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

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.
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PMID:The incidence and aetiology of respiratory tract infections in general practice--with emphasis on Mycoplasma pneumoniae. 78 48

This study tested how general practitioners diagnose streptococcal infection on clinical grounds alone, in patients who presented with sore throats.Four hundred and fifty-two patients were admitted to the study. A clinical diagnosis, prognosis and follow-up was completed in each case and the clinical assessment was checked by throat swabbing at first contact and a week later.The doctors were inaccurate in predicting streptococcal infection, but better than might be expected if prediction were a matter of pure guesswork. Colds and influenza implied negative prediction, tonsillitis a positive prediction, and pharyngitis was doubtful.In this series negative prediction for pharyngitis was 85.2 per cent and positive prediction 31.5 per cent accurate. The equivalent figures for tonsillitis were 61.5 per cent and 38.9 per cent respectively. There was a general tendency to overpredict streptococcal infection which was most marked in acute follicular tonsillitis, but this led to few false negatives. The tendency to overpredict streptococci was most marked when the patient was an adolescent female.There were differences between the urban and rural patterns. During the same period, influenza (and similar illnesses) was recorded less often in the country, whereas urban practitioners were more likely to predict streptococcal infection. Rural practitioners were more accurate in prediction because they were less prone to implicate streptococcal infection than their urban colleagues; there was a higher proportion of cases with proven streptococcal infection in the town and there is a disproportionately high number of adolescent females among the urban patients.
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PMID:Acute sore throat--diagnosis and treatment in general practice. 117 7

Researchers analyzed data from the National Child Development Study--a cohort of every child born in England, Scotland, and Wales during the 1st week of March 1953 with follow up studies in 1965, 1969, 1973, and 1980-1981 to examine the relationship between health status and birth order and whether children with low birth orders were less likely to experience illness than those with older siblings. 1st born children tended to have received the needed number of immunizations, but children of higher birth order did not tend to have received them. Further they were more likely to have attended infant welfare and toddler clinics for health care than children of higher birth order. The only childhood contagious disease which demonstrated a social class effect was pertussis. It tended to afflict children from nonmanual homes regardless of birth order. Absences from school lasting between 1 week-1 month of 1st born children were less frequent than for other children. The leading reasons for 1st, 3rd, and later born 11 year old children who experienced such long absences included infectious diseases; bronchitis; ear, nose, and throat complaints; pneumonia; tonsillitis, or viral influenza. After age 15, 1st and 2nd born children were less likely to be absent and, if absent, they tended to only miss 1 week of school. Significantly more 3rd and 4th born children were absent from school for 1 week-3 months. 1st and 2nd born children from more affluent families tended to have early childhood asthma. In conclusion, the health experiences of the later birth orders were different than those of the 1st born. This did not mean, however, that later birth order children were in poorer health than 1st born children.
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PMID:Birth order and health status in a British national sample. 173 12

Respiratory tract pathogens (beta-haemolytic streptococci groups A, C and G, Haemophilus influenzae, Branhamella catarrhalis or pneumococci), were isolated from nasopharyngeal and/or throat swabs in 73/138 (53%) patients greater than 10 years of age with a clinical diagnosis of acute sinusitis, acute tonsillitis, purulent nasopharyngitis or acute bronchitis. Serological evidence of a viral infection (influenza A and B, parainfluenza 1, 2 and 3, respiratory syncytial virus, adenovirus) or Mycoplasma pneumoniae infection was found in 10% of the patients. The serum content of C-reactive protein (S-CRP) was increased (greater than 12 mg/l) in 26/33 (79%) patients with streptococci and in 22/59 (37%) patients without respiratory tract bacteria. In patients with a serological evidence of a virus tonsillitis, the S-CRP was also high (32-64 mg/l). At follow-up 10-12 days after the first visit, the clinical effect of erythromycin and penicillin V was judged to be similar (90% clinical effect). Relapse or re-infection with group A streptococci were seen in 7 patients (4 on erythromycin, 3 on penicillin). In another 6 patients (3 on erythromycin, 3 on penicillin), antibiotic treatment was switched owing to persisting symptoms, probably due to H. Influenzae infection in 3 cases. The patients' own estimates of their symptoms suggested treatment with erythromycin to have a more rapid effect than treatment with penicillin.
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PMID:Erythromycin and phenoxymethylpenicillin (penicillin V) in the treatment of respiratory tract infections as related to microbiological findings and serum C-reactive protein. 190 52

Among 75 clinically diagnosed cases of tonsillitis, 55 (73.3%) were found to be of viral aetiology. Serological and virological investigations identified adenovirus as the main causative agent in children as well as in adults. In only two instances, both in children, was an association with respiratory syncytial virus (RSV) in tonsillitis detected, an extremely rare finding. A cross-sectional sero-epidemiological study of respiratory infections caused by adenovirus, RSV, influenza (A,B) and para-influenza (types 1,2,3) viruses was carried out in 289 Saudi children (newborn to 15 years of age) and 86 adults (healthy male blood donors and pregnant women) using a single serological technique. In children as well as in adults, adenoviruses were the most predominant respiratory pathogens, with no marked variation in age-specific antibody prevalence rates.
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PMID:Tonsillitis and respiratory infections of viral aetiology in a developing country. 245 26

