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

In man streptococcal septicaemia is most often associated with the streptococci of Lancefield's groups, A, B and D, with pneumococci, with Streptococcus milleri and with viridans streptococci. The specific determinants of the ability of streptococci to establish infection and to invade the blood stream are only partially understood. Even if fully comprehended, they would provide an incomplete picture of the factors responsible for the capacity of streptococci to produce a myriad of disease states the clinical expression of which include such diverse manifestations as acute sore throat, impetigo contagiosa, scarlet fever, erythema marginatum, St. Vitus dance, mitral stenosis, bloody urine and dental caries, to name only a few.
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PMID:Virulence factors in streptococci. 612 28

New qualitative and quantitative methods are described for the investigation of the antibacterial activity of lipids on solid media by the application of lipid-impregnated filter paper over a lawn of the organisms. The methods have been used to investigate the antibacterial activity of unsaturated fatty acids that are important in skin defence. Oleic and linoleic acids inhibited Streptococcus pyogenes markedly, Staphylococcus aureus and Staph epidermidis to a lesser extent and had no effect on Escherichia coli and Pseudomonas aeruginosa. The inhibition of growth of a strain of Str. pyogenes from a sore throat was greater than that of a strain from an outbreak of impetigo. Linoleic acid was a more potent inhibitor of bacterial growth than oleic acid, and with both acids inhibition was more pronounced under aerobic than under anaerobic conditions of incubation. The methods described could be applied in other fields such as pharmacology, horticulture and industry.
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PMID:Qualitative and quantitative methods of studying the effect of lipids on bacteria grown on the surface of solid culture media. 741 88

GABHS is the most common bacterial cause of tonsillopharyngitis, but this organism also produces acute otitis media; pneumonia; skin and soft-tissue infections; cardiovascular, musculoskeletal, and lymphatic infections; bacteremia; and meningitis. Most children and adolescents who develop a sore throat do not have GABHS as the cause; their infection is viral in etiology. Other bacterial pathogens produce sore throat infrequently (e.g., Chlamydia pneumoniae and Mycoplasma pneumoniae), and when they do, other concomitant clinical illness is present. Classic streptococcal tonsillopharyngitis has an acute onset; produces concurrent headache, stomach ache, and dysphagia; and upon examination is characterized by intense tonsillopharyngeal erythema, yellow exudate, and tender/enlarged anterior cervical glands. Unfortunately only about 20% to 30% of patients present with classic disease. Physicians overdiagnose streptococcal tonsillopharyngitis by a wide margin, which almost always leads to unnecessary treatment with antibiotics. Accordingly, use of throat cultures and/or rapid GABHS detection tests in the office is strongly advocated. Their use has been shown to be cost-effective and to reduce antibiotic overprescribing substantially. Penicillin currently is recommended by the American Academy of Pediatrics and American Heart Association as first-line therapy for GABHS infections; erythromycin is recommended for those allergic to penicillin. Virtually all patients improve clinically with penicillin and other antibiotics. However, penicillin treatment failures do occur, especially in tonsillopharyngitis in which 5% to 35% of patients do not experience bacteriologic eradication. Penicillin treatment failures are more common among patients who have been treated recently with the drug. Cephalosporins or azithromycin are preferred following penicillin treatment failures in selected patients as first-line therapy, based on a history of penicillin failures or lack of compliance and for impetigo. GABHS remain exquisitely sensitive to penicillin in vitro. There are several explanations for penicillin treatment failures, but the possibility of copathogen co-colonization in vivo has received the most attention. Treatment duration with penicillin should be 10 days to optimize cure in GABHS infections. A 5-day regimen is possible and approved by the United States Food and Drug Administration for cefpodoxime (a cephalosporin) and azithromycin (a macrolide). Prevention of rheumatic fever is the primary objective for antibiotic therapy of GABHS infections, but a reduction in contagion and faster clinical improvement also can be achieved. Development of streptococcal toxic shock syndrome and necrotizing fasciitis ("flesh-eating bacteria") are rising concerns. The portal of entry for these invasive GABHS strains is far more often skin and soft tissue than the tonsillopharynx.
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PMID:Group A beta-hemolytic streptococcal infections. 974 11

Staphylococcal scalded skin syndrome (SSSS) is a common disorder that is usually seen in infants and children and rarely seen in adults. SSSS usually presents with a prodrome of sore throat or conjunctivitis. Extremely tender flaccid bullae, which are Nikolsky sign-positive, develop within 48 hours and commonly affect the flexures; occasionally, large areas of the skin may be involved. The bullae enlarge and rupture easily to reveal a moist erythematous base, which gives rise to the scalded appearance. SSSS in adults is a rare disorder, though there are now over 50 documented cases. Usually SSSS occurs in predisposed individuals, but not all adults have an underlying illness. Whereas mortality in childhood SSSS is approximately 4%, the mortality rate in adults is reported to be greater than 60%. SSSS is caused by an infection with a particular strain of Staphylococcus aureus, which leads to blistering of the upper layer of the skin, by the release of a circulating exotoxin. It has recently been demonstrated that the exfoliative exotoxin responsible for SSSS leads to the cleavage of desmoglein 1 complex, an important desmosomal protein. The same toxins that are responsible for causing SSSS also cause bullous impetigo. There appears to be a relationship between the disease extent, the amount of toxin produced and whether the toxin is released locally or systemically. As a result there is likely to be a spectrum of disease and there are likely to be a number of milder cases of adult SSSS that go undiagnosed. Social improvements and hygiene have led to a dramatic fall in the number of cases of SSSS. Treatment is usually straightforward, when there is no coexistent morbidity and the presentation is mild, but can be demanding if the patient is particularly ill. SSSS is still associated with mortality, particularly when it occurs in adults.
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PMID:Staphylococcal scalded skin syndrome: diagnosis and management. 1262 92

Monitoring of general practice antibiotic prescribing is important to allow concordance with prescribing guidelines to be assessed. National Prescribing Analysis and Cost Data are limited by lack of information on the condition for which antibiotics are prescribed. Using the General Practice Research Database, we found that the 10 leading indications for antibacterial prescribing were (in descending order): upper respiratory tract infection (RTI), lower RTI, sore throat, urinary tract infection, otitis media, conjunctivitis, vague skin infections without a clear diagnosis, sinusitis, otitis externa and impetigo. Although for some conditions there appeared to be inappropriately high levels of antibacterial prescribing, the antibiotics chosen were usually those recommended for first-line treatment.
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PMID:Antibacterial prescribing in primary care. 1765 80

Admissions for skin and soft-tissue infections have been increasing steadily in children and in the general population. Concerns have been raised recently about the increasing widespread use of topical fusidic acid and concurrent increase of fusidic acid-resistant Staphylococcus aureus. Fusidic acid resistance and methicillin resistant Staphylococcus aureus (MRSA) are both more prevalent in youngest age group (<5 year-olds) and particularly in the North island. In New Zealand, fusidic acid is recommended for treatment of minor impetigo and is the only fully-funded topical antibiotic. The evidence base for alternative treatment strategies for mild impetigo is limited. Most children with impetigo in the current Counties Manukau skin and sore throat schools programme received care with wound management with only a few requiring escalation. An upcoming randomised controlled trial comparing topical hydrogen peroxide cream, topical fusidic acid and wound management only (clean and cover) will help provide evidence about the effectiveness of alternative treatments in the New Zealand setting.
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PMID:Where to from here? The treatment of impetigo in children as resistance to fusidic acid emerges. 2773 55