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

A review of 72 cases of epiglottitis seen at the Children's Hospital of Denver was undertaken to determine the incidence of extraepiglottic and septic foci in this disease. A parallel review of the literature was also undertaken. The clinical, bacteriologic, laboratory, and radiologic findings of this patient population are described. A 25% incidence of both pneumonia and cervical lymphadenitis was found to be associated with this illness. Exudative tonsillitis and otitis media were the only other complications, although they were infrequently noted. No cases of septic arthritis or meningitis were encountered, although 50% of these patients were recognized as bacteremic. A low incidence of septic complications (eight cases of meningitis and one case of periarticular abscess) is noted in a review of the literature. Recommendations for antibiotic management and definition of the population at risk for septic complications are given.
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PMID:Epiglottitis: incidence of extraepiglottic infection: report of 72 cases and review of the literature. 108 24

Uvulitis is an uncommonly reported disorder with the potential for significant morbidity. We describe three cases of uvulitis seen within a six month period in our emergency department. In two cases with respiratory distress, but without epiglottitis, Haemophilus influenzae was isolated from throat or blood cultures. The third case was associated with group A streptococcus tonsillitis and no respiratory compromise. Atypical presentations of upper airway infection with H. influenzae may be increasingly common.
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PMID:Uvulitis in three children: etiology and respiratory distress. 151 29

If our broad goal for undergraduate education is to prepare students for residency and the eventual practice of medicine, the specific knowledge and skills we teach should reflect those that will be required of them to perform well as residents and practicing physicians. To determine and compare priority goals and objectives, we surveyed otolaryngology educators, a representative group of physicians in practice, and a representative group of residents. Participants were asked to evaluate the level of knowledge and skills necessary for students to attain in various areas of otolaryngology by ranking each item by a score of 0 to 3 according to its required depth of knowledge or skill. A rank "order of importance" was developed based on mean scores. The highest-ranking areas of knowledge were otitis media, airway obstruction, tonsillitis, and croup/epiglottitis, whereas the highest-ranking skills were history and physical examination of the head and neck, throat cultures, and use of the otoscope and pneumatoscope. The lowest-ranking areas of knowledge were voice disorders and ear deformities, whereas the lowest-ranking skills were interpreting electronystagmograms and stapedial reflex testing. We review the findings of our survey and comment on their role in undergraduate curriculum planning for otolaryngology.
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PMID:Are we teaching medical students what they need to know? 249 24

The combination of sulbactam and ampicillin is a safe and effective therapy for acute otitis media and acute epiglottitis in infants and children. Despite the lack of similar studies proving efficacy for other infections of the upper airway and certain adjacent structures, such as sinusitis, tonsillitis and cellulitis/abscess of the head and neck, this drug combination should also have a therapeutic role in the future for these conditions.
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PMID:Role of sulbactam/ampicillin and sultamicillin in the treatment of bacterial infections of the upper respiratory tract of children. 266 Aug 69

Acute epiglottitis is a life-threatening infection of the supraglottic airway that can occur at any age. Although it is traditionally described as a childhood infection, recent reports describe an increased recognition of this problem in adults. When appropriate and timely therapy is instituted, this condition is generally self-limited. Recurrent acute epiglottitis is exceedingly uncommon, and its treatment rarely is addressed. We encountered and treated a case of recurrent acute epiglottitis in an adult. After the third recurrence, careful consideration was given to possible pathophysiologic mechanisms and potential therapeutic options. Further recurrence was prevented effectively by performing a lingual tonsillectomy. Although this is an unusual condition, the cause of recurrent acute epiglottitis may be related to chronic lingual tonsillitis. Lingual tonsillectomy in these cases may help prevent further recurrent episodes.
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PMID:Recurrent adult acute epiglottitis: the role of lingual tonsillectomy. 278 83

