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

Microscopy of methylene-blue and Gram-stained smears from the tonsillar surface and an immunofluorescence (IF) test were carried out for 130 patients, 129 with genital and/or anal gonorrhoea, 27 of whom also had tonsillar gonorrhoea. One patient had only tonsillar gonorrhoea. 5 of the 28 patients with tonsillar gonorrhoea had acute tonsillitis and for these, agreement was found between culture, light microscopy and IF test, while only 5 of the remaining 23 patients had positive microscopy. Among the 102 patients who did not have tonsillar gonorrhoea a few false-positive light microscopies and IF tests were found. Microscopy of haematoxylin-eosin stained sections of 8 tonsils from 4 patients with recurrent tonsillitis and tonsillar gonorrhoea showed subacute tonsillitis. Methylene-blue and Gram-stained sections revealed gram-negative diplococci morphologically similar to gonococci. The bacteria were located in the superficial layers of the mucous membrane (frequently intracellularly in leukocytes) and occasionally in cellular debris in the crypts.
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PMID:Microscopy of tonsillar smears and sections in tonsillar gonorrhoea. 6 17

A group of patients with a history of recurrent tonsillitis were observed during an acute episode to determine the cause of the infection. The microbial pathogen that was consistently implicated was the Epstein-Barr virus. Seventeen (65%) of 26 patients exhibited a substantial seroconversion to the early antigen of Epstein-Barr-virus-infected lymphoblastoid cells (P3HR-1). We conclude that there is a high incidence of tonsillitis associated with the Epstein-Barr virus. The propensity of the virus for the palatine tonsils, a rich source of B cells, in suggested. Furthermore, the value of monitoring early antigen titers to confirm the nature of the infection is apparent, bearing relevance to future studies of this virus.
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PMID:Epstein-Barr virus associated with episodes of recurrent tonsillitis. 16 72

The presence of Epstein-Barr virus (EBV) antigens in human palatine tonsilderived lymphocytes (TDL) was investigated using the indirect fluorescent antibody (FA) technique. The TDL were screened for the presence of EBV early antigen (EA), virus capsid antigen (VCA), and EBV nuclear antigen (EBNA). In 76% of the patients diagnosed as recurrent exudative tonsillitis, and in 33% diagnosed as recurrent tonsillitis and/or serous otitis media, EBNA was demonstrated in the purified TDLs. No EA- or VCA-producing cells were found in either the glass adsorbed or TDL cell preparations from all of the patients. These data suggest that in our patient sample, the tonsils may serve as a reservoir for EBV carrying lymphocytes and a basis for recurrent disease.
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PMID:Epstein-Barr nuclear antigen (EBNA) carrying lymphocytes in human palatine tonsils. 18 41

Patients suffering from recurrent tonsillitis (RT), hyperplastic tonsillitis (HT) or idiopathic tonsillar hyperplasia (ITH) were compared in immunological studies with subjects showing clinically normal palatine tonsils. Serum concentrations of immunoglobulins, particularly IgG, were increased in association with tonsillitis. Conversely, the number of IgG-, IgA- and IgM-producing immunocytes was reduced per tonsillar tissue unit. The density of such cells was decreased in the germinal centres of the lymphoid follicles, in the extrafollicular areas and in the reticular parts of the crypt epithelium. However, only small changes in immunocyte class ratios were observed, excepting a significantly raised proportion of IgD-producing cells. The immunohistochemical results indicated a defect in the tonsillar immunological function associated with disease, perhaps as a result of inadequate stimulatory signals for local maturation of B-cell clones. An influence of low age on this result in the HT and ITH groups could not be excluded. In the RT group there was a significant negative correlation between the tonsillar density of IgA-producing cells and the rate of synthesis of serum IgA. This may indicate that compensatory mechanisms are reflected in inversely related levels of local and systemic IgA synthesis.
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PMID:Immunoglobulin systems of human tonsils. II. Patients with chronic tonsillitis or tonsillar hyperplasia: quantification of Ig-producing cells, tonsillar morphometry and serum Ig concentrations. 35 Apr 58

Patients suffering from recurrent tonsillitis (RT), hyperplastic tonsillitis (HT), or idopathic tonsillar hyperplasia (ITH) were compared in immunological studies with subjects showing clinically normal tonsils. Serum concentration of immunoglobulins, particularly IgG, were found to be increased in association with tonsillitis. Conversely, the number of IgG-, IgA- and IgM-producing immunocytes per tissue unit was reduced in the germinal centres of lymphoid follicles, in the extrafollicular areas, and in the reticular parts of the crypt epithelium. The overall percentage distribution of these cells was normally 65:30:3.5:1.2 for the IgG, IgA, IgM and IgD classes, respectively. In RT these figures were 53:39:4.7:4.4; in HT, 67:25:4.0:4.5; and in IHT, 50 : 33 : 7.2 : 10. Thus, there were only small alterations in the immunocyte class proportions, except for a significant relative increase in IgD-producing cells. The results indicate that there is a functional defect of the tonsils in association with disease. The relative accumulation of IgD cells is probably explained by an inadequate local maturational process in B-cell system, altough some influence of low age cannot be excluded in the HT and ITH groups.
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PMID:Immunoglobulin-producing cells in clinically normal, hyperplastic and inflamed human palatine tonsils. 37 4

