Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040425 (tonsillitis)
 1,594 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report the case of a seven year-old boy bearing of exudative acute tonsillitis after strawberry ingestion with no previous infectious history. After having diagnosed it as hypersensitivity type I, this patient began to suffer repetitive episodes of exudative and purulent tonsillitis, related to cool drinks and direct manipulation of tonsils. These were hyperplastic and Staphylococcus sp. and Streptococcus sp. were isolated in them. The episodes were shortened by the use of corticosteroids. Tonsillectomy was the definitive therapy. Biopsy informed of mast cells infiltration in germinal centers of both palatine tonsils.
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PMID:[Tonsillar mast cell infiltration and allergic tonsillitis]. 1282 46

This prospective study was designed to identify important clinical features in patients with recurrent acute tonsillitis. A total of 195 consecutive children aged from 1 to 16 years were examined and a history of recurrent acute tonsillitis recorded. Patients with obstructive sleep apnoea or recent acute tonsillitis were excluded. Tonsil size was measured on the Brodsky scale [Brodsky L. (1989) Paediatr Clin N Am 36, 1551], tonsil symmetry, cervical lymphadenopathy, and hyperaemia of the anterior pillars was recorded. Patients with a history of recurrent tonsillitis had larger tonsils than those without tonsillitis (P < 0.001). Tonsil asymmetry and cervical lymphadenopathy were more common in patients with recurrent tonsillitis (P < 0.001). Anterior pillar hyperaemia was also more frequent in recurrent tonsillitis (P < 0.01). In addition to the frequency and severity of tonsillitis it is suggested that the size and symmetry of the tonsils, plus cervical lymphadenopathy and anterior pillar hyperaemia should be taken into account when deciding which patients would benefit from tonsillectomy.
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PMID:Tonsillar size is an important indicator of recurrent acute tonsillitis. 1583 86

The potential role of anaerobic bacteria in acute tonsillitis was investigated in a retrospective study that evaluated the efficacy of antimicrobial therapy with metronidazole on the management of acute episodes of non-beta-hemolytic streptococcal tonsillitis (NST). Forty children suffering from NST were included, 20 that were treated with metronidazole 250 mg b.i.d. for 10 day, and 20 that had received no therapy. The efficacy of therapy was evaluated by the ability to alleviate the symptoms of acute infection. As compared with the untreated group, the group that received metronidazole, had a significant reduction in fever and sore throat one day after initiation of therapy, a significant reduction in the presence of fever, pharyngeal injection and sore throat within 2 days, and reduction in pharyngeal injection and tonsillar size at day 3. These findings illustrated that metronidazole therapy was more efficacious than no therapy in relieving the signs and symptoms of acute episodes of NST. These findings should encourage further studies that are prospective and blinded that are needed to evaluate the use of antimicrobials effective against anaerobic bacteria in the treatment of non-GABHS (group A-beta-hemolytic streptococcus) tonsillitis.
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PMID:Treatment of non-streptococcal tonsillitis with metronidazole. 1562 49

For the first six months of 2001, tonsillectomy operations were effectively suspended in Scotland. This was due to concern regarding the potential transmission of vCJD prions by surgical instruments, and the subsequent gradual introduction of disposable instruments. The number of patients awaiting tonsillectomy therefore increased and theoretically there should have been an increase in the number of tonsillitis episodes in the community, or even in the number of tonsillitis-related complications seen in secondary care. We examined for these effects using available national data sources which record primary and secondary care activity. No increases in the incidences of acute tonsillitis or tonsillitis-related complications were found for this period. The reasons and implications are discussed.
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PMID:Suspending tonsillectomy: the effects on primary and secondary acute care in Scotland. 1564 9

Pustulosis palmaris et plantaris (PPP) is known to be a skin disease related to tonsillitis, because the pustulosis often become exacerbated during acute tonsillitis and disappears after tonsillectomy. However, etiology of PPP remains unclear. In this study, we investigated the activation of tonsillar T-cell from PPP patients. Furthermore, we analyzed expressions of cytotoxic T-lymphocyte antigen-4 (CTLA4) that is a co-stimulatory molecule for inhibition of T-cell activation and of Smad7 that is a regulatory factor of TGF-beta intracellular signaling. For 47 Japanese patients with PPP who had tonsillectomy, the skin lesion was improved in 87% of PPP patient at 12 months after tonsillectomy. In quantitative immunohistologic analysis, T-cell nodules on tonsillar tissues from PPP patients were more expanded than those from the patients with obstructive sleep apnea syndrome (OSAS) (P = 0.015), and there was a positive correlation between the enlargement and clinical improvement (r = 0.422, P = 0.021). Flow cytometric analysis showed that the numbers of CD4+CD25+ and CD4+CD29+ cells in tonsils from PPP patients increased significantly compared to those from OSAS patients (P = 0.017, P = 0.016, respectively). Using reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting analyses with CD3+ tonsillar lymphocytes, we found that both expressions of Smad7 mRNA and protein were enhanced in PPP patients compared with OSAS patients (P = 0.03, P = 0.02, respectively), but expression of TGF-beta mRNA was not different between 2 groups. Although mRNA expression of CTLA4 was reduced in PPP patients compared with OSAS patients (P = 0.04), the CTLA4 surface protein expression was not different between 2 groups. These data suggest that helper T-cells are frequently activated in tonsils from PPP patients, and this activation may be related to unresponsiveness of TGF-beta1 by overexpression of Smad7. Such hyper-activation of T-cell may increase the risk of elicitation of self-reactive T-cell, being associated with pathogenesis of PPP.
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PMID:Increase of activated T-cells and up-regulation of Smad7 without elevation of TGF-beta expression in tonsils from patients with pustulosis palmaris et plantaris. 1588 43