Laboratory and clinical studies on cefteram pivoxil(cefteram) a new cephem antibiotic, were carried out in the field of pediatrics. The results obtained are summarized as follows: 1. Serum concentrations, urinary concentrations and urinary recovery rates of cefteram (CFTM) were determined upon oral administration after meal of cefteram pivoxil (CFTM-PI) at doses of 3 mg/kg granules in 2 cases and 6 mg/kg granules in 2. Peak serum levels of CFTM were obtained at 3 hours in 2 cases and 4 hours in 2 cases after administration of the drug with a range of 0.74-2.2 micrograms/ml with half-lives of 0.77-3.62 hours. Urinary recovery rates in 8 hours after administration ranged from 9.6-23.0%. 2. MICs of CFTM against 22 clinical isolates (Streptococcus pyogenes 4 strains, Streptococcus pneumoniae 4, Staphylococcus aureus 2, Branhamella catarrhalis 1, Haemophilus influenzae 8, Haemophilus parainfluenzae 1, and Escherichia coli 2) were compared with those of cefaclor (CCL), cephalexin (CEX), and ampicillin (ABPC). The antibacterial activity of CFTM was superior to those of CCL and CEX, and was superior against Gram-negative rods and equal against Gram-positive cocci to those of ABPC. 3. Twenty-six pediatric patients with acute infectious diseases (scarlet fever 3 cases, tonsillitis 7, epiglottitis 1, bronchitis 5, pneumonia 5, urinary tract infection 3, cervical lymphadenitis 2) were treated with CFTM-PI at daily doses of 9.3-15.3 mg/kg t.i.d. as a rule. The efficacy rates were 100% clinically and 70% bacteriologically. 4. Side effects or abnormal laboratory test values were not observed except for an increased platelet count in 1 case.
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PMID:[Laboratory and clinical studies on cefteram pivoxil in the field of pediatrics]. 281 Jul 48

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

Infections of the upper airways reduce life quality of adults on average twice, that of children even 4 to 8 times a year. Usually these are viral infections subsiding spontaneously without antibiotics. Only if concomittant circumstances arise and in specific clinical situations (otitis, sinusitis, tonsillitis, epiglottitis) as well as in acute exacerbation of chronic bronchitis are antibiotics already indicated at first consultation. The physician who is usually consulted by a patient with increasing discomfort under self-medication and who is expecting an antibiotic treatment has next to the clinical findings and prior laboratory test results to consider before all the individual (home, workplace, school) and epidemiologic (influenza) situation, the possible pathogens, their susceptibility to antibiotics as well as the side effects and costs for the decision to prescribe antibiotics. Today because of an increasing pressure of selection for pathogens resistant to antibiotics a greater reluctance to prescribe antibiotics is recommended. This requires close follow-up of the patient with symptomatic treatment or only short "probatory" antibiotic therapy and a good patient-physician relationship.
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PMID:[When and why are antibiotics indicated in airway infections (except pneumonia)?]. 924 62

The paper reports a lethal outcome of false croup in a 62-year-old man. In pathogenetic chain of the disease the leading role belonged to purulent tonsillitis with peritonsillar abscess and epiglottitis with phlegmone of the adjacent soft tissues including the vocal cords. A severe edema of the latter provoked a complete obstruction in the larynx and asphyxia with all its macro- and microscopic morphological features. Chronic alcoholic intoxication seemed to cause immunodeficiency and slow progression of the disease. Tonsillitis, chronic with exacerbation, was alleviated by chronic alcoholic intoxication leading to weak symptoms, delayed reactions and "strange" outcome. Hyperergia could be due to intake of alcohol surrogate.
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PMID:[A fatal outcome of false croup in lacunar angina complicated by peritonsillar abscess]. 1124 54

The emergence of beta-lactamase-mediated resistance to established beta-lactam antibiotics prompted the development of beta-lactamase inhibitors for co-administration. Ampicillin has been combined with sulbactam for both parenteral and oral (as the mutual pro-drug sultamicillin) administration. The combination is active in vitro against a wide variety of Gram-positive and Gram-negative pathogens, including aerobic and anaerobic organisms. In clinical trials, ampicillin/sulbactam has proved clinically and bacteriologically effective against a variety of frequently encountered pediatric infections, including mild-to-moderate upper respiratory tract infections (acute otitis media, sinusitis, pharyngitis, and tonsillitis), severe post-operative and intra-abdominal infections, periorbital infections (which, left untreated, can lead to blindness, brain abscess, or death), acute epiglottitis, bacterial meningitis, and brain abscess. Ampicillin/sulbactam has also proved effective in the prevention of post-operative surgical infections in pediatric patients. The clinical efficacy profile of ampicillin/sulbactam and sultamicillin, combined with their excellent tolerability profile, make these agents attractive options for the management of many life-threatening infections in pediatric patients.
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PMID:Experience with ampicillin/sulbactam in severe infections. 1192 91


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