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

The failure of penicillin to eradicate Group A beta-haemolytic streptococcal tonsillitis may be caused by beta-lactamase producing bacteria in the tonsillar tissue. A prospective randomized clinical study comparing the efficacy of penicillin-V potassium with amoxycillin plus clavulanate potassium (Augmentin) in the treatment of acute episodes of recurrent streptococcal tonsillitis was conducted. Twenty children were included in each group. Surface tonsillar cultures were obtained before therapy, ten days after termination of therapy, and then once every two months for up to one year. beta-Lactamase producing aerobic and anaerobic bacteria were present in 34 of the 40 (85%) tonsillar cultures prior to treatment. Group A beta-haemolytic streptococci were eradicated in 14 of 20 (70%) patients treated with penicillin and in all those treated with amoxycillin/clavulanate potassium (P less than 0.001). In a one-year follow-up, 11 of the 19 patients treated with penicillin and two of the 18 treated with amoxycillin/clavulanate potassium had recurrent streptococcal tonsillitis (P less than 0.005). This study demonstrates the efficacy of amoxycillin/clavulanate potassium in the therapy of acute episodes of recurrent tonsillitis and prevention of recurrent infection.
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PMID:Treatment of patients with acute recurrent tonsillitis due to group A beta-haemolytic streptococci: a prospective randomized study comparing penicillin and amoxycillin/clavulanate potassium. 211 Sep 40

A qualitative and quantitative analysis of the tonsillar surface and core of children with recurrent streptococcal tonsillitis and children with obstructive tonsillar hypertrophy was performed. No qualitative difference was found within the two population groups. Haemophilus influenzae and Bacteroides melaninogenicus were the most prevalent beta-lactamase-producing isolates in both groups. Staphylococcus aureus had the highest rate of beta-lactamase production on the tonsillar surface of children with recurrent tonsillitis, while Streptococcus pyogenes was more prevalent in the tonsillar surface cultures of children with obstructive tonsillar hypertrophy. The bacterial density was high but not significantly different in both groups of children. The similar microbial composition and density of both groups and the higher rate of S pyogenes recovery may signify a subclinical disease or normal flora in children with obstructive tonsillar hypertrophy.
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PMID:Microbiology of obstructive tonsillar hypertrophy and recurrent tonsillitis. 271 31

Forty patients with a history of recurrent non-beta-hemolytic streptococcal tonsillitis (RNST) participated in a prospective randomized study comparing penicillin and clindamycin in the treatment of acute non-group A streptococcal infection. The efficiency of each antibiotic was evaluated according to its ability to alleviate acute infection and prevent recurrence. Surface tonsillar cultures were obtained both before and ten days after the termination of therapy, and specimens were processed for aerobic and anaerobic bacteria. Beta-lactamase-producing bacteria (BLPB) were present in 36 (90%) tonsillar cultures. Thirty-one BLPB were isolated in 17 patients before penicillin therapy and 42 BLPB were recovered from 19 after such treatment. Thirty-three BLPB were recovered in 19 patients before clindamycin therapy, after which four BLPB were isolated in three patients (P less than .05). From the second day posttherapy onward, significantly fewer patients who received clindamycin had fever, pharyngeal injection, and sore throat. In a 1-year follow-up period, recurrent tonsillitis was noted in 13 of the patients who received penicillin and in two treated with clindamycin (P less than .001). The data clearly demonstrate the superiority of clindamycin therapy over penicillin in patients with RNST.
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PMID:Medical treatment of non-streptococcal recurrent tonsillitis. 276 34

Employing a series of monoclonal antibodies directed against T cell subsets using the avidin-biotin complex method as the immunoperoxidase technique and using fluorescein-conjugated antisera directed against the major immunoglobulins, we have studied the distribution of immunocompetent cells in sections of tonsils from 21 patients with various inflammatory diseases of the tonsils, including Streptococcal tonsillitis, recurrent tonsillitis and tonsillitis associated with infectious mononucleosis. The following conclusions can be made in regard to our study. The percentage of T cells decreases in all compartments of the tonsils with increasing episodes of tonsillitis as well as with infectious mononucleosis and Streptococcal tonsillitis. Similarly, the percentage of HLA-DR positive cells decreases with increasing episodes of tonsillitis and is statistically significant in the mantle zone. The percentage of IgM B cells and IgD B cells tends to increase in the extrafollicular zone and decrease in the mantle zone with increasing episodes of tonsillitis as well as with increasing age. The percentage of IgG and IgA plasma cells is highest in children who have had 3-5 episodes of tonsillitis, but markedly decreases in the follicle and extrafollicular compartments in patients who have had more than 5 episodes of tonsillitis. FACS analysis of B cells in the tonsils and peripheral blood show a marked decrease in IgD in both the tonsil and the peripheral blood and a significant increase of IgG in the peripheral blood. These findings may suggest late clonal expansion of B cells in recurrent tonsillitis and Streptococcal tonsillitis. Finally, the distribution of immunocompetent cells in recurrent tonsillitis, Streptococcal tonsillitis and tonsillitis associated with infectious mononucleosis appears to be independent of age.
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PMID:The distribution of immunocompetent cells in the compartments of the palatine tonsils in bacterial and viral infections of the upper respiratory tract. 306 3