Group A beta-hemolytic streptococci were found in 38% of 257 young men in military service with acute tonsillitis. Of the 108 patients tested also for viral antibodies, 42% showed a 4-fold rise in antibody titers. Adenovirus was the most frequent (31%) nonstreptococcal agent, followed by Epstein-Barr virus (6%), and influenza virus (5%). Non-group A streptococci were isolated in about the same proportion (18%) as in healthy control subjects. Other data also suggested that these bacteria were carried and not true infecting organisms. Group A streptococci and adenovirus occurred in mixed infection in 9% of the 108 cases. In group A streptococcal tonsillitis compared to others, white blood cell counts were higher (13.3 vs. 8.3 x 10(9)/l, p less than 0.01), C-reactive protein was higher (70 vs. 48 mg/l, p less than 0.01), tonsillitis was more often non-exudative (p less than 0.05), and the duration of fever was shorter (2.2 vs. 3.5 days, p less than 0.01), while there was no difference in the height of the fever or erythrocyte sedimentation rate.
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PMID:Acute tonsillitis in young men: etiological agents and their differentiation. 254 62

An one-year examination of 315 children shows that under the diagnosis of follicular tonsillitis or lacunar tonsillitis many aetiological different diseases are summarized. More frequently than previously assumed adeno-, respiratory syncytial-, influenza A-, entero-, herpes simplex- and probably other viruses are the cause. It is shown to what extent the critical general evaluation also of discrete clinical data enables a differentiation. The usual general penicillin therapy of the patients with tonsillitis can be dispensed with.
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PMID:[What hides behind the diagnoses angina follicularis and lacunaris? A contribution to the differentiation of tonsillitis]. 269 5

In a group of women, which had children with hereditary isolated and syndromal chest deformations, acute respiratory diseases, tonsillitis or influenza occurred during pregnancy in 42.9 +/- 6.6% and 53.8 +/- 13.8% of cases, respectively, whereas in the control group only 17.8 +/- +/- 7.2% of the women were impaired with identical infectious diseases during pregnancy (P less than 0.02 and P less than 0.05, respectively). Excretion of hydroxyproline was distinctly dissimilar in 22 children with isolated and in 13 children with syndromal chest deformations depending on presence or absence of the above-mentioned infections during pregnancy. Under conditions of these infections the higher level of total hydroxyproline excretion was noted as well as relatively lower content of bound hydroxyproline was detected in those peptides, which appear to be responsible for the content of newly synthesized collagen. The data obtained suggest that acute respiratory diseases, influenza, chronic and acute tonsillitis may impair collagen metabolism in children with hereditary chest deformations as well as that these infectious diseases occurred during pregnancy may increase the risk of the pathology development in the children.
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PMID:[Relation between infections during the pregnancy and the rate of hydroxyproline excretion in children with congenital chest deformities]. 319 33

Weekly data for seven conditions reported to the weekly returns service of the Royal College of General Practitioners' Birmingham research unit over a 52-week period have been compared with those reported to the Oxford regional sentinel practice scheme. The mean weekly recorded rates for otitis media, asthma and intestinal infectious disease were similar in both systems; in the weekly returns service, mean weekly rates for common cold, acute bronchitis and influenza/influenza-like illness were approximately twice and for sore throat/tonsillitis slightly higher than rates in the Oxford scheme.In the weekly returns service no recommendations are made about criteria for diagnosis but in the Oxford scheme diagnostic criteria agreed by the participants are used. Where rates in both monitoring systems are the same, agreed criteria are likely to be conventional clinical practice and therefore superfluous. Where rates are different, the use of criteria enhances specificity of the information content but results in an underestimation of the total incidence of - respiratory disease presented to general practitioners.For common cold, acute bronchitis, otitis media and influenza/ influenza-like illness the associations between the rates in the two systems were high (R>/=O. 79), as might be expected, but these high values cross validate both recording systems in their monitoring of trends. For the remaining (non-epidemic) conditions the associations were low. There were no significant associations between the rates for asthma and the upper respiratory infectious diseases in either recording system, which suggests there was effective discrimination of asthma.
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PMID:Comparison between the weekly returns service and the Oxford regional sentinel practice scheme for monitoring communicable diseases. 255 50

A prospective 1-year study of acute febrile exudative tonsillitis in 110 children was carried out. Viral infection was associated with 42% of the cases, beta-hemolytic streptococci with 31% (12% group A), Mycoplasma pneumoniae with 5%, and unknown cause with 35%. More than one agent was implicated in 14% of the cases. Adenovirus was the viral agent most frequently (19%) recorded. Other viruses involved were Epstein-Barr virus, parainfluenza, influenza A, herpes simplex, and respiratory syncytial viruses. The responsible agent was found by rapid viral antigen detection in 20% of all cases and by rapid test for group A streptococcal antigen detection in 10%. Age was the most important factor in predicting the causative agent. Viral tonsillitis was most common in children younger than 3 years of age and group A beta-hemolytic streptococci tonsillitis in children 6 years of age or more. Clinical analysis of the illness, WBC count, and ESR did not reveal differences that could help in differentiating bacterial from viral tonsillitis. All patients were treated with a regimen of oral penicillin. Fever associated with group A beta-hemolytic streptococci tonsillitis responded to penicillin therapy significantly more rapidly than fever associated with viral infections. These observations demonstrate the prominent role of viruses in the etiology of febrile exudative tonsillitis, especially in young children, and reinforce the benefit of rapid tests before antibiotic therapy is started.
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PMID:Febrile exudative tonsillitis: viral or streptococcal? 360 20


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