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)

Two adults were admitted to the University Hospital of Geneva with acute Haemophilus influenzae type b epiglottitis. The disease was characterized by rapid progression of sore throat, upper dysphagia, fever and dyspnea. Acute upper airway obstruction required emergency tracheotomy in both cases. The patients recovered under ampicillin therapy. All the 100 cases from the literature for which clinical data were available have been analyzed:--Epiglottitis in adult is not exceptional.--Haemophilus influenzae type b is the most common infective organism documented, and was found in all positive blood cultures but one.--The typical presentation is severe sore throat, with upper dysphagia, fever and dyspnea.--Clinical course is rapid and serious, and acute respiratory distress develops in 57% of cases; overall mortality is 27%.--Emergency routine tracheotomy appears to be the most reliable treatment.
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PMID:[Acute epiglottitides in the adult]. 30 60

The diagnosis, management and outcome in 12 adults with acute epiglottitis was reviewed. Painful dysphagia was a universal symptom and respiratory distress affected eight patients, six of whom required urgent airway intervention. All patients received parenteral antibiotics, ten received steroids and four received adrenaline. Respiratory distress resolved in two patients given adrenaline and airway intervention was avoided. Indirect laryngoscopy is the investigation of choice and this is preferable to neck radiology. Two patients died and it is stressed that this condition must be distinguished from other more common causes of a severe sore throat. The patient should be managed in a unit with the facilities and expertise to effect acute airway intervention.
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PMID:Acute epiglottitis in adults: a potentially lethal cause of sore throat. 769 36

From 1987 to 1989, 14 adults with acute epiglottitis were seen and treated at the ENT clinic of Geneva. All patients presented with a severe sore throat as primary symptom. An indirect laryngoscopy, which bears no risk in adults, was performed and revealed a swollen, cherry-red epiglottis. The course of the disease is unpredictable, and rapid development of airway obstruction may occur. In most cases, these patients can be treated medically with antibiotics and corticoids, and there is no need for systematic orotracheal intubation. However, patients presenting with respiratory distress syndrome or stridor require intubation, which may be impossible because of edema of the epiglottis. Therefore, a surgeon must be ready to perform a tracheotomy.
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PMID:[Epiglottitis in adults]. 239 55

Epiglottitis may occur at any age. The typical presentation in the young child and young adult is well known, but the presentation in patients at the extremes of age has not been characterized. At our locale, from 1974 to 1984, 19 children 24 months of age or less and, from 1979 to 1984, 9 adults 50 years of age or greater with epiglottitis were seen in the emergency department. In the infantile group, rapidly progressive interference with swallowing, vocalization, and respiration was encountered in less than half the patients. Symptoms were often prolonged before parents sought attention for their child. No preference was shown for maintenance of the upright position while at rest, as recumbency did not promote stridor or initiate respiratory distress. Respiratory complaints were common and included cough, tachypnea, and retractions. Drooling or retention of pharyngeal secretions was uncommon. The adult population had a history of symptoms that spanned several days. Extreme sore throat, pooling of oral secretions, muffled voice, and elevated temperature were uncommon. Dysphagia and mild respiratory complaints were frequent. Upper airway obstruction did occur. At both extremes of age, exceptions to the classic clinical pattern of epiglottitis occurred with significant frequency. Despite this, diagnosis and management in the emergency department were appropriate in most cases.
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PMID:Epiglottitis at the extremes of age. 337 97

Ingestion of commercially processed honeybee-collected pollen produced potentially fatal consequences in a 19 year old asthmatic male. Symptoms of sore throat, facial itch and swelling, difficulty in breathing and stridor lasted for approximately two hours and was followed by clinical respiratory distress with widespread wheeze on auscultation of his chest. RAST and skin test data suggest that these complications appear to be mediated by IgE antibodies directed against the processed pollen, but not bee venom. Consumption of processed pollen by atopic individuals is, therefore, a potentially hazardous procedure with little therapeutic benefit.
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PMID:Acute hypersensitivity to ingested processed pollen. 386 27