Acute tonsillitis is a common condition and usually runs a benign course. However life-threatening complications do still occur, even in this postantibiotic era. Infection can spread downwards into the mediastinum through the anatomic cervical spaces, causing widespread cellulitis, necrosis, abscess formation and sepsis. We present a case of descending mediastinitis in an 18-year-old woman, arising from her first episode of tonsillitis and treated successfully by surgical drainage. We believe that an awareness of this complication, early diagnosis using computed tomography scanning, and prompt, adequate surgical drainage will reduce morbidity and mortality.
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PMID:Mediastinitis: a life-threatening complication of acute tonsillitis. 1615 22

Kawasaki syndrome is an acute, self-limiting vasculitis that occurs mainly in children. The disorder is difficult to diagnose, a problem compounded by the lack of a specific diagnostic test. If the condition is unrecognised or treated sub-optimally, there is a 25% risk of developing serious cardiovascular complications. We report the case of an 8-year-old boy presenting with a history of acute tonsillitis and cervical lymphadenopathy in which the diagnosis of Kawasaki syndrome became apparent 4 days after admission. The case emphasises the importance of having a high index of suspicion for Kawasaki syndrome in children presenting with tonsillitis and cervical lymphadenopathy who do not respond to antibiotics or who have atypical features at the time of or after admission. A literature review of previous cases reveals a higher than usual age of presentation for the disease that could result in a greater percentage of cardiac complications.
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PMID:Acute tonsillitis: an unusual presentation of Kawasaki syndrome: a case report and review of the literature. 1632 4

Although unilateral peritonsillar abscesses (PTA) are a common complication of acute bacterial tonsillitis, bilateral PTA are quite rare. We present the case of a 14-year-old female teenager with a 1-week history of acute tonsillitis. Physical examination revealed significant trismus, symmetrically inflamed tonsils and soft palate, and a midline uvula. A contrast-enhanced CT scan of the neck demonstrated bilateral PTA. After bilateral needle aspiration and administration of antibiotics, complete disease resolution was rapidly achieved. Patients with bilateral PTA present a diagnostic dilemma because they do not demonstrate the classic asymmetric signs and symptoms seen in the more prevalent unilateral PTA. Contrast-enhanced CT imaging can help diagnose bilateral PTA and should be considered in the presence of marked trismus but with the absence of unilateral inflammatory findings.
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PMID:Bilateral peritonsillar abscesses: case report and literature review. 1708 35

Tonsillitis is a common disease especially of children and young adults. The diagnosis of tonsillitis generally requires the consideration of Group A beta-hemolytic streptococci infection. Pneumonia is an inflammation of the alveoli and terminal airspaces in response to invasion by an infectious agent that is introduced into the lungs through hematogenous spread or inhalation. We present a case of a concurrent acute tonsillitis and pneumonia due to S. pyogenes. To our knowledge, a similar case has not been previously described in the literature.
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PMID:Concurrent tonsillitis and pneumonia due to S. pyogenes. 1839 60

Recurrent tonsillitis is 1 of the common human infectious diseases worldwide, but, to date, its pathogenesis remains unclear. Although Streptococcus pyogenes (GAS) is involved in recurrent bouts of acute tonsillitis, conventional cultures usually fail to isolate it. The purpose of this study was to clarify whether the deep tonsillar tissues of patients with recurrent tonsillitis might harbour GAS, resulting in reinfections. Deep tonsillar tissues obtained from 285 patients with recurrent tonsillitis and 172 patients with tonsillar hypertrophy, who had undergone tonsillectomy, were examined for the presence of GAS, using conventional and molecular methods. Cultures from all patients were negative for GAS. GAS DNA was found in the deep tonsillar tissues of 57 out of 285 patients with recurrences (20%), and GAS RNA, indicating the viability of GAS, was detected in 47 of them (82%). On the other hand, Haemophilus influenzae DNA was found in 15% and 16% of patients with recurrences and hypertrophy, respectively; but no Haemophilus influenzae RNA presence was detected. The low level of presence of GAS in patients with recurrent tonsillitis indicates that other unknown factors may be responsible for the recurrences.
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PMID:Level of Streptococcus pyogenes in patients with recurrent tonsillitis and tonsillar hypertrophy. 1878 68


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