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Query: UMLS:C0040425 (tonsillitis)
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Infections with Herpesvirus hominis type 1 were associated with 11.5% of acute respiratory illnesses of university students who were admitted to the student infirmary over a 6-year period. Over three-quarters of these infections were detected in students with pharyngitis or tonsillitis; 42% had ulcerated lesions on tonsils or posterior pharynx but only 11% had lesions in the anterior portion of the mouth or lips. Almost all of the H. hominis infections were accompanied by significant rises in neutralizing antibodies and few students had detectable antibodies in the initial serum collected during the acute phase of illness. Special studies revealed herpes-specific IgM antibodies in the early convalescent sera of some of these patients. The data demonstrate that 80% of the infections detected were primary infections with H. hominis. Only 30% of university students possessed neutralizing antibodies to H. hominis and about 10% of those without antibodies acquired antibodies each year. These data suggest that the majority of persons from middle income families reach young adulthood without acquiring infections of H. hominis and the spread of the virus requires close and intimate contact.
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PMID:Acute respiratory disease of university students with special reference to the etiologic role of Herpesvirus hominis. 16 68

The incidence of respiratory tract infections in patients seeking medical advice at a community care centre (Dalby) during 1973 and 1974 was studied. About every third patient seen at this primary health station presented with signs of such infections. In the age groups less than 10, 10-19, 20-39, 40-59 and greater than or equal to 60 years, respiratory tract infections accounted for 65, 45, 32, 18 and 9% of the fotal number of diagnoses made during 1974. The aetiology of acute respiratory tract infections in a series of patients seen at this health station was studied. The series included randomly selected cases, but excluded children under seven years of age and patients presenting with signs of acute otitis media and tonsillitis. Attempts to establish the aetiology were made on the basis of the history, the clinical examination, and cultures for beta-haemolytic streptococci and Mycoplasma pneumoniae, complement foxation tests for influenza A and B, para-influenza 1, 2, and 3, adeno, cytomegalovirus and respiratory syncytial virus, and Chlamydia psittaci. Paul-Bunnell test and tests for cold agglutinins were also performed. With this test battery, an aetiological diagnosis was obtained in only 33% of the 101 patients studied. The findings suggest an infection with M.pneumoniae in 16%, with beta-haemolytic streptococci in 9%, and with viruses (adeno and para-influenza) in 7% of the patients. The present communication highlights the role of M.pneumoniae in upper respiratory infections, as few data have appeared on such infections in patients seen in general practice. The difficulty of establishing the aetiology of respiratory tract infections and the consequent treatment dilemma is discussed.
Infection 1976
PMID:The incidence and aetiology of respiratory tract infections in general practice--with emphasis on Mycoplasma pneumoniae. 78 48

Ten-day, double-blind, randomized, parallel treatment regimens of loracarbef (200 mg capsule twice daily or 15 mg/kg/day oral suspension in two divided doses up to a maximum of 375 mg/day; n = 169) and penicillin V (250 mg capsule four times daily or 20 mg/kg/day suspension in four divided doses up to a maximum of 500 mg/day; n = 175) were compared in the treatment of group A beta-haemolytic streptococcal (GABHS) pharyngitis and tonsillitis. Post-therapy clinical responses were similar for evaluable patients in both treatment groups: 97.4% of the loracarbef group (101/115 patients cured and 11/115 improved) and 96.0% of the penicillin group (101/124 patients cured and 18/124 improved). A statistically significant difference in the pathogen elimination rate was noted between treatment groups: post-therapy throat cultures were negative for GABHS in 94.8% (109/115) of loracarbef-treated patients compared with 87.1% (108/124) of penicillin-treated patients (p = 0.040). Loracarbef and penicillin V were comparable in terms of safety. Headache and nausea/vomiting were the most common events reported during therapy (nausea/vomiting were slightly less common in the loracarbef group). Three patients in each group were discontinued from the study due to drug-related adverse events; one due to rash in the loracarbef group and one due to rash and one due to vomiting in the penicillin group. These data support the conclusion that loracarbef twice daily is more effective in eradicating GABHS than penicillin V four times daily, and the two drugs are comparable in safety and clinical efficacy in the treatment of GABHS pharyngitis and tonsillitis.
Infection
PMID:Loracarbef versus penicillin V in the treatment of streptococcal pharyngitis and tonsillitis. 142 89

