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Query: UMLS:C0040425 (tonsillitis)
 1,594 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The second common problem to be presented in this series is the acute sore throat. The common causes are viral pharyngitis and tonsillitis due to streptococcus pyogenes. Another important cause that warrants attention is Epstein Barr virus (infectious mononucleosis) so that prescribing of penicillins is carefully considered. The sore throat may be the presentation of serious and hidden systemic diseases, such as blood dyscrasias, AIDS and diabetes (due to moniliasis).
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PMID:Acute sore throat. 227 71

A review of 54 cases of AIDS established the ORL manifestations of this constantly fatal disease. Simple infections such as sinusitis, otitis and tonsillitis were frequent and quite typical, but buccopharyngeal herpes and particularly buccopharyngo-esophageal candidosis were widespread affections. The onset of candidosis in a subject at risk is a valid diagnostic factor for AIDS. A buccopharyngeal Kaposi tumor is specific and is usually associated with lesions in other, particularly cutaneous localizations. Marked emphasis is placed on the role of specialists in the detection of this disease, currently increasing at a high rate. In the USA, where AIDS is very prevalent and doctors very clearly informed, 40% of cases are detected from cervicofacial manifestations.
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PMID:[ORL manifestations reported in AIDS. Apropos of 54 cases]. 409 98

The otorhinolaryngological signs of AIDS are reviewed (both analysis and synthesis) following the chronological order of the literature. The earliest clinical pictures, their frequency and time of onset, are described by the authors studied. In 1986 the ENT signs of this disease were well known, and in our region the same multiple, polyfacetic aspects are seen. Personal experience of this is described, emphasizing how seldom the diagnosis has been made, except early on. Usually the cases seen and diagnosed by the Department of Infectious Diseases were referred for specialist opinion. The commonest findings were, amongst the opportunist infections: oropharyngeal and oesophageal candidiasis, and tuberculous adenopathies. Classical ENT pathology was represented by sinusitis and to a lesser extent by otitis and tonsillitis. The tumours seen were non-Hodgkin lymphomas, but no Hodgkin's or Burkitt's lymphomas. There was an unusual case of 'high grade centroblastic lymphoma', localized to the tonsil and presenting as necrotic tonsillitis and peritonsillar abscess. Recently a patient with a large pharyngeal tumour (still being investigated) has been provisionally diagnosed as having a cavernous angioma. Both these patients were diagnosed by us, since we saw the first sign of the disease. We have seen few Kaposi's sarcomas, since cutaneous and oral lesions are not usually referred to us.
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PMID:[AIDS manifestations in otorhinolaryngology]. 906 87

The global epidemic of HIV infection remains appalling. By 2001, there were an estimated 1.4 million HIV-infected children, with 4.5 million deaths. In the UK, paediatric cases are clustered around population centres where there are high concentrations of infected immigrant adults, and to a lesser extent, areas where IV drug abuse is common. The highest incidence remains in London and the southeast. With the national redistribution of immigrant and refugee families, any doctor in any specialty may expect to be involved with children who are HIV positive, or have clinical AIDS. The majority of children are infected vertically, i.e. infection of the infant from an infected mother in the pre-, peri-, or post-natal periods. Rates of transmission vary from 15-20% in the developed countries. Children with HIV infection may have their primary presentation to ENT doctors, who should have appropriate thresholds for suspecting the diagnosis. The most common presenting features include persistent generalised lymphadenopathy, hepatosplenomegaly, chronic/recurrent diarrhoea, poor growth, and fever. Fifteen to twenty percent of untreated children will present with an AIDS-defining illness by 12 months, typically with Pneumocystis pneumonia at approximately 3-4 months of age. Seventy percent of perinatally infected children will exhibit some signs or symptoms by 12 months Without treatment, the median age to progression to AIDS is approximately 6 years, and 25-30% will have died by this age. The median age of death is approximately 9 years. Children may also present with repeated/unusual ear infections, sinus disease (inc. mastoiditis), tonsillitis, orbital/peri-orbital cellulitis, oral candidiasis, and dental infections. Infections with streptococcus pneumoniae and group A streptococcus are common, and often progress to severe systemic infection with an appreciable mortality. Infections may be due to unusual pathogens such as Pseudomonas, 'typical' and atypical Mycobacteria, Candida, Aspergillus, etc. Fungal infections of the sinuses (inc. Aspergillus and Rhizopus spp.) may be particularly devastating, with rapid spread to involve bone and the central nervous system. Another classical presentation, which may present to ENT doctors, is that of bilateral parotid enlargement, especially in children who are 'slow progressors', many of whom also have Lymphoid Interstitial Pneumonitis (LIP). A major attitudinal change has occurred due to advances in 3 main areas: (i) the multidisciplinary management of the infected mother (inc. counselling, antenatal screening, elective caesarean section, advising against breast feeding, etc.), (ii) the prevention of vertical transmission, using anti-retroviral therapy to the infected mother during pregnancy, and to the potentially infected infant in the first weeks of life, and (iii) major advances due to the advent of highly active anti-retroviral treatment. With effective use of these measures, transmission rates may be reduced to <2%. None of the measures though, affect a cure, and it will still be many years before the development of effective vaccines. ENT doctors may be referred children already known to be HIV-positive. Knowing how to talk to infected children (and their parents) is full of potential pitfalls, and requires careful forethought. Many infection-control policies have required considerable rethinking due to the AIDS epidemic. This has especially been the case with respect to needle-stick injuries, post-exposure prophylaxis, sterilization and re-use of equipment, and safe approaches to surgery.
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PMID:HIV infection in children--impact upon ENT doctors. 1466 74