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

Chlamydia pneumoniae has recently been recognized as an important cause of respiratory tract disease, including atypical pneumonia. Serosurveys suggest that C. pneumoniae is endemic in most countries and is capable of causing outbreaks and epidemics of pneumonia, especially in countries where the antibody prevalence is relatively low. The population incidence of infection appears to be cyclical, with approximately 4-year cycles in the US (Seattle) and 6-year cycles in Denmark having been demonstrated. Pneumonia caused by the organism is unusual in young children in developed countries but may be an important cause of lower respiratory infections among children in developing and tropical countries. In otherwise healthy adults, C. pneumoniae pneumonia usually can be treated effectively on an outpatient basis. Patients with C. pneumoniae pneumonia often have a gradual onset of symptoms: a sore throat and hoarseness followed by a cough. Auscultatory and radiographic findings usually are prominent, even in patients with mild disease, and a cough and malaise may persist for several weeks or more after appropriate therapy. Microimmunofluorescence serologic testing is available in only a few laboratories. However, the new HL cell line holds promise of making culture and isolation of C. pneumoniae more widely available. Questions remain about the routes of transmission of C. pneumoniae, its incubation period, its role in lower respiratory disease in children in developing countries, the optimal antibiotic therapy, the existence and importance of chronic and latent C. pneumoniae infections, and the organism's association with nonrespiratory tract disease.
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PMID:Infections with Chlamydia pneumoniae strain TWAR. 185 69

Several studies have implicated Mycoplasma pneumoniae as an important cause of nonstreptococcal pharyngitis in certain clinical settings. This study was performed to determine the prevalence of M. pneumoniae infection in family practice patients with sore throats and to identify patient characteristics predictive of this infection. M. pneumoniae throat cultures were obtained from 419 patients aged five years or older who were seen in one of four family practice offices with a complaint of sore throat. The overall prevalence of M. pneumoniae infection was 13%. It was characterized by more frequent hoarseness and less frequent complaint of postnasal drip when compared with other nonstreptococcal infections. Compared to patients with streptococcal pharyngitis, M. pneumoniae patients revealed a strikingly dissimilar clinical presentation. In particular, while pharyngitis is predictive of streptococcal infections, its presence did not predict M. pneumoniae infection. Recently developed rapid office-based tests for M. pneumoniae may allow timely diagnosis of this common and formerly elusive pathogen. Further study is required to validate the utility of such methods and to evaluate the efficacy of treatment.
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PMID:The prevalence of Mycoplasma pneumoniae in ambulatory patients with nonstreptococcal sore throat. 190 44

A 46-year-old healthy man suffered from sore throat, fever and right otalgia. On the next day, he developed hoarseness and difficulty in swallowing. On the 6th day, he suffered from vertigo, nausea and vomiting associated with unsteady gait. He was admitted to the otorhinolaryngology department in our hospital and pointed out to have vesicles at his right ear. On the 13th day, he was referred to our service. On admission, no vesicles were noted at the right ear or pharynx. Neurological examination revealed mild nuchal rigidity and marked hoarseness, associated with poor elevation of soft palate and loss of pharyngeal reflex on the right side. He also had horizontal-clockwise rotatory nystagmus in primary gaze and ataxic gait. There was no hearing loss nor facial palsy. No other abnormal neurological findings were noted. The cerebrospinal fluid showed pleocytosis associated with increased protein. The viral antibody titre for herpes zoster was significantly elevated on 18th day in serum as well as in cerebrospinal fluid. Vertigo, nausea, vomiting, ataxia and difficulty in swallowing were all disappeared by the 25th day, whereas hoarseness was improved but still noted 6 months later. Among cranial nerves, trigeminal and facial nerves are the most commonly affected in patients with herpes zoster, but there have been a few reported cases of the 9th and 10th cranial nerve involvement in the literature. In these previously reported cases, all were written before the era of serological diagnosis, and herpes zoster was diagnosed by the vesicles at the ear or pharynx.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of unilateral VIIIth, IXth and Xth cranial nerve involvement with herpes zoster]. 216 88

