Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0242429 (sore throat)
 2,760 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Different vehicles of transmission of the same pathogen may induce different clinical manifestations of the disease. The hypothesis was tested that the clinical manifestation of food-borne streptococcal pharyngitis is different from air-borne streptococcal pharyngitis. The symptoms and signs of 77 patients with endemic air-borne streptococcal pharyngitis compared to 103 patients with epidemic food-borne streptococcal pharyngitis (T type 8/25/imp19, M protein negative) and 11 patients with secondary air-borne epidemic streptococcal pharyngitis (T type 8/25/imp19, M protein negative) were prospectively evaluated. The patients with food-borne streptococcal pharyngitis had a significantly higher frequency of sore throat, fever, pharyngeal erythema, tonsillar enlargement and submandibular lymphadenopathy and a lower frequency of coryza and cough compared to the patients with endemic air-borne streptococcal pharyngitis. Although both food-borne and air-borne streptococcal infection caused upper respiratory tract infection, the clinical manifestation of food-borne streptococcal pharyngitis was more severe and more confined to the pharynx compared to the endemic air-borne disease. Involvement of the nasal mucosa and bronchial tree was more common in air-borne streptococcal pharyngitis than in the food-borne disease.
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PMID:Food-borne and air-borne streptococcal pharyngitis--a clinical comparison. 903 31

We determined the effect of influenza vaccine in patients with relapsing/remitting MS. Considerable controversy surrounds the question of whether to administer influenza vaccines to MS patients. Prevention of a febrile viral illness is clearly desirable in MS, and previous studies suggest that immunization is safe. Despite this, many clinicians avoid vaccination because they fear precipitating an MS exacerbation. We conducted a multicenter, prospective, randomized, double-blind trial of influenza immunization in patients with relapsing/remitting MS. In the autumn of 1993, 104 patients at five MS centers received either standard influenza vaccine or placebo. Patients were followed for 6 months for evaluation of neurologic status and the occurrence of influenza. Influenza was operationally defined as fever > or = 38 degrees C in the presence of coryza, cough, or sore throat at a time when the disease was present in the community. Attacks were defined in the standard manner, requiring objective change in the examination. Patients were examined at 4 weeks and 6 months after inoculation and were contacted by telephone at 1 week and 3 months. They were also examined at times of possible attacks but not when they were sick with flu-like illness. Three vaccine patients and two placebo patients experienced attacks within 28 days of vaccine (no significant difference). Exacerbation rates in the first month for both groups were equal to or less than expected from published series. The two groups showed no difference in attack rate or disease progression over 6 months. Influenza immunization in MS patients is neither associated with an increased exacerbation rate in the postvaccination period nor a change in disease course over the subsequent 6 months.
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PMID:A multicenter, randomized, double-blind, placebo-controlled trial of influenza immunization in multiple sclerosis. 937 55

A prospective study was conducted over a 3-month winter period in three general practice clinics in an urban population in southern Israel to identify the etiological agents of respiratory tract infections (RTI) in adults. RTI was defined as an acute febrile illness with cough, coryza, sore throat or hoarseness. Serum samples were taken from all patients in both the acute and convalescent phases of their illness. Tests were conducted for detection of 17 microorganisms known to cause RTI, including serological tests for 16 known pathogens. An etiological diagnosis was established in 80 (66%) of the 122 patients who participated in the study. The distribution of the etiological agents was as follows: influenza B virus in 27 (22%) patients. Chlamydia pneumoniae in 22 (18%), Legionella spp. in 15 (12%), Mycoplasma pneumoniae in 13 (11%), influenza A virus in 11 (9%), Bordetella pertussis in 9 (7%), adenovirus in 4, Epstein Barr virus in 4, Haemophilus influenzae in 3, beta-hemolytic streptococci in 3, Streptococcus pneumoniae in 2, respiratory syncytial virus in 2, parainfluenza 1 virus in 2 and parainfluenza 2 virus in 1. No patients were found to be infected with Coxiella burnetii, Moraxella catarrhalis or parainfluenza 3 virus. More than one pathogen was identified in 27 (34%) patients in whom an etiological diagnosis was established. It is concluded that RTI is caused by a broad spectrum of etiological agents, a considerable number of patients having evidence of infection with more than one pathogen. The therapeutic significance of these findings should be elucidated in further studies.
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PMID:Etiology of respiratory tract infection in adults in a general practice setting. 986 80

