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

Miliary tuberculosis associated with cutaneous lesion has been rarely reported. We report a case of miliary tuberculosis in whom the cutaneous lesion was confirmed as tuberculosis by skin biopsy and bacterial examination. A 46-year-old man was admitted because of cough, fever, sore throat and abnormal shadow on the chest X-ray. Physical examination revealed an emaciated man with two ulcerous lesions overlying yellowed crust on the chest wall and fine crackles on the left side of the lung. Laboratory workup revealed a white blood cell count of 10,000 with 15% lymphocytes and positive CRP. Chest X-ray film showed the infiltration with cavity formation in left upper lung field and nodular dissemination. His tuberculin reaction was negative on admission. Sputum, urine and secrete from cutaneous lesion were positive for the acid-fast bacilli and the culture grew Mycobacterium tuberculosis. Examination of the skin biopsy specimen and bone marrow aspiration showed Langhans giant cells around necrotic lesion; therefore the diagnosis of miliary tuberculosis was made. After an initiation of antituberculosis therapy with combined regimen composed of streptomycin (SM), isoniazid (INH), ethambutol (EB) and rifampicin (RFP), this patient improved significantly. Although the case report of miliary tuberculosis tends to increase recently, the report of cutaneous lesion is relatively rare in association with miliary tuberculosis. We discussed this subject with reference to the literatures.
Kekkaku 1990 Dec
PMID:[A case of miliary tuberculosis with cutaneous lesion]. 207 57

Sore throats are most commonly due to infections, many of which are viral and do not require specific treatment. Symptoms and signs of the common cold, influenza or croup, the occurrence of conjunctivitis in some adenoviral infections, generalised lymphadenopathy and splenomegaly in glandular fever or the presence of vesicles characteristic of herpangina (Coxsackie A virus) or of herpes simplex infection, occasionally enable a clinical diagnosis and avoid the need for antibiotic therapy. In the case of treatable conditions a typical membrane may suggest diphtheria, a scarlatiniform rash infection due to Streptococcus pyogenes or to Corynebacterium haemolyticum, and a cherry-red epiglottis Haemophilus influenzae type b. Associated atypical pneumonia suggests infection with Mycoplasma pneumoniae or Chlamydia pneumoniae. Pharyngitis due to Neisseria gonorrhoeae may be accompanied by infection at other sites or by other sexually transmitted diseases. Candidal infection, in the appropriate clinical circumstance, should suggest HIV infection. Surgical drainage is required in the case of peritonsillar or retropharyngeal abscess. Noninfectious cases of sore throat, e.g. thyroiditis, are relatively uncommon considerations in the differential diagnosis of acute febrile pharyngitis. The most common problem is to recognise streptococcal pharyngitis, which requires antibiotic treatment for 10 days to avoid the risk of rheumatic fever.
Drugs 1990 Dec
PMID:The sore throat. When to investigate and when to prescribe. 207

An increasing number of cases of sore throat caused by group A beta-hemolytic streptococci occur with concomitant colonization by organisms that may "protect" the streptococci through beta-lactamase inactivation of penicillin at the site of infection. The failure of penicillin to eradicate many of these bacteria, which include Staphylococcus aureus, Haemophilus influenzae, Moraxella (Branhamella) catarrhalis and a multitude of pharyngeal anaerobes, may help to explain why penicillin is sometimes ineffective for acute and recurrent group A streptococcal infections. Therapeutic alternatives currently include cephalosporins, erythromycin, rifampin combined with penicillin, amoxicillin/clavulanate potassium and others.
Am Fam Physician 1990 Dec
PMID:Controversies in the treatment of streptococcal pharyngitis. 224 47

The authors report an episode of mass psychogenic illness exacerbating respiratory symptoms in military recruits. The epidemic occurred over a 10- to 12-hour period in September 1988, in a group initially complaining of cough and pleuritic chest pain. More than 1,800 men were evacuated from their barracks because of a suspected toxic gaseous exposure. Approximately 1,000 recruits developed at least one new symptom, 375 were evacuated by ambulance to receive further medical evaluation, and at least eight were hospitalized. Air sample testing from the area was unremarkable, and there were few abnormal physical examination or laboratory findings. The epidemiologic investigation included a questionnaire administered 2 weeks after the epidemic to 1,000 of the recruits involved. A total of 55% of those who completed the questionnaire reported the onset of at least one new symptom after supper, with at least 25% reporting the new onset of cough, light-headedness, chest pain, shortness of breath, headache, sore throat, or dizziness. A total of 18% received further medical evaluation. The development of new symptoms and the receipt of further medical evaluation were associated with evidence of physical stress, mental stress, and awareness of rumors of odors, gases, and/or smoke. This epidemic was unique because of its size and its occurrence in an all-male population.
Am J Epidemiol 1990 Dec
PMID:An epidemic of respiratory complaints exacerbated by mass psychogenic illness in a military recruit population. 226 May 44