Clinical and serologic data were collected on 667 University of Washington students who presented to the David Hall Student Health Center between 1983 and 1987 with acute respiratory disease. Sera were tested for evidence of acute or past infections with Chlamydia pneumoniae strain TWAR, Chlamydia trachomatis, Mycoplasma pneumoniae, influenza A virus, influenza B virus, adenovirus, and respiratory syncytial virus. Pharyngeal swab specimens were cultured for C. pneumoniae and C. trachomatis, but not for the other agents. Evidence of acute infection with C. pneumoniae was found in 20 patients and evidence of an acute infection with M. pneumoniae in 29 patients. C. pneumoniae was associated with 9% and M. pneumoniae with 11% of 149 pneumonias diagnosed clinically, and with 20% and 22%, respectively, of the 59 pneumonias confirmed on chest radiograph. There was no evidence of seasonality in C. pneumoniae or M. pneumoniae infections. Compared with patients with M. pneumoniae, patients with C. pneumoniae were less likely to have a temperature greater than 37.8 degrees C (10% vs. 34%), but were more likely to present with a sore throat (80% vs. 52%) or hoarseness (30% vs. 3%). The mean number of days from onset of symptoms until enrollment was longer in patients with C. pneumoniae infections than in those with M. pneumoniae (12.8 vs. 7.9 days), or those with a viral infection (12.8 vs. 7.3 days), suggesting a more gradual onset of disease caused by C. pneumoniae.
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PMID:Chlamydia pneumoniae strain TWAR, Mycoplasma pneumoniae, and viral infections in acute respiratory disease in a university student health clinic population. 237 5

A clinical study was made of 131 patients with laryngeal cancer treated in our department during 13 years from 1975 to 1987. The mean age of patients was 64.8 years, and the male-female ratio was 20.8:1. There were 87 cases of the glottic type, 42 of the supraglottic, and 2 of the subglottic type. Cases in the early stages (stage I, II) predominated in the glottic type, whereas advanced stage tumors (stage III, IV) were predominant in the supraglottic type (chi 2-test, p less than 0.01). Hoarseness was the most frequent complaint in the patients with glottic cancer. The proportion of complaints other than hoarseness, such as sore throat, on the other hand, was significantly higher among patients with supraglottic cancer (chi 2-test, p less than 0.01). There was no significant correlation between stage and duration of complaints until visits to our department. The overall five-year survival rate was 73.8%. The five-year survivals for the glottic and supraglottic type were 84.3 and 54.3% respectively, and for stage I through stage IV were 94.6, 73.7, 58.6, and 36.4%, respectively. In patients classified as T1 or T2, the following treatment is recommended as basic policy: radiotherapy as initial treatment and, if unsuccessful, secondary salvage surgery should be performed. In patients classified as T3 or T4, however, total laryngectomy is recommended as initial treatment. Metastases to cervical lymph nodes were observed in 6 patients with glottic cancer and 14 with supraglottic cancer, and the incidence of cervical lymph node metastases was significantly higher in the supraglottic type (chi 2-test, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical study on laryngeal cancer]. 238 32

Eleven patients presenting to an ear, nose, and throat specialist were diagnosed as having idiopathic hoarseness and prospectively evaluated for evidence of gastroesophageal reflux (GER) to determine if an association existed. Testing for GER included voice analysis, EGD, esophageal manometry, Bernstein test, and ambulatory 24-hr pH monitoring. Six of the 11 (55%) hoarse patients studied had GER by pH monitoring (mean score 105 +/- 23), and most reflux episodes were supine and prolonged (20.9 +/- 8.2% supine pH less than 4.0, longest 129 min). All patients with abnormal pH monitoring had endoscopic esophagitis (Barrett's esophagus in two, peptic stricture in one, and erosive esophagitis in three), while none of the patients with normal scores had esophagitis. Symptoms of throat pain or nocturnal heartburn were more common in the GER-positive patients (6 of 6 vs 1 of 5), and clinically helpful in discriminating which hoarse patients had pathologic GER. Treatment with ranitidine 150 mg per os twice a day for 12 weeks improved esophagitis in all patients, but the voice improved in only one of the two patients with completely healed esophagitis. This study suggests that (1) GER is frequently seen in patients with idiopathic hoarseness (55%), (2) hoarse patients with throat pain or nocturnal heartburn are likely to have severe esophagitis and should be evaluated by EGD, and (3) additional antireflux and voice therapy may be necessary to heal esophagitis and improve the voice.
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PMID:Evaluation of gastroesophageal reflux as a cause of idiopathic hoarseness. 259 57

