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Query: UMLS:C0348321 (Haemophilus)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

So far, no ideal study providing an exhaustive knowledge of acute pharyngitis epidemiology has been carried out. What is available now is a number of investigations, all with deficiencies, which concern the duration of the disease (there may be seasonal variations), its limits in space and, above all, the number of pathogens sought for. A well-organized investigation span over at least one year, involve a fairly wide range of age-groups and be repeated in several countries. Bacterial epidemiology is dominated by beta-haemolytic streptococci group A, but other streptococcal groups, notably group C, have been incriminated. Other responsible bacteria, such as Haemophilus spp., Staphylococcus spp. and Corynebacterium spp., are extremely rare but most probable. Mycoplasma pneumoniae and perhaps Chlamydia pneumoniae are probably found more frequently. Rheumatic fever--which had virtually disappeared in medically advanced countries due to a higher level of life and to the general use of penicillin therapy--has reappeared in recent years, as shown by a few North-American epidemics. Such epidemics have come on time to remind us that we should be vigilant and continue, as in the past, to treat all streptococcal foci systematically, in order to prevent the occurrence of rheumatic fever.
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PMID:[Current status on the epidemiology of acute pharyngitis and post-streptococcal syndromes]. 157 15

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.
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PMID:The sore throat. When to investigate and when to prescribe. 207

Sore throat can be caused by different microorganisms and diseases. Most cases of acute pharyngitis are caused by group A streptococcus or viruses; however, uncommon organisms may be suggested by other clinical information or the persistence of symptoms. A thorough history and physical examination are essential for the appropriate selection of diagnostic tests for sore throat. Routine testing for the uncomplicated case should consist of a pharyngeal culture in most patients, with rapid streptococcal antigen testing only for the more severe cases. Those with positive streptococcal tests should be treated to prevent rheumatic fever and mitigate symptoms in severe cases. Sore throat caused by viruses usually resolves spontaneously. Cases that persist should be thoroughly re-evaluated, with alternative causes being considered. Acute epiglottitis is a medical emergency and requires treatment with appropriate antibiotics for Hemophilus influenzae type b and intubation.
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PMID:The sore throat. Pharyngitis and epiglottitis. 307 5

In the field of infectious diseases, the emergence of new pathogens or old diseases in newly recognized forms; changing virulence of pathogens; changing patterns of antimicrobial susceptibility; new diagnostic techniques, drugs or vaccines; changing concepts of chemoprophylaxis; controversies about medical vs. surgical techniques; and the challenge of care of children with infectious diseases within new guidelines of managed care are recently identified areas of change. The increased resistance of Streptococcus pneumoniae to many commonly used antimicrobials and the increased proportion of beta-lactamase-producing nontypable Haemophilus influenzae and Moraxella catarrhalis concern many practitioners. The decreased antibiotic susceptibility of S. pneumoniae is a relatively new phenomenon in the United States. Optimal therapy for mild, moderate or severe pneumococcal disease is dependent on current local susceptibility patterns. Group A streptococci are uniformly susceptible to readily achieved concentrations of all penicillins and cephalosporins. However, recent clusters of cases of rheumatic fever, increased recognition of toxic shock syndrome and bacteremic and localized severe pneumococcal disease have increased concern about the changing ecology of the Streptococcus and the implications for therapy. Finally recognition that many children with acute bacterial otitis media have resolution of disease without use of antimicrobial agents has led to more rigorous study designs for evaluating new drugs.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Antimicrobial therapy issues facing pediatricians. 763 30

Recurrent group A beta-hemolytic streptococcus (GABHS) pharyngotonsillitis related to penicillin failure presents a serious clinical problem. Failure to eradicate streptococci from patients can occasionally lead to rheumatic fever and rarely to glomerulonephritis. beta-lactamase-producing strains of aerobic and anaerobic bacteria in inflamed tonsils have been associated with increased failure rates of penicillins in the eradication of these infections. These organisms include Staphylococcus aureus, Haemophilus influenzae and H parainfluenzae, Moraxella catarrhalis, Fusobacterium sp, and pigmented Prevotella and Porphyromonas spp. The indirect pathogenicity of these organisms is apparent in their ability not only to survive penicillin therapy but also to protect penicillin-susceptible pathogens from that drug. These organisms have demonstrated the ability to protect GABHS in vitro and in vivo from penicillin. Numerous reports have described the successful therapy of recurrent GABHS tonsillitis with antimicrobials directed at both GABHS and the beta-lactamase-producing organisms.
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PMID:Penicillin failure and copathogenicity in streptococcal pharyngotonsillitis. 830 10

