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Query: UMLS:C0242429 (sore throat)
 2,760 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to devise a strategy for the management of acute pharyngitis, the clinical features of 418 adults with sore throat were noted and throat cultures were obtained. Patients with cultures positive for group A beta-hemolytic streptococci had a significantly higher (P less than or equal to .01) frequency of recent exposure to streptococcal infection, pharyngeal exudate, enlarged or tender cervical nodes, and high fever (greater than or equal to 38.3 C [101 F]. Patients with negative cultures complained more frequently of cough. On the basis of these symptoms and signs, a clinical algorithm was developed and discriminant function scores were computed that identify patient populations with different probabilities of having streptococcal pharyngitis. The patients with moderate and high probabilities included 91% of patients with positive cultures but only 67% of the total patient population. These methods could be the basis for more efficient evaluation of adults with sore throat.
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PMID:Recognition of streptococcal pharyngitis in adults. 110 66

The impact of a rapid streptococcal screening test (RSS) on clinical decision making in the management of patients with acute pharyngitis was evaluated. Physicians managing 95 ambulatory patients with the complaint of sore throat were asked to estimate the probability of group A beta-hemolytic streptococcal pharyngitis (GRABS) in each patient and whether they intended to treat with antibiotics both before and after the results of the RSS were known. Simultaneous throat cultures were obtained for 80 patients at the discretion of the treating physicians. Regression analysis revealed that the RSS result was an important independent predictor for the posttest decision to treat with antibiotics and for the estimated probability of disease. The mean absolute log-likelihood ratio was used to quantify the effect of the RSS on diagnostic certainty; a greater contribution to diagnostic certainty occurred when the RSS was positive. Physicians would have prescribed an antibiotic 49 times without the benefit of the RSS and prescribed an antibiotic 48 times given the RSS result. Without the RSS, the treatment decision contradicted the throat culture result in 25 cases. With the RSS, this occurred in 26 cases. The RSS, while influencing decision making, especially when positive, did not decrease the use of antibiotics.
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PMID:The impact of a rapid screen for streptococcal pharyngitis on clinical decision making in the emergency department. 186 80

The ampicillin analog, amoxicillin, can potentially produce the same hypersensitivity reaction as the ampicillin. The case of a patient treated with amoxicillin for a sore throat, who later presented with a rash, is reviewed. Infectious mononucleosis was considered and then supported by a positive mono spot. It would appear therefore that amoxicillin can produce the same hypersensitivity reaction as ampicillin in the setting of acute infectious mononucleosis. The clinical decision to use antibiotics in acute pharyngitis is complicated by the identical presentation of both viral and bacterial illnesses. If empiric therapy is elected, the incidence of hypersensitivity reaction is less common with penicillin or tetracycline compared to ampicillin or its analog, amoxicillin.
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PMID:Making a rash diagnosis: amoxicillin therapy in infectious mononucleosis. 214 Mar 84

A serological investigation has suggested that Legionella pneumophila may be associated with sore throat in adults. In a study of 177 adults and children with acute pharyngitis, Legionella species were not isolated from pharyngeal cultures, which utilized selective and nonselective buffered charcoal-yeast extract media. Group A beta-hemolytic streptococci were isolated from 14 percent of the 177 symptomatic patients. Throat cultures from 88 asymptomatic control subjects were negative for Legionella and beta-hemolytic streptococci. Further studies are needed to determine if Legionella species are associated with acute pharyngitis.
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PMID:Prevalence of Legionella in pharyngeal secretions of patients with pharyngitis. 304 28

Sore throat can be caused by different microorganisms and diseases. Most cases of acute pharyngitis are caused by group A streptococcus or viruses; however, uncommon organisms may be suggested by other clinical information or the persistence of symptoms. A thorough history and physical examination are essential for the appropriate selection of diagnostic tests for sore throat. Routine testing for the uncomplicated case should consist of a pharyngeal culture in most patients, with rapid streptococcal antigen testing only for the more severe cases. Those with positive streptococcal tests should be treated to prevent rheumatic fever and mitigate symptoms in severe cases. Sore throat caused by viruses usually resolves spontaneously. Cases that persist should be thoroughly re-evaluated, with alternative causes being considered. Acute epiglottitis is a medical emergency and requires treatment with appropriate antibiotics for Hemophilus influenzae type b and intubation.
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PMID:The sore throat. Pharyngitis and epiglottitis. 307 5