A questionnaire, sent to a 10% random sample of Dutch general practitioners (n = 635) included descriptions of four cases of upper respiratory tract infections (acute tonsillitis, recurrent tonsillitis, acute otitis media and sinusitis). This was used to study the general practitioners' management of upper respiratory tract infections. A total of 376 doctors responded (59%). The majority of general practitioners would prescribe antibiotics for sinusitis (80% of respondents) but only 29% would prescribe antibiotics for acute otitis media. For acute tonsillitis and recurrent tonsillitis the proportions were 52% and 59%, respectively. The low prescription rate for acute otitis media was in accordance with national standards, such as the standard of the Netherlands college of general practitioners. A penicillin (phenoxymethylpenicillin or phenethicillin) was most likely to be selected for the two types of tonsillitis, amoxycillin for acute otitis media and doxycycline for sinusitis. Other antibiotics such as erythromycin, other tetracyclines and ampicillin, were seldom selected. Most respondents would prescribe antibiotics for seven days, but there was considerable variation. The influence of the characteristics of the general practitioners and their practices on their antibiotic prescribing was small. Only type of practice correlated with antibiotic treatment, in that general practitioners in single-handed practices would prescribe antibiotics more often than their colleagues in health centres. Among those who would prescribe symptomatic treatment nearly all would prescribe nosedrops for acute otitis media and sinusitis. Eighty five per cent of the respondents would refer the patient with recurrent tonsillitis, while 10% would refer the patient with acute otitis media. The results suggest that some aspects of the prescribing behaviour of Dutch general practitioners might be improved.
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PMID:Management of upper respiratory tract infection in Dutch general practice. 158 60

The incidence of tonsillitis that is unresponsive to penicillin therapy is leading to concern. This phenomenon has been linked to a change in the core tonsil bacteria, in particular beta-lactamase production. To date, the only way to identify the presence of these resistant microbes is at tonsillectomy. In this prospective study, we performed fine-needle tonsil aspiration in 34 patients (mean age, 7.6 years) before tonsillectomy. The bacteriologic nature of the aspirate was compared with that obtained from culturing the tonsillar surface (in situ) and core of the resected tonsils. The bacteriologic findings of the aspirate corresponded closely with those of the tonsil core (qualitative and quantitative comparison), while the superficial swab was of limited value in predicting the core bacteria. Based on this study, tonsil fine-needle aspiration may have a place in the treatment of recurrent tonsillitis.
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PMID:Fine-needle aspiration in recurrent tonsillitis. 203 88

The authors report a study designed to explore the usefulness of long-acting penicillin in the management of recurrent tonsillitis. The trial, conducted in Sri Lanka, involved 179 patients aged 2 to 20 who had suffered multiple attacks of tonsillitis annually. The results showed a significant reduction in the number of attacks of tonsillitis experienced by the treated group, especially those aged 5 to 11, resulting in a drop in the number requiring tonsillectomy.
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PMID:The use of long-acting penicillin in the prophylaxis of recurrent tonsillitis. 226 55

30 patients with recurrent tonsillitis were treated with amoxycillin/clavulanic acid (500 mg/125 mg) t.i.d. for 10 days. The most often isolated potential aerobic pathogenic bacteria were Staphylococcus aureus, Streptococcus milleri and Haemophilus parainfluenzae. Group A streptococci were isolated from 7 patients. Anaerobic cocci and Bacteroides species were the dominating anaerobic bacteria isolated from the tonsils. Tonsillar cultures were taken before antibiotic treatment started, on days 11-12, day 30, and day 90. Beta-lactamase producing aerobic and anaerobic bacteria were present in 13 patients prior to treatment, on days 11-12 in 18 patients, on day 30 in 15 patients, and on day 90 in 13 patients. Group A streptococci were eradicated in 6/7 patients. In the aerobic tonsillar microflora, the numbers of viridans streptococci decreased during treatment but were normalized after 30 days. Only minor changes in the numbers of other aerobic microorganisms occurred during the investigation. The effect on the anaerobic microflora was minor and no new colonizing microorganisms were isolated during or after antibiotic treatment. All patients except one were cured on days 11-12. Five patients had another episode of tonsillitis during the observation period of 3 months. The antibiotic treatment was well tolerated in most patients and mild adverse events such as nausea, vomiting and diarrhoea were observed in 3 patients.
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PMID:Effect of amoxycillin/clavulanic acid on the aerobic and anaerobic tonsillar microflora in the treatment of recurrent tonsillitis. 228 75

Seventy-eight of 107 general practitioners completed a questionnaire to assess the management of recurrent acute tonsillitis by the primary care physician. Penicillin was the antibiotic of choice in acute tonsillitis, used by 74 (95%) respondents. Of these, 45% recommended ampicillin/amoxycillin. In the case of penicillin allergy, 67 (86%) chose erythromycin. For the treatment of tonsillitis unresponsive to initial therapy, a wide variety of agents were quoted; the most common being erythromycin (27 cases, 35%) and co-trimoxazole (16 cases, 20%). There were 17 separate indications for surgical referral given, the most common being recurrent tonsillitis (68 cases, 87%). Two or more reasons for surgical referral were stated by 55 (71%) GPs. These findings are discussed with particular reference to recent reports of penicillinase producing bacteria in association with recurrent acute tonsillitis.
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PMID:Management of tonsillitis by the general practitioner. 239 Dec 14


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