Erythromycin and other macrolides have enjoyed a renaissance in the 1970s, 1980s and 1990s secondary to the discovery of "new' pathogens such as Chlamydia, Legionella, Campylobacter and Mycoplasma spp. Erythromycin is an important therapeutic agent in the paediatric age group for several reasons: (a) it exhibits proven efficacy for a wide range of infections (upper and lower respiratory tract infections, skin/skin structure infections, prophylaxis of endocarditis/acute rheumatic fever/ophthalmia neonatorum and pre-colonic surgery, campylobacteriosis, chlamydial and ureaplasmal infections, diphtheria, whooping cough, streptococcal pharyngitis) and gastrointestinal (GI) dysmotility states; (b) intravenous formulations are widely available; and (c) it is available in a number of formulations as a generic product, which is likely to result in significant cost savings. Nevertheless, erythromycin and similar earlier macrolides are characterised by a number of drawbacks including a narrow spectrum of antimicrobial activity, unfavourable pharmacokinetic properties and poor GI tolerability. Newer macrolides such as clarithromycin and azithromycin are useful in serving the needs of paediatric patients who are erythromycin-intolerant or who have infections caused by organisms that are intrinsically erythromycin-resistant, or for which a high percentage of strains are resistant (e.g. Haemophilus influenzae, Helicobacter pylori, Mycobacterium avium complex). In addition, these newer macrolides may be considered as alternatives to oral amoxicillin-clavulanic acid, second or third generation cephalosporins, or erythromycin plus sulphonamide in this patient population. Selection between specific macrolides and between macrolides and other antibiotics in the paediatric population is likely to depend, at least for the immediate future, on separate comparisons of product availability, cost, effectiveness and tolerability profiles.
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PMID:Macrolide antibiotics in paediatric infectious diseases. 870 92

Antimicrobials are frequently used to prevent infections. Principles of prophylaxis, and antimicrobial prophylaxis in surgery, tuberculosis, acquired immunodeficiency syndrome, influenza A, traveller's diarrhoea, malaria, recurrent otitis media, Haemophilus influenzae type b infection, pertussis, rheumatic fever, and urinary tract infection are described. Various strategies to improve the prophylactic use of antibiotics are discussed. Collaborative efforts among health care disciplines are needed to assure optimal antimicrobial prophylaxis. This should maximize efficacy and minimize adverse effects, the development of bacterial resistance and associated costs.
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PMID:Guidelines for antimicrobial prophylaxis. 893

Erythromycin, the prototypical macrolide, has been widely used since the 1950s in the management of pediatric infections. Erythromycin is the drug of choice for infants and children with Legionnaire's disease, pertussis, diphtheria, lower respiratory tract infections caused by Mycoplasma pneumoniae, Chlamydia pneumoniae and Chlamydia trachomatis and enteritis caused by Campylobacter jejuni. It is also indicated for treatment of syphilis; for streptococcal, staphylococcal and pneumococcal infections; genital infections caused by Ureaplasma urealyticum; and for the prevention of rheumatic fever and endocarditis in patients who are allergic to beta-lactam antibiotics. The new macrolides azithromycin and clarithromycin are also active against Borrelia burgdorferi, Helicobacter pylori, Mycobacterium avium-intracellulare complex, Cryptosporidium spp. and Toxoplasma gondii. Erythromycin is associated with a low risk of serious side effects, although gastric distress occurs in a significant proportion of patients. Drug interactions with theophylline, carbamazepine, warfarin, cyclosporine, terfenadine and digoxin limit erythromycin use. The newer macrolides azithromycin and clarithromycin are more stable, better absorbed and better tolerated than erythromycin. Azithromycin is more active than erythromycin against Haemophilus influenzae. Excellent tissue and intracellular penetration may contribute to their clinical efficacy. In children both azithromycin and clarithromycin are indicated for acute otitis media caused by Streptococcus pneumoniae, H. influenzae and Moraxella catarrhalis and for pharyngitis/tonsillitis caused by Streptococcus pyogenes. (As of December, 1996, azithromycin for oral suspension was approved for community-acquired pneumonia in children caused by C. pneumoniae, H. influenzae, M. pneumoniae and S. pneumoniae.) Claritromycin is also indicated for acute maxillary sinusitis, uncomplicated skin and skin structure infections, pneumonia and disseminated mycobacterial infections. Azithromycin and clarithromycin are associated with a lower incidence of gastrointestinal side effects, a low rate of drug discontinuation caused by side effects and a low potential for interaction with other drugs.
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PMID:History of macrolide use in pediatrics. 910 54