To investigate the causes and clinical characteristics of acute pharyngitis among school-aged children (4 to 18 years), we obtained throat cultures for respiratory viruses, Mycoplasma pneumoniae, group A streptococcus, and Chlamydia trachomatis from 320 patients with sore throat and 308 controls without respiratory complaints. The study was conducted from January to April 1985 in a private pediatric practice in central New York State. Sixty percent of the patients and 26% of the control subjects had positive cultures for at least one organism. Forty percent of patients had positive cultures for group A streptococcus, compared with 11.9% of the controls. Fifty (16%) patients had positive viral cultures, compared with eight (2.6%) controls; the predominant viral isolate was influenza A Philippines. Patients infected with influenza A were significantly more likely to complain of cough and hoarseness, and were less likely to have pharyngeal exudate or tender cervical adenopathy, than were patients who had positive cultures for group A streptococcus. Although 49 (15.8%) patients with acute pharyngitis had cultures positive for M. pneumoniae, 53 (17.6%) asymptomatic controls were also had M. pneumoniae-positive cultures. Thus detection of M. pneumoniae in the throat of school-aged children with pharyngitis may not be sufficient to establish a diagnosis of disease caused by this organism. C. trachomatis was not isolated from any patient or control.
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PMID:Viral and bacterial organisms associated with acute pharyngitis in a school-aged population. 353 96

Mycoplasma hominis seldom colonizes the human respiratory tract and only rarely causes acute respiratory infection. It can be recovered from the respiratory secretions of 1-3% of healthy persons and of less than or equal to 8% of persons with chronic respiratory disease, but it has not been implicated definitely in the etiology of this disease or in the exacerbations that characterize its course. M. hominis has been isolated from less than or equal to 6% of persons with acute pharyngitis or acute upper respiratory tract illnesses and can induce exudative pharyngitis in susceptible volunteers when administered intranasally and oropharyngeally. Colonization of the respiratory tract by M. hominis occurs in approximately 15% of persons who engage in oral-genital sexual practices, but colonization alone is not necessarily associated with sore throat or other upper respiratory diseases. Although M. hominis has been recovered from adults with pneumonia more often than from controls, a pathogenic role in pneumonia of adults has not been established. Under special conditions, e.g., neonatal pneumonia, M. hominis appears to be pathogenic for the lower respiratory tract. Thus M. hominis probably is only an occasional respiratory pathogen in the adult and a rare "opportunistic" pathogen of the respiratory tract of the neonate.
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PMID:Mycoplasma hominis: a review of its role as a respiratory tract pathogen of humans. 666 78

The Neisseria species with which most otolaryngologists are familiar is N gonorrhoeae, which can cause acute pharyngitis or tonsillitis. Less well known is N meningitidis, responsible for potentially fatal meningococcal meningitis and meningococcemia. Although present in the carrier state in the pharynx of asymptomatic individuals, N meningitidis previously has not been associated with symptomatic pharyngeal or tonsillar disease. Its isolation from a patient with acute tonsillitis and failure to eliminate the symptoms and organism with penicillin led to use of rifampin. Disappearance of sore throat following use of this antibiotic and inability at completion of therapy to isolate the organism from a homogenate of excised tonsil would appear to implicate the organism as a cause of acute pharyngeal and tonsillar infection. It should be added to the list of organisms capable of producing acute tonsillitis, and rifampin should be considered a chemotherapeutic agent.
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PMID:Tonsillitis due to neisseria meningitidis. Its treatment with rifampin. 678 29

Acute sore throat is a very common pathology, but should not because of this be considered as banal. In effect, the beta-haemolytic streptococcus A, which is responsible for most of the bacteriological etiologies is not only responsible for distant inflammatory complications, acute articular rheumatism (RAA) and glomerulonephritis, which are re-appearing in the United States, but also a fulminating septicemia and a syndrome of visceral failure that makes a grave prognosis for life. Moreover, today, streptococcus A is one of the factors involved in a series of fatal fasciites and necrosing myosites seen in several European countries. Understanding of these complications gives better definition of the causative immunological mechanisms and particularly the adverse role of the "superantigens" of streptococci in the start of an increase in the responses of immunocompetent cells and pro-inflammatory and prothrombic mediators. Finally, availability now of rapid diagnostic tests with monoclonal antibody techniques confirms the presence of streptococci A in acute sore throat and should help the physician to make an etiological diagnosis that takes into account the clinical signs. Unfortunately, these tests are not widely available in France and are not subject to reimbursement. All these factors justify the introduction of an antibiotherapy targetted at streptococcus A in the context of bacterial sore throat. Oral penicillin V (phenoxymethyl penicillin, Oracilline) is always the reference, with an excellent anti-bacterial and clinical activity and without risk of production of strains of streptococcus that are of reduced sensitivity or resistant.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Targetted antibiotic therapy. Acute sore throat: streptococcus A update]. 786 18

While the numerous complications of intravenous hyperalimentation (IVH) are well recognized, we encountered a unique one. A 60-year-old man developed a sore throat, neck pain and fever seven days after catheterization of the subclavian vein to provide post-operative nutrition. Marked swelling was visible at the right posterior wall of this oropharynx and hypopharynx. X-ray of the neck revealed that the tip of the catheter was positioned in the internal jugular vein, not the subclavian vein as intended. The acute pharyngitis, diagnosed as due to phlebitis of the internal jugular vein due to the malpositioned catheter, subsided within two days of catheter removal.
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PMID:Acute pharyngitis, an unusual complication of intravenous hyperalimentation. 816 21


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