Influenza is a serious disease for the elderly. Influenza causes high fever in the elderly, similar as in healthy adults. Cough lasts longer, but frequency and degree of sore throat and coryza is lower in the elderly. Rapid diagnosis kits based on enzyme-linked immunoassay contribute to quick diagnosis, improving treatment of the elderly. Amantadine can mitigate various symptoms and hastens recovery. Other newly developed neuraminidase inhibitors are also hopeful for treatment. The poor prognosis of influenza in the elderly is associated with a high frequency of pneumonia complications. Decreased serum albumin level is a risk factor for post-influenza pneumonia. To reduce excess influenza death in the elderly, prophylaxis and management of the general health condition of elderly patients may be most important.
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PMID:[Clinical features of influenza in the aged]. 1122 12

The purpose of this article is to define the distinguishing characteristics of food-borne streptococcal pharyngitis by reviewing the literature. The main cause of this infection lies in poor handling and preservation of cold salads, usually those which contain eggs and are prepared some hours before serving. A shorter incubation period and a higher attack rate (51-90%) than in transmission by droplets was noted. The epidemics tend to occur in warm climates and in the hottest months of the year. Streptococcus pyogenes seems to originate from the pharynx or hand lesions of a food handler. In comparison to airborne transmission symptoms such as sore throat, pharyngeal erythema, and enlarged tonsils, submandibular lymphadenopathy are more frequent than coughing and coryza. Seven out of 17 reports revealed an M-untypeable serotype, which may possess virulent characteristics. Penicillin prophylaxis was shown to limit additional spread of the infection. There were no non-suppurative sequels, and suppurative sequels were very rare. We assume that the guidelines for the prevention of food poisoning would apply to food-borne streptococcal pharyngitis. Food handlers should be supervised to ensure they comply with strict rules of preparation and storage of food. Cold salads, especially those containing eggs, should not be left overnight before serving.
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PMID:Streptococcal contamination of food: an unusual cause of epidemic pharyngitis. 1169 94

Upper respiratory tract infections (URTIs) are responsible for a large amount of community antibacterial use worldwide. Recent systematic reviews have demonstrated that most URTIs resolve naturally, even when bacteria are the cause. The high consumer expectation for antibacterials in URTIs requires intervention by the general practitioner and a number of useful strategies have been developed. Generic strategies, including eliciting patient expectations, avoiding the term 'just a virus', providing a value-for-money consultation, providing verbal and written information, empowering patients, conditional prescribing, directed education campaigns, and emphasis on symptomatic treatments, should be used as well as discussion of alternative medicines when relevant. The various conditions have differing rates of bacterial infection and require different approaches. For acute rhinitis, laryngitis and tracheitis, viruses are the only cause and, therefore, antibacterials are never required. In acute sore throat (pharyngitis) Streptococcus pyogenes is the only important bacterial cause. A scoring system can help to increase the likelihood of distinguishing a streptococcal as opposed to viral infection, or alternatively patients should be given antibacterials only if certain conditions are fulfilled. Strategies for treating acute otitis media vary in different countries. Most favour the strategy of prescribing antibacterials only when certain criteria are fulfilled, delaying antibacterial prescribing for at least 24 hours. In otitis media with effusion, on the other hand, there is no primary role for antibacterials, as the condition resolves naturally in almost all patients aged >3 months. Detailed strategies for acute sinusitis have not been worked out but restricting antibacterial prescribing to certain clinical complexes is currently recommended by several authorities because of the high natural resolution rate.
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PMID:Responsible prescribing for upper respiratory tract infections. 1173 33