The head and neck contain a number of spaces that can be invaded by organisms of the mouth or by spread of cervical osteomyelitis. Infection in these spaces may progress from superficial infection to cellulitis to the formation of an abscess requiring immediate drainage. Spread of infection between spaces depends on anatomic location. Most patients require hospitalization and intravenous antibiotic therapy. Because a deep space infection may be occult, a high index of suspicion is required for diagnosis. Early recognition is necessary to avoid tissue damage, bacteremia or airway compromise. The possibility of deep space infection should be considered in any patient who does not respond to the usual treatment of an abscessed tooth or tonsillitis. This type of infection also should be considered in a toxic patient who has a fever of unknown origin, with or without blood cultures that show anaerobic organisms. Computed tomography or magnetic resonance imaging is usually necessary to locate the infection and to detect suppuration that will be amenable to surgical exploration and drainage.
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PMID:Serious soft tissue infections of the head and neck. 187 30

The pattern of illness in 60 consecutive children with homozygous sickle cell disease who attended the Paediatric Emergency Room of a busy Lagos hospital with acute illness was studied prospectively. Their ages ranged from 3 months to 13 years with a peak in the 2nd year. There were twice as many boys as girls. The commonest symptoms were fever, limb or abdominal pain and cough, and the commonest signs were pallor and hepatomegaly. Painful crises occurred in 27, anaemic crises in 11, and a combination of these in 12 children. Infection was detected in 76% of subjects in crises. Infection was found in 82% of all the children and was mainly bacterial. The commonest infections were pneumonia (35%), bacteraemia (32%), tonsillitis/pharyngitis (17%) and osteomyelitis (8%). The predominant bacteria isolated were Klebsiella spp (38%), E. coli (23%), Staph. aureus (23%), Staph. albus (23%) and Pseudomonas spp (23%). Some children had multiple isolates. Bacterial infection was a major cause of morbidity in very young children and merits appropriate control and preventive measures in this age group. The spectrum of bacteria isolated makes it unlikely that the specific anti-pneumococcal measures widely advocated in Europe and America for young children with SCA would be appropriate in Nigeria.
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PMID:Acute illness in Nigerian children with sickle cell anaemia. 244 66

In a one-year study 274 general practitioners performed office cultures on Streptocult of throat swabs from 2,699 patients with acute pharyngotonsillitis in order to identify those with beta-haemolytic streptococci in the throat. The finding of group A beta-haemolytic streptococci by laboratory culture of corresponding throat swabs was used as a reference when determining the diagnostic value of either clinical assessment or Streptocult culture for the identification of patients with streptococcal pharyngotonsillitis. Based on 2,150 cases, sensitivity was 70% and 84%, respectively; specificity, 63%, respectively 77%; positive predictive value, 38%, respectively 53%; and negative predictive value, 87%, respectively 94%. Compared to the clinical assessment of the etiology, use of Streptocult resulted in the additional identification of 14% of the patients with group A streptococci and 13% of the patients without this organism present in the throat, as judged by laboratory culture. Overall, 78% of the patients were correctly diagnosed by the use of Streptocult, compared to 65% by clinical assessment. It is concluded that the use of Streptocult in general practice may be of substantial benefit in the identification of patients with group A streptococcal tonsillitis.
Infection
PMID:Diagnosis of streptococcal tonsillitis in general practice by clinical assessment and by office culture of throat swabs on Streptocult. 329 68