Acute epiglottitis in adults occurs more frequently than generally realized. Haemophilus influenzae type b is the major causative agent. While H influenzae resistant to ampicillin sodium has been associated with epiglottitis in children, no adult cases have been reported. We describe a 48-year-old woman with epiglottitis and associated typical rapid onset of sore throat, fever, respiratory distress, and swollen, red supraglottic structures. Blood cultures were positive for beta-lactamase-producing, ampicillin-resistant H influenzae. We conclude that H influenzae resistant to ampicillin should be considered when diagnosing and treating adult epiglottitis.
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PMID:Acute epiglottitis and bacteremia with ampicillin-resistant Haemophilus influenzae. 698 Jun 42

Spontaneous hemorrhage of a parathyroid adenoma is a rare occurrence which may manifest with a variety of symptoms including cervical pain, hoarseness, respiratory distress, and dysphagia. We report a case of an elderly woman with a parathyroid adenoma diagnosed 10 years ago and for which she had refused surgery. Throughout this period her hypercalcemia was carefully monitored, and she experienced no symptoms or adverse sequelae from her disease. However, the patient subsequently presented with a 1 day history of a sore throat and a nonproductive cough followed by the acute onset of dysphagia. At this time she was found to have an anterior neck hematoma extending to the midthorax. Computerized tomography and direct laryngoscopy were suggestive of the diagnosis and neck exploration confirmed the presence of a large hematoma beginning at the site of the 3 x 4 cm parathyroid adenoma and extending into the left strap musculature. We report this case of spontaneous hemorrhage of a cervical parathyroid adenoma to bring to mind a rare etiology of acute pharyngoesophageal dysphagia.
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PMID:Acute pharyngoesophageal dysphagia secondary to spontaneous hemorrhage of a parathyroid adenoma. 843 23

In order to evaluate complications due to cervical spine surgery using the anterior cervical approach a prospective study was conducted on 125 patients. ENT examination with the fibroscope was employed for all the patients before the procedure. The patients were operated on under general anesthesia and were intubated with an armoured tube, and then were placed in an intensive care unit for 24 hours. Assessment of deglutition and an ENT examination were performed the day after surgery. Before surgery, two cases of vocal cord paralysis were noted. 111 patients (88.8%) presented with subjective disorders: problems such as sore throat, odynophagia, dysphagia, dysphagia with overspill and hoarseness were respectively noted in 55 (44%), 34 (27.2%), 32 (25.6%), 11 (8.8%) and 13 (10.4%) cases. Dyspnoea was found in 2 cases (1.6%). 117 patients (93.6%) presented postoperative anomalies which were found on the posterolateral pharyngeal wall, on the arytenoids and on posterior third of the vocal cords. Inflammatory and/or swollen lesions were slight, moderate, significant or very significant in respectively 22.4%, 22.4%, 15.2% and 1.6% of cases. Very significant circumferential swelling of the pharyngeal wall and of the arytenoids was responsible for two cases of respiratory distress, and the patients required reintubation and return to theatre. Severe pharyngeal lesion correlated with duration of surgery (r = 0.20; p < 0.05), with the number levels of fusion (r = 0.02; p < 0.02) and with the age of the patient (p < 0.02). Six patients presented problems of mobility of the vocal cords: 3 had a right vocal cord paresis which was temporary and 3 had paralysis, also on the right but which persisted. There were no other complications. It is concluded that (i) ENT complications are frequently found in postoperative cervical spine surgery using the anterior cervical approach, some of them being severe. An ENT examination must be performed before the procedure for legal reasons. It is also recommended in the postoperative period in the case of discomfort; (ii) patients need to be placed in an intensive care unit during for the first 24 hours (iii). This study needs to be attended over more patients (iv) comparison with a control group of patients having non cervical surgery and intubated in the same way is needed to differentiate lesions related to surgery or intubation.
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PMID:[A prospective study of ENT complication following surgery of the cervical spine by the anterior approach (preliminary results)]. 977 50

