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Journal of Clinical Anesthesia Sep 2024Periodic fever syndromes are autoinflammatory disorders associated with recurrent fevers unrelated to infection. Little is known about the perioperative management of... (Review)
Review
Periodic fever syndromes are autoinflammatory disorders associated with recurrent fevers unrelated to infection. Little is known about the perioperative management of patients with these syndromes, and existing literature consists primarily of case reports and occasional case series. This narrative review discusses background information and diagnostic criteria for the three most common periodic fever syndromes: periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA), familial Mediterranean fever (FMF), and TNF receptor-associated periodic syndrome (TRAPS), and describes perioperative considerations for anesthesia providers when caring for the patient with a periodic fever syndrome. We include a systems-based framework in which to organize these considerations.
Topics: Humans; Perioperative Care; Hereditary Autoinflammatory Diseases; Anesthesia; Fever; Familial Mediterranean Fever; Pharyngitis
PubMed: 38728932
DOI: 10.1016/j.jclinane.2024.111497 -
BMC Pediatrics Feb 2018Group A streptococcus (GAS) is the most common bacterial etiology of pharyngitis but is difficult to distinguish clinically from viral pharyngitis. There are benefits to...
BACKGROUND
Group A streptococcus (GAS) is the most common bacterial etiology of pharyngitis but is difficult to distinguish clinically from viral pharyngitis. There are benefits to early antibacterial treatment of GAS pharyngitis, but administering antibiotics to children with viral pharyngitis is ineffective and costly. We evaluated adherence to guidelines that were developed to help clinicians distinguish between viral and GAS pharyngitis and guide management.
METHODS
Retrospective cohort study of patients ages 3-18 who had a rapid streptococcal test and/or throat culture performed in an outpatient setting. We collected data on documentation of components of the McIsaac score and classified tests as indicated if the score was ≥2. Based on McIsaac score and GAS test results, we determined whether each antibiotic course prescribed was indicated according to the Infectious Diseases Society of America guideline.
RESULTS
Among 291 eligible children, 87 (30%) had all five components of the McIsaac score documented. There was sufficient data to classify the score as either < 2 or ≥2 in 234 (80%); among these, 96% of tests were indicated. Twenty-nine patients (10%) were prescribed antibiotics. Eight (28%) of these prescriptions were not indicated according to guidelines.
CONCLUSIONS
The majority of GAS tests in children with pharyngitis are indicated, although providers do not regularly document all elements of a validated pharyngitis scoring tool. Over one quarter of children prescribed antibiotics for pharyngitis did not require antibiotics according to guidelines. There remains a role for targeted antimicrobial stewardship education regarding pharyngitis management in pediatric outpatient settings.
Topics: Adolescent; Anti-Bacterial Agents; Child; Child, Preschool; Diagnosis, Differential; Female; Guideline Adherence; Humans; Male; Pharyngitis; Practice Guidelines as Topic; Retrospective Studies; Streptococcal Infections; Virus Diseases
PubMed: 29426305
DOI: 10.1186/s12887-018-0988-z -
BMC Anesthesiology Oct 2023Postoperative sore throat and sleep disturbance are prevalent among patients undergoing spinal surgery, and these conditions can substantially impact their postoperative... (Randomized Controlled Trial)
Randomized Controlled Trial
Effects of ultrasound-guided stellate ganglion block on postoperative sore throat and postoperative sleep disturbance after lumbar spine surgery: a randomized controlled trial.
BACKGROUND
Postoperative sore throat and sleep disturbance are prevalent among patients undergoing spinal surgery, and these conditions can substantially impact their postoperative satisfaction and quality of life. The present study aimed to examine the impact of ultrasound-guided stellate ganglion block (SGB) on the occurrence of postoperative sore throat (POST) and postoperative sleep disturbance (PSD) in patients who undergo lumbar spine surgery under general anesthesia.
METHODS
Sixty patients were randomly assigned to either the experimental group (SGB group) or the control group (CG). Both groups received the same induction and maintenance drugs. However, the SGB group received a right SGB under ultrasound guidance 15 min before anesthesia induction, while the CG did not receive any block anesthesia intervention before anesthesia induction. We monitored the incidence and severity of POST at 1, 6, 24, and 48 h after surgery in both groups. Additionally, we evaluated the deep sleep quality score on the first, second, and fifth days after surgery in both groups.
RESULTS
The incidence of POST at 1 h and 6 h after surgery was significantly lower in the SGB group (10.0% and 13.3%) than in the CG (43.3% and 36.7%) (P < 0.05). The postoperative sore throat scores of the SGB group (0.10 ± 0.31 and 0.17 ± 0.46) at 1 h and 6 h after surgery were lower than those of the CG (0.57 ± 0.73 and 0.50 ± 0.77) (P < 0.05). Moreover, the deep sleep quality score on the first, second, and fifth days after surgery were significantly higher in the CG (5.40 ± 3.37, 4.70 ± 3.19, 4.53 ± 3.44) than in the SGB group (3.87 ± 2.30, 3.13 ± 1.77, 3.03 ± 1.84) (P < 0.05).
CONCLUSION
Ultrasound-guided SGB can reduce the incidence and severity of POST and improve PSD in patients undergoing lumbar spine surgery.
TRIAL REGISTRATION
This study was registered on Chinese Clinical Trial Registry, (ChiCTR2200065279) on 01/11/2022.