Risk factors, etiology, and outcome of 180 cases of infective endocarditis (IE) in the Slovak Republic for 5 years were prospectively studied in a national survey. According to the Duke Endocarditis Service Criteria (1994), 169 cases were considered definitive and 21 possible/probable. The aortic valve was infected in 46.7%, mitral in 47.2%, and tricuspidal/pulmonary in 6.1% of cases. The majority of endocarditis cases was caused by Staphylococcus aureus and coagulase-negative staphylococci (CNS) (33.3%); only 12.2% were due to viridans streptococci; 11.7% were due to Enterococcus faecalis; 6.1% due to Haemophilus spp.; 10.1% due to other organisms; and 26.7% were culture negative. Single positive cultures of CNS were not considered clinically significant. More than 25% of 180 patients were older than 60 years. Rheumatic fever was a risk factor in 35.5%, dental surgery in 20.5%, prior cardiosurgery in 7.8%, and neoplasia in 6.7%. All patients were treated with antimicrobials (average length of therapy was 29.5 days) and 33.3% of patients also had surgery (valvular prosthesis replacement). Forty (22.2%) died, and 140 (77.8%) survived at day 60 after the diagnosis of endocarditis was made. All 40 deaths were attributable to infection. Univariate analysis comparing deaths and survivors did not show significant differences in most of the recorded risk factors between both groups, except age > 60 (40.0% versus 21.4%, p < 0.05), staphylococcal etiology (55.0% versus 27.1%, p < 0.04), and antibiotic therapy < 21 days (without surgery) (65.0% versus 3.6%, p < 0.01). These risk factors were significantly more frequently associated with deaths. Viridans streptococcal IE and surgical therapy in addition to antibiotics were associated with lower mortality in comparison to staphylococcal endocarditis (p < 0.045) or to cases treated with antibiotics only (p < 0.05). In comparison to other nationally based surveys in Europe (Greece, Croatia, France), the percentage of culture-negative endocarditis and spectrum of pathogens differed significantly.
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PMID:Etiology and risk factors of 180 cases of native valve endocarditis. Report from a 5-year national prospective survey in Slovak Republic. 963 34

The authors studied the etiology, outcome and risk factors of 339 cases of infective endocarditis (IE) in Slovakia over the last 10 years. Aortic valve was infected in 59.9%, mitral in 38.1% and tricuspidal/pulmonary in 5.0% of cases. The majority of IE were caused by staphylococci (29.2%), 15.0% were due to viridans streptococci, 7.4% due to Enterococcus faecalis, 3.9% due to the HACEK group (Haemophilus spp., Actinobacillus spp., Corynebacterium spp., Eikenella spp., Kingella spp.) and 39.2% were culture negative. The following risk factors were the most frequently identified: rheumatic fever in 24.2%, dental surgery in 13.3%, previous cardiosurgery in 7.1% and neoplasia in 7.1%. All patients were treated with antimicrobials and 42.5% of patients also with surgery (valvular prosthesis replacement): 61 (18.0%) died, and 278 (82.0%) survived at day 60 after the diagnosis of endocarditis was made. Univariate analysis did not show significant differences in most of the recorded risk factors between patients who died and those who survived: apart from staphylococcal etiology (44.3% vs. 26.6%, P < 0.01), persistent bacteremia (with three or more positive blood cultures 24.6% vs. 9.7% P < 0.002) which were significantly associated with higher attributable mortality, as was absence of surgery (55.7% vs. 6.1% P < 0.001), whereas antibiotic therapy in combination with surgery significantly predicted better outcome (P < 0.001). We compared risk factors, etiology, therapeutic strategies and outcome of IE in two periods: from 1991-1997 (180 cases) and from 1998-2001 (159 cases). Rheumatic fever was less commonly observed in second period (1998-2001) P < 0.01 since its prevalence in Slovakia is rapidly decreasing. Dental surgery was less frequent as well (20.5% vs. 5.0% P < 0.001). There was a significant shift in etiology within the second study period: negative-culture endocarditis (despite better bacteriological techniques) (P < 0.001) was more frequently observed in the 1st period and represented 53.3% of all cases in 1998-2001 in comparison to 26.7% in 1991-1997. Enterococci (P < 0.0002) were also more frequent in the 2nd period. Persistent bacteremia (3 or more positive blood cultures 20.5% vs. 3.1%, P < 0.001 was less commonly observed within the 2nd period (1998-2001) in comparison to 1991-1997. More patients in the second period (1998-2001) had complications of IE (P < 0.001) than in the 1st period. However mortality was lower (22.2% vs. 13.2%, P < 0.044) because of more surgical intervention in the 2nd period (52.8% vs. 33.3%, P < 0.001).
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PMID:Etiology and risk factors of 339 cases of infective endocarditis: report from a 10-year national prospective survey in the Slovak Republic. 1499 84


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