At the onset or in the course of IgA nephropathy (IgA NP), upper respiratory tract infections and tonsillitis are often followed by periods of gross haematuria. In a search for possible abnormalities in the tonsillar IgA- and IgG-cell system, the palatine tonsils from seven patients with IgA NP and eight controls, all 15 suffering from chronic recurrent tonsillitis, were subjected to an immunohistochemical study. Compared with the controls, tonsils of NP patients contained a significantly (P less than 0.001) increased proportion of IgA-producing cells (49.6% versus 35.7%). There was also an increase (P less than 0.001) in the ratio of IgA polymer- (J-chain-positive) to monomer-producing cells in NP tonsils compared with controls (35.0% versus 18.8%). Although the tonsillar IgA cells were generally producing mainly IgA1, this subclass was even more predominant in NP tonsils (P less than 0.03). These results are compatible with the hypothesis that in some patients with IgA NP, the polymeric IgA1 deposited in the mesangium may be of tonsillar origin.
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PMID:Tonsillar distribution of IgA and IgG immunocytes and production of IgA subclasses and J chain in tonsillitis vary with the presence or absence of IgA nephropathy. 312 77

38 children aged 1-15 years treated for peritonsillar abscess (PTA) between 1976 and 1986 have been reviewed. The patients were divided into those with a history of recurrent tonsillitis prior to developing PTA (T+) (10 patients = 26.3%) and those without such history (T-) (28 patients = 73.4%). 19 patients were surgically drained, 2 abscesses ruptured spontaneously, 2 patients were treated by repeated needle aspirations and 15 patients were treated by medication only. Neither the pre-PTA history (T+ versus T-) nor the mode of treatment during the acute event showed any significant differences in comparing the recurrency rate of PTA or tonsillitis. Therefore, it seems that a single event of PTA among pediatric population should not be considered an indication for tonsillectomy.
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PMID:Peritonsillar abscess in children and its indication for tonsillectomy. 320 58

We have summarized our experience in recovery of beta-lactamase-producing bacteria (BLPB) in head and neck infection (HNI). These HNI include conjunctivitis, serous and chronic otitis media, cholesteatoma, chronic mastoiditis, chronic sinusitis, adenoiditis, recurrent tonsillitis in children and adults, peritonsillar abscess, and retropharyngeal abscess. Beta-lactamase-producing bacteria were found in 262 (51%) of 513 patients with HNI; 72% had aerobic BLPB and 57% had anaerobic BLPB. The infections, where these organisms were most frequently recovered, were adenoiditis (85% of patients), tonsillitis in adults (82%) and children (74%), retropharyngeal abscess (71%), and chronic otitis media (57%). The predominant BLPB were Staphylococcus aureus (49% of patients with BLPB), the Bacteroides-melaninogenicus group (28%), the Bacteroides fragilis group (20%), Pseudomonas aeruginosa (13%), Hemophilus influenzae (5%), and Branhamella catarrhalis (3%). The high incidence of recovery of BLPB in head and neck infections may have important implications on the antimicrobial management of these infections.
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PMID:Beta-lactamase-producing bacteria in head and neck infection. 325 96

Two hundred ninety patients treated for peritonsillar abscess (PTA) between 1970 and 1982 were reviewed. The patients were divided into those with a history of recurrent tonsillitis prior to developing PTA (72 patients, 25%), and those without (218 patients, 75%). The patients in the first group had four times more recurrences than those in the second group (40% versus 9.6%). Patients older than 40 years were found to have a lower incidence of throat infections than younger patients, and no PTA recurrences were observed. Neither subsequent tonsillitis nor recurrent PTA was observed among 72 patients (25%) who underwent tonsillectomy 6 to 12 weeks after PTA. The pre-PTA history was found to be a dominant factor in determining the need for tonsillectomy. In patients who suffered from recurrent tonsillitis prior to PTA, tonsillectomy is recommended. In those with a single episode of PTA and no history of tonsillitis, tonsillectomy is not indicated.
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PMID:Peritonsillar abscess: recurrence rate and the indication for tonsillectomy. 347 42

We analysed subsets of tonsillar lymphocytes and activated cells in each subset by two-color flow cytometry. There were many helper T cells (CD 4+ leu 8-) and few inducer T cells (CD 4+ leu 8+) in the tonsil. The situation was the reverse in the peripheral blood. The tonsil had few suppressor T cells (CD 8+ CD 11+). The proportion of activated cells (HLA-DR+) was low in the peripheral blood and high in the tonsil. In the tonsil, the ratio of cells with transferrin receptors to total lymphocytes was higher in the B than in the T subset, and higher in the subset of CD 4+ than in that of CD 8+ cells. Activated and proliferating lymphocytes were more abundant in the tonsils of children than in those of adults and more abundant in patients with hyperplastic tonsillitis than in those with recurrent tonsillitis.
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PMID:Subsets of tonsillar lymphocytes and activated cells in each subset analysed by two-color flow cytometry. 349 45

Lingual tonsillitis can cause various signs and symptoms including nocturnal or supine cough, constant discomfort in the throat, glossal pain, and otalgia. Most patients with lingual tonsillitis have already had palatine tonsillectomy. A lingual tonsil may be visible only by using a laryngeal mirror. An embedded foreign body can cause recurrent tonsillitis with abscess formation, and life-threatening airway obstruction may result. Aberrant lingual thyroid may be the only functioning thyroid tissue. Cryosurgery and the CO2 laser have made lingual tonsillectomy a safe and simple procedure. An abscess of a lingual tonsil should be drained under general anesthesia, and lingual thyroid should be treated conservatively unless it produces obstructive symptoms.
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PMID:Lingual tonsillitis. 374 99


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