There are three clinical presentations of anthrax in humans: cutaneous (>95% of cases), orogastric and inhalational. The infectious form, the spore, enters the body and is thought to germinate within macrophages either at the site of inoculation (cutaneous or orogastric) or in the regional lymph node (inhalational). The bacillus then synthesizes its antiphagocytic capsule and the lethal and oedema toxins which interfere with the non-specific host defences leading to the characteristic locally destructive lesion and spread by lymphatics to the systemic circulation and other organs. The cutaneous form begins as a papule which progresses over several days to a vesicle and then ulcerates. There is often oedema, sometimes massive, probably due to the oedema toxin that surrounds the lesions which then develop a characteristic black eschar. The patient may be febrile with mild to severe systemic symptoms of malaise, headache and toxicity. Oropharyngeal anthrax presents with severe sore throat or an ulcer in the oropharyngeal cavity associated with neck swelling, fever, toxicity and dysphagia. Gastrointestinal anthrax begins with anorexia, nausea, vomiting and abdominal pain which may be similar to an acute abdomen. There may be diarrhoea and ascites, both of which may be haemorrhagic. Inhalational anthrax begins with non-specific symptoms of malaise, fever, myalgia and non-productive cough. After a period of 2-3 days, this is followed by a sudden onset of severe respiratory distress associated with diaphoresis, cyanosis and increased chest pain. There may be a widened mediastinum and pleural effusions on chest X-ray. Death follows in 24-36 h from respiratory failure, sepsis and shock. The diagnosis of anthrax is easy if it is considered. The organism is readily observed by Gram or Wright stain in local lesions or blood smear and can be easily cultured from the blood and other body fluids. However, because of its rarity, it is not often included in the differential diagnosis and in inhalational disease the diagnosis is rarely made until the patient is moribund. More rapid diagnostic tests are under development. Penicillin, combined with supportive care, remains the mainstay of treatment, although the organism is susceptible in vitro to many antibiotics. In recent years, there have been significant advances in our knowledge of the organism and its toxins and it is anticipated that similar progress will be made in the future in developing more rapid diagnostic tests and new modalities of treatment.
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PMID:Clinical aspects, diagnosis and treatment of anthrax 1047 74

Adult onset Still's disease (AOSD), the adult variant of the systemic form of the juvenile rheumatoid arthritis, is an uncommon disorder of unknown origin. Although the pathogenesis has not yet been clarified, an immunologically mediated inflammation occurs in active AOSD. High spiking fever, evanescent maculo-papular skin rash, arthralgias/arthritis, neutrophilic leukocytosis, negative rheumatoid factor and antinuclear antibodies, as well as a marked hyperferritinemia are the major features of AOSD. Sore throat, lymphadenopathies, hepato-splenomegaly, abdominal pain, polyserositis, respiratory distress syndrome, multiple organ dysfunction and disseminated intravascular coagulation may also occur. The clinical course of AOSD is extremely variable and unpredictable and can be divided into three main patterns: a self-limited or monocyclic pattern, a polycyclic or intermittent course, with one or more flares of the disease and complete remission among the episodes, and a chronic course, characterized by persistently active disease, usually due to a chronic, destructive arthritis. Since there are not pathognomonic laboratory parameters or histological findings, the diagnosis of AOSD requires the exclusion of infectious, malignant and autoimmune disorders. Some sets of criteria for classification have been proposed, but so far not validated. The prognosis of AOSD is usually considered relatively benign, although a destructive arthritis may cause severe disability and the multisystemic life-threatening complications of the disease may determine a fatal outcome. Treatment usually consists in nonsteroidal anti-inflammatory drugs and corticosteroids, but a more aggressive approach with disease modifying antirheumatic or immunosuppressive drugs may be required.
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PMID:[Adult onset Still's disease]. 1185 Jun 12


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