The dose-response (dose, 0.01, 0.05, 0.1, 0.5, 1, and 5 mg) profiles of 10 atopic and 10 nonatopic subjects were determined for nasal patency, secretion weight, pulmonary function, eustachian tube function, middle-ear function, and symptoms after intranasal inhalation challenges with histamine, bradykinin, methacholine, prostaglandin D2, and prostaglandin F2 alpha (PGF2 alpha). Results demonstrated that challenge with PGF2 alpha increased nasal patency, whereas challenge with all other substances decreased patency. The relationship between substances in eliciting a nasal congestive response was prostaglandin D2 greater than histamine greater than bradykinin greater than methacholine. A similar effect ordering was noted for the postchallenge development of eustachian tube dysfunction. Secretion weights were significantly greater after challenge with histamine compared to all other substances. A decrease in pulmonary function was observed only after challenge with PGF2 alpha, although the effect was not statistically significant. No changes in middle-ear pressure were observed for challenges with any of the substances. Only histamine challenge provoked sneezing, whereas challenge with either of the prostaglandins provoked cough. With the exception of methacholine, all substances caused symptoms of rhinorrhea, congestion, and sore throat. Bradykinin was particularly effective in provoking "pain/pressure"-related symptoms. With the exception of secretion weight, the differences between responses of atopic and nonatopic subjects were not statistically significant. These results document mediator specificity in the physiologic and symptomatic responses to intranasal challenge.
J Allergy Clin Immunol 1990 Dec
PMID:Physiologic responses to intranasal dose-response challenges with histamine, methacholine, bradykinin, and prostaglandin in adult volunteers with and without nasal allergy. 226 47

Seven males and nine females with glossopharyngeal neuralgia were treated by microvascular decompression (MVD) over a 4-year period. Their ages ranged from 40 to 72 years (average, 54.7 years). The duration of pain ranged from 2 months to 13 years, and all except one patient had brief attacks of lancinating pain in the throat and/or ear. One patient reported dull, paroxysmal throat pain. At surgery, vascular compression of the 9th and 10th nerves at the root entry-exit zone was observed in all cases. The offending vessels were the posterior inferior cerebellar artery (PICA) in 11 cases, the PICA and the anterior inferior cerebellar artery (AICA) in two, the PICA and vertebral artery (VA), and AICA and VA in one case each. The patient with atypical pain had compression by a large vein. In 15 cases of arterial compression, the pain completely disappeared after MVD, and there was no recurrence during the follow-up period, which ranged from 1 month to 4 years. One patient with venous compression had significant pain relief, although mild throat pain persists. In one case, postoperative complications included transient 6th, 7th, and 10th nerve palsies and sensory disturbance, which were assumed to be due to disturbance of the circulation in the perforating branches from the compressing artery. The experience with these 16 patients indicates that vascular compression is the etiology of glossopharyngeal neuralgia and that MVD provides excellent results.
Neurol Med Chir (Tokyo) 1989 Dec
PMID:[Results of microvascular decompression in 16 cases of glossopharyngeal neuralgia]. 248 90

For many individuals undergoing routine surgical procedures, their satisfaction with the operation may depend upon their postoperative experience. We used the McGill Pain Questionnaire and the McGill Nausea Questionnaire to study the intensity of 5 common postoperative problems--sore throat, muscle pain, headache, backache, and nausea. We found that the questionnaires were able to determine the intensity of the postoperative problem but due to time pressures, a shorter version would be needed to study large numbers of patients. Using a discriminant analysis, we found that the 25 most frequently chosen words were able to distinguish between the 4 pain-related problems. As well the Present Pain Intensity (PPI) correlated highly with the standard form word choices and appeared to be measuring the same dimension of intensity for these complaints.
Pain 1989 Dec
PMID:Using the McGill Pain Questionnaire to study common postoperative complications. 253 40

A prospective study of patients with fever and petechiae was performed. Of 190 patients enrolled in the 1-year study, 13 (7%) had meningococcal disease. The most common bacterial association was Streptococcus pyogenes (19 patients). Viral infections were documented in 28 patients. Patients with invasive bacterial disease (group I) appeared more sick, were more likely to have signs of meningeal irritation, and were more likely to have petechiae on the lower extremities than those with less serious, nonbacteremic disease (group II). No patient in group I had petechiae only above the nipple line. Patients in group I had a significantly higher peripheral white blood cell count and absolute band form count. Although no laboratory test or physical finding was sufficiently sensitive to detect all patients with serious disease, the patient with abnormal cerebrospinal fluid, elevated white blood cell count, or elevated absolute band form count was at increased risk for invasive, bacterial disease. Conversely, the risk of serious disease was small if all of these values were in the normal range in the nonill-appearing child or if sore throat and clinical pharyngitis were present in the patient older than 3 years of age.
Pediatrics 1989 Dec
PMID:Fever and petechiae in children. 223 43

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.
Dig Dis Sci 1989 Dec
PMID:Evaluation of gastroesophageal reflux as a cause of idiopathic hoarseness. 259 57

Eighty-nine of 150 patients having a Monospot test filled out a questionnaire about their illness, and the General Health Questionnaire. They completed a follow-up questionnaire 6 months later. Twelve (8%) had a positive Monospot. Twenty-eight of 83 serum samples tested (34%) were positive for VP1 enteroviral antigen. Forty of the patients had a self limiting illness, 13 had a definite diagnosis (excepting glandular fever), 14 had a possible postviral syndrome, 10 had recurrent sore throats/flu, and 12 had a chronic non-specific illness. Patients with a specific diagnosis were less likely to complain of aching muscles/joints, sore throat, tiredness or loss of concentration. Their GHQ scores were lower, although this just failed to reach significance (P = 0.08), and they scored significantly lower on the somatic symptoms subscale (P = 0.022). Overall 72% scored above the GHQ threshold for 'psychological caseness' which is higher than in other studies. Sixty-five per cent of the sample questioned at 6 months felt that their illness started with a viral infection. The methodological problems involved in making a diagnosis of postviral syndrome are discussed.
J R Soc Med 1989 Dec
PMID:Postviral syndrome--how can a diagnosis be made? A study of patients undergoing a Monospot test. 239 56


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