Topics: Humans; Stellate Ganglion; Quality of Life; Pain; Pharyngitis; Ultrasonography, Interventional; Sleep
PubMed: 37838663
DOI: 10.1186/s12871-023-02301-y -
Advanced Emergency Nursing JournalA 9-year old male presented to the emergency department for the evaluation of a sore throat. Initial history of present illness stated in the triage note was that "the...
A 9-year old male presented to the emergency department for the evaluation of a sore throat. Initial history of present illness stated in the triage note was that "the child complained of a sore throat," suggesting possible pharyngitis. There was no evidence of stridor, sialorrhea, hypoxia, or aphonia. Further investigation of the history of present illness identified the concern for a possible esophageal foreign body. Imaging studies of the neck identified a fishbone in the esophagus. This case presentation discusses an atypical presentation of an esophageal foreign body and the subtle findings on assessment and imaging. This case highlights the importance of illiciting a history of present illness and the subtleties of esophageal foreign body identification.
Topics: Animals; Bone and Bones; Child; Diagnosis, Differential; Emergency Service, Hospital; Esophagoscopy; Fishes; Foreign Bodies; Humans; Male; Pharyngitis
PubMed: 34397496
DOI: 10.1097/TME.0000000000000362 -
The New England Journal of Medicine Mar 2021
Topics: Child, Preschool; Color; Female; Humans; Pharyngitis; Streptococcal Infections; Streptococcus pyogenes; Tongue
PubMed: 33761210
DOI: 10.1056/NEJMicm2026930 -
Ear, Nose, & Throat Journal Dec 2020
Topics: Acute Disease; Adolescent; Diagnosis, Differential; Humans; Male; Medical Illustration; Peritonsillar Abscess; Pharyngitis; Streptococcal Infections; Streptococcus
PubMed: 31309845
DOI: 10.1177/0145561319858927 -
The Journal of Emergency Medicine Feb 2023The emerging 2022 human mpox virus outbreak has presented with unique disease manifestations challenging prior case definitions.
BACKGROUND
The emerging 2022 human mpox virus outbreak has presented with unique disease manifestations challenging prior case definitions.
CASE REPORT
We present a case of a 42-year-old transgender woman with human immunodeficiency virus controlled on antiretroviral therapy, presenting with sore throat, who, after three emergency department visits, was found to have acute tonsillitis complicated by airway obstruction secondary to mpox. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Sore throat is a common presentation to the emergency department. mpox should be placed on the list of differential diagnoses when evaluating patients who present with pharyngitis to avoid complications or a missed diagnosis.
Topics: Female; Humans; Adult; Tonsillitis; Mpox (monkeypox); Peritonsillar Abscess; Pharyngitis; Diagnosis, Differential
PubMed: 36822985
DOI: 10.1016/j.jemermed.2022.12.029 -
BMC Infectious Diseases Aug 2016Burden of Group A streptococcus (GAS) pharyngitis is scarce in developing countries, still unknown in China. The objective of this study was to determine the incidence...
BACKGROUND
Burden of Group A streptococcus (GAS) pharyngitis is scarce in developing countries, still unknown in China. The objective of this study was to determine the incidence of clinical cases of pharyngitis and GAS culture-positive pharyngitis, and their outpatient visits among children aged 0-14 years in Beijing, the capital of China.
METHODS
Multiplier model was used to estimate the numbers of pharyngitis cases, based on reported numbers of clinical cases and GAS culture-positive rates from GAS surveillances in Beijing, consultation rate, population coverage of GAS surveillances, sampling success rate, and test sensitivity of GAS culture from previous studies, surveys and surveillances.
RESULTS
An average of 29804.6 (95 % CI: 28333.2-31276.0) clinical cases of pharyngitis per 100,000 person-years occurred among children aged 0-14 years, resulting in correspondingly 19519.0 (95 % CI: 18516.7-20521.2) outpatient visits per 100,000 person-years from 2012 to 2014 in Beijing. On average, there were 2685.1 (95 % CI: 2039.6-3330.6) GAS culture-positive cases of pharyngitis and 1652.7 (95 % CI: 1256.5-2049.0) outpatient visits per 100,000 person-years during the same period. The estimated burden of GAS pharyngitis was significantly higher than that of scarlet fever. Children aged 5-14 years had a higher burden of GAS pharyngitis than those aged 0-4 years.
CONCLUSIONS
The present data suggests that GAS pharyngitis is very common in children in China. Further studies and surveillances are needed to monitor trends and the effectiveness of control measures.
Topics: Adolescent; Beijing; Child; Child, Preschool; China; Female; Humans; Incidence; Infant; Infant, Newborn; Male; Pharyngitis; Streptococcal Infections; Streptococcus pyogenes
PubMed: 27566251
DOI: 10.1186/s12879-016-1775-9 -
Annals of Internal Medicine Jun 2015
Topics: Female; Fusobacterium Infections; Humans; Male; Pharyngitis; Pneumonia, Mycoplasma; Streptococcal Infections
PubMed: 26075767
DOI: 10.7326/L15-5099-2 -
Annals of Internal Medicine Jun 2015
Topics: Female; Fusobacterium Infections; Humans; Male; Pharyngitis; Pneumonia, Mycoplasma; Streptococcal Infections
PubMed: 26075766
DOI: 10.7326/L15-5099