Acute human immunodeficiency virus (HIV) seroconversion illness is a difficult diagnosis to make because of its nonspecific and protean manifestations. We present such a case in an adolescent. A 15-year-old boy presented with a 5-day history of fever, sore throat, vomiting, and diarrhea. The patient also reported a nonproductive cough, coryza, and fatigue. The patient's only risk factor for HIV infection was a history of unprotected intercourse with 5 girls. Physical examination was significant for fever, exudative tonsillopharyngitis, shotty cervical lymphadenopathy, and palpable purpura on both feet. Laboratory studies demonstrated lymphopenia and mild thrombocytopenia. Hemoglobin, serum creatinine, and urinalysis were normal. The following day, the patient remained febrile. Physical examination revealed oral ulcerations, conjunctivitis, and erythematous papules on the thorax; the purpura was unchanged. Serologies for hepatitis B, syphilis, HIV, and Epstein-Barr virus were negative. Bacterial cultures of blood and stool and viral cultures of throat and conjunctiva showed no pathogens. Coagulation profile and liver enzymes were normal. Within 1 week, all symptoms had resolved. The platelet count normalized. Repeat HIV serology was positive, as was HIV DNA polymerase chain reaction. Subsequent HIV viral load was 350 000, and the CD4 lymphocyte count was 351/mm3. HIV is the seventh leading cause of death among people aged 15 to 24 in the United States, and up to half of all new infections occur in adolescents. Our patient presented with many of the typical signs and symptoms of acute HIV infection: fever, fatigue, rash, pharyngitis, lymphadenopathy, oral ulcers, emesis, and diarrhea. Other symptoms commonly reported include headache, myalgias, arthralgias, aseptic meningitis, peripheral neuropathy, thrush, weight loss, night sweats, and genital ulcers. Common seroconversion laboratory findings include leukopenia, thrombocytopenia, and elevated transaminases. The suspicion of acute HIV illness should prompt virologic and serologic analysis. Initial serology is usually negative. Diagnosis therefore depends on direct detection of the virus, by assay of viral load (HIV RNA), DNA polymerase chain reaction, or p24 antigen. Both false-positive and false-negative results for these tests have been reported, further complicating early diagnosis. Pediatricians should play an active role in identifying HIV-infected patients. Our case, the first report of acute HIV illness in an adolescent, emphasizes that clinicians should consider acute HIV seroconversion in the appropriate setting. Recognition of acute HIV syndrome is especially important for improving prognosis and limiting transmission. It is imperative that we maintain a high index of suspicion as primary care physicians for adolescents who present with a viral syndrome and appropriate risk factors.
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PMID:Acute human immunodeficiency virus syndrome in an adolescent. 1452 19

Influenza is a serious disease for the elderly. Although influenza causes a high fever in the elderly similar to that of healthy adults, the cough lasts longer but frequency and degree of sore throat and coryza are lower in the elderly. A characteristic of influenza in the elderly is a high frequency of pneumonia complications. Decreased serum albumin level is a good indicator of the risk of post-influenza pneumonia. Rapid diagnosis kits have contributed to better diagnosis of influenza in clinical practice. In addition to amantadine, newly developed neuraminidase inhibitors are available for treatment of influenza. These drugs can mitigate various symptoms efficiently and hasten recovery. To treat influenza in the elderly, not only are prophylaxis and treatment of pneumonia important, but management of the general health condition is essential.
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PMID:[Clinical characteristic of the elderly in influenza infection]. 1461 33

Influenza is a highly contagious acute respiratory disease, caused by influenza viruses infecting the host at the respiratory mucosa and repeated annually by appearance of variant viruses with altered surface antigens. To control influenza, a protective immunity must be provided in advance by administration with an inactivated or attenuated virus vaccine. Current inactivated vaccine, licensed for parenteral administration, can induce systemic IgG antibodies, but not highly cross-reactive mucosal IgA and heterosubtypic cytotoxic T lymdhocytes(CTL), to results in lowered protective efficacy against variant virus infection. Current attenuated virus vaccine, licensed for intranasal administration, can induce IgA and CTL, as well as IgG, with coryza, sore throat and febrile reactions and with forbidden use to high-risk patients. To improve shortcomings of the current inactivated or attenuated vaccine, many trials, including the development of DNA vaccine, are still going on.
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PMID:[Present situation of influenza vaccine development]. 1461 44

In order to understand the prevalence of childhood streptococcal pharyngitis, isolation of group A Streptococcus (GAS) was attempted from throat swabs of pharyngitis patients. Children aged between 1 and 15 years presenting to the outpatient department with pharyngeal erythema were prospectively enrolled in the study. Demographic data and presenting symptoms and signs for each patient were recorded and a throat swab was taken. Of 1175 throat cultures obtained, GAS was isolated in 252 cases (21.4%). Of these, 142 (56.3%) were boys and 110 (43.7%) girls. A higher proportion of boys was found with GAS pharyngitis (1.29: 1). The mean age of GAS culture-positive patients was 7.8 +/- 2.3 years old. Patients aged between 6 and 11 years were more prevalent in GAS pharyngitis. Ninety (35.7%) of our GAS pharyngitis patients occurred between March and May. A second smaller peak occurred between October and December. The following factors showed independent positive correlation with GAS infection: sore throat (p < 0.001), no coryza (p = 0.011), tonsillar swelling (p < 0.001), anterior cervical adenopathy (p = 0.029) and scarlatiniform rash (p < 0.001). However, GAS was found in less than half of the patients who had these clinical manifestations. In conclusion, pharyngeal infection with GAS in children is not uncommon. The prevalence of GAS pharyngitis is related to patient gender, age, and month of the year. Diagnosis of GAS pharyngitis based on clinical features alone is unreliable.
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PMID:Epidemiological and clinical features of group A Streptococcus pharyngitis in children. 1496 82


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