involving the pulmonary, ophthalmologic, neurologic and hematologic systems. Treatment is focused on managing the symptoms, unless more severe disease involving other organ systems occurs. The most common potentially fatal complication is splenic rupture.
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PMID:Diagnosis and treatment of infectious mononucleosis. 811 21

Twenty-two consecutive patients presenting with symptomatic human immunodeficiency virus 1 (HIV-1) seroconversion were studied. Most of the patients had a glandular fever-like illness. All patients had fever and pharyngitis, and eight of them also suffered from ulcers of the oral, genital or anal mucosa. Uniform skin eruptions were observed in 17 of the 22 patients. The exanthem consisted of varying numbers of macular or maculopapular lesions that were oval or rounded in shape, ranging from a few millimetres to 1 cm in diameter. The lesions were distributed on the upper thorax in all cases, and were particularly profuse in the collar region. The face, forehead and scalp were involved in most cases, but the eruption was sparse or absent at the periphery of the extremities. In the majority of patients, the exanthem appeared after 2 or 3 days of fever. The exanthem developed during the first day, persisted for 5-8 days, and then cleared concurrently with the general recovery of the patients. Histopathological studies of skin punch biopsy specimens from four patients showed a sparse lymphocytic cell infiltrate distributed around vessels of the dermal superficial plexus. The infiltrates predominantly consisted of equally represented T-helper/inducer and T-suppressor/cytotoxic cells. A vacuolar aberration of basal layer cells was found in two of the four cases studied histologically. The microscopic findings correspond to the histopathological patterns seen in toxicodermia and in the interface dermatitis of morbilliform viral exanthems. The exanthem is a frequent and characteristic sign of primary HIV infection, which is further indicated if mucosal ulcers are present.
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PMID:Mucocutaneous manifestations in 22 consecutive cases of primary HIV-1 infection. 874 38


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