A patient (ASA class I) scheduled for an elective gynecological operation, could not be intubated by conventional means, as no part of the glottis could be seen on direct laryngoscopy. Endotracheal intubation was successful on the first attempt using a lighted intubation stylet (Tube-Stat, Concept Corporation, Clearwater, Florida, USA). Transillumination of the neck tissues acted as a guide for correct placement of the endotracheal tube. Postoperatively, the patient complained of hoarseness and sore throat that cleared up completely within 5 days. Cases of difficult-intubation are often impossible to recognize preoperatively [3]. When problems arise, a difficult-intubation drill should be instituted without delay. The view obtained at laryngoscopy in our patient corresponded to a Grade III case according to the classification of Cormack and Lehane [3]. Our usual routine in such cases calls for blind intubation using a flexible introducer passed posteriorly to the epiglottis or blind nasal intubation. Recent reports testify to the potential dangers of blind procedures [4, 19, 23]. Light-wand-guided intubation has been reported to be an easily learned, atraumatic alternative to laryngoscopic or blind nasal intubation [6, 9]. We employed the Tube-Stat light-wand in a series of routine surgical cases with encouraging results. Our case report documents our first patient intubated with the light-wand after failure of conventional larnygoscopy. The first lighted stylet was described some 30 years ago, and the method of transillumination as an aid in difficult intubation developed over the following years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The Tube-Stat: a useful aid in difficult intubation]. 271 27

The authors examined and followed 104 patients who had undergone surgery under endotracheal anesthesia in order to recognize the lesions of the oropharynx and the larynx resulting from intubation and other manipulations within the oral cavity and the pharynx. Laryngoscopic examination disclosed: a hematoma of true vocal cords in 5 patients, hematoma of the aditus ad laryngem and soft palate in 1 patient, edema in 4 patients, and in 8 patients hematoma of the oropharyngeal mucosa. The patients reported the following post-extubation discomforts: sore throat, hoarseness, dysphagia, a feeling of burning, clenching or foreign body in the throat, rough throat, irritation to hacking cough, and pains in the cervical musculature. Laryngitis was singled out as a disorder found in an increased percentage in the study group, as compared to the literature data, for which an explanation is given.
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PMID:[Intubation lesions of the oropharynx, larynx and trachea]. 273 96

Two patients with sudden progressive profound hearing loss resulting from Ramsay Hunt syndrome are reported. Case 1: A 63-year-old woman was admitted to Jichi Medical School Hospital with sudden, progressing deafness of the left ear, vertigo, sore throat, and hoarseness. An otoscopic examination revealed the external ear and the tympanic membrane to be normal. Pure-tone audiometry revealed profound deafness in the left ear. A horizontal nystagmus in the non-affected direction was observed by gaze nystagmus test. An endoscopic examination revealed herpetic vesicles and shallow ulcers on the left side of the pharynx and the larynx. There was complete paralysis of the left recurrent nerve. Hearing acuity of the left ear did not recover at all with steroid hormone therapy. Case 2: A 75-year-old man was referred to the ENT Clinic by a dermatologist for hearing evaluation in Ramsay Hunt syndrome. The man had noticed severe otalgia and sudden progressive deafness of the right ear approximately 2 weeks prior to admission. Physical examination revealed herpetic vesicles and ulcers in the right external ear and lateral neck. Complete paralysis of the right facial nerve was noted. Profound hearing loss in the affected ear was observed by pure-tone audiometry. A gaze nystagmus test revealed a horizontal nystagmus in the non-affected direction. No recovery of the cochlear function was noted following administration of antiviral drug. The pertinent literature is briefly reviewed.
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PMID:Acute profound deafness in Ramsay Hunt syndrome. Two case reports. 285 31

Agranulocytosis is a rare but potentially lethal adverse effect of sulfasalazine. We report a case of sulfasalazine-associated agranulocytosis that occurred in a 79-year-old woman who had been taking the drug for approximately seven weeks. The patient had discontinued the drug on her own initiative nine days prior to admission. The patient was admitted with complaints of hoarseness, fever, odynophagia, and malaise. The total white blood cell count was 600/mm3 with a differential of 0% neutrophils, 8% bands, 67% lymphocytes, and 25% monocytes; a bone marrow aspirate and biopsy revealed maturation arrest. The patient's peripheral white blood cell count and differential progressively increased over the nine-day hospital course. Upon discharge the white blood cell count was 12,000 cells/mm3 with 66% neutrophils, 8% bands, 16% lymphocytes, and 10% monocytes. Complete blood counts should be performed periodically in patients receiving sulfasalazine, especially during the first two months of therapy. Pharmacists should counsel patients to discontinue the drug and consult their physician immediately if they develop unexplained fever, chills, sore throat, malaise, or other nonspecific illness during the initial two months of treatment.
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PMID:Agranulocytosis associated with sulfasalazine. 289 66


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