Spontaneous tonsillar hemorrhage (STH) of non-iatrogenic causes occurs most frequently from infection. Infection can lead to erosion into a major vessel, such as the carotid artery or a smaller peripheral tonsil vessel. Whereas fatal erosion into a major vessel from a deep neck abscess was relatively common in the past, it is rare since the advent of antibiotics. Spontaneous tonsillar hemorrhage, when it does occur, appears to occur most commonly in a peripheral tonsil vessel from bacterial tonsillitis. Medical records of 860 patients with conditions considered to be susceptible to STH were reviewed. Ten cases of STH were identified. All were from peripheral tonsil vessel hemorrhage; none was secondary to major vessel erosion. Bacterial tonsillitis was the most common cause of STH and occurred in 8 of 10 cases. This condition accounted for an incidence of STH in tonsillitis of 1.1%. A history of chronic tonsillitis appeared to predispose a patient to STH. Other causes of STH were infectious mononucleosis and neoplasm. Seven of the ten peripheral STHs presented with bleeding from an obvious venous source. The other three patients had significant hemorrhages which led to arteriography. Arteriograms are indicated in patients with clinical features suggesting possible major vessel erosion or in those patients where significant bleeding is not from an obvious peripheral source. A peripheral STH can be successfully managed with local intervention and tonsillectomy.
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PMID:Spontaneous tonsillar hemorrhage. 335 32

A multi-centered clinical study was carried out to evaluate the efficacy of ofloxacin in otorhinolaryngological infections in Japan. Ofloxacin was used at a dosage of 300 mg to 800 mg daily for three to 20 days in 206 cases of various infectious diseases in the otorhinolaryngological field such as otitis media, external otitis, paranasal sinusitis, tonsillitis and pharyngolaryngitis. Its efficacy rate was 79.9%. Minor side effects were seen in three cases (1.5%), gastro-intestinal disorders in two and headache in one. The antibacterial activity of ofloxacin was compared with the activity of pipemidic acid, nalidixic acid and norfloxacin against clinically isolated microorganisms. Ofloxacin was highly superior to pipemidic acid and nalidixic acid, and slightly more active than or equivalent to norfloxacin.
Infection 1986
PMID:Clinical efficacy of ofloxacin in the treatment of otorhinolaryngological infections. 354 57

Infections of the upper respiratory tract are common to both the immunodeficient and the normal child during their development. The most common head and neck manifestations of immunodeficiency disease are recurrent suppurative otitis media, tonsillitis, sinusitis, rhinitis, and nasopharyngitis. Often the head and neck specialist is confronted with a child with one or more of these problems and must institute the appropriate therapy or decide on an avenue for further investigation. This paper outlines the major immunodeficiency state, discusses the immune defects thought to be responsible for the spectrum of clinical findings, and suggests a systematic approach to the evaluation of these difficult diseases. The recognition of immunodeficient individuals is an important step in their treatment so that adjunctive immunological therapy can be provided.
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PMID:Immunodeficiency diseases: head and neck manifestations. 698 47

Ceftezole (CTZ) was administered to 20 patients with hematopoietic malignancy complicated with infections. These patients consisted of 7 cases of AML, 2 ALL, 2 AMMoL, 1 APL, 1 blast crisis of CML, 2 HD, and 5 NHL. In 13 cases, sites of infection were determined and causative organisms were identified. In other 7 cases, sites of infection or causative organisms were unknown. In the former 13 cases, pneumonia was demonstrated in 6 patients, tonsillitis in 4 patients, pyelonephritis in 2 patients and sepsis in 1 patient. Klebsiella was separated from 5 patients as the causative organisms, E. coli from 2 patients, E. coli and Pseudomonas aeruginosa from 1 patient, Pseudomonas cepacia from 1 patient, Streptococcus viridans from 2 patients, Proteus from 1 patient and Torulopsis from 1 patient. Gram-negative rods were separated from 10 of the 13 cases (77%) as the causative organisms. CTZ was administered intravenously in dose from 4 g to 16 g per day combined with other antibiotics (AMK, GM, DKB, TOB, SBPC, CBPC, LC, ST). The response rate in 12 cases of acute leukemia and in 7 cases of malignant lymphoma was 58% and 43%, respectively. Infections occurred in 4 patients with less than 100 neutrophil per mm3 did never favorably responded even with CTZ.
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PMID:[Treatment of infection in the patients wih hematopoietic malignancy with ceftezole (Falomesin) (author's transl)]. 721 16


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