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Infectious Diseases Now Nov 2023Ear, nose and throat (ENT) or upper respiratory tract infections (URTI) are the most common infections in children and the leading causes of antibiotic prescriptions. In... (Review)
Review
Ear, nose and throat (ENT) or upper respiratory tract infections (URTI) are the most common infections in children and the leading causes of antibiotic prescriptions. In most cases, these infections are due to (or are triggered by) viruses and even when bacterial species are implicated, recovery is usually spontaneous. The first imperative is to refrain from prescribing antibiotics in a large number of URTIs: common cold, most cases of sore throat, laryngitis, congestive otitis, and otitis media with effusion. On the contrary, a decision to treat sore throats with antibiotics is based primarily on the positivity of the Group A Streptococcus (GAS) rapid antigen diagnostic tests. For ear infections, only (a) purulent acute otitis media in children under 2 years of age and (b) complicated or symptomatic forms of purulent acute otitis media (PAOM) in older children should be treated with antibiotics. Amoxicillin is the first-line treatment in the most cases of ambulatory ENT justifying antibiotics. Severe ENT infections (mastoiditis, epiglottitis, retro- and parapharyngeal abscesses, ethmoiditis) are therapeutic emergencies necessitating hospitalization and initial intravenous antibiotic therapy.
Topics: Child; Humans; Infant; Anti-Infective Agents; Pharyngitis; Respiratory Tract Infections; Anti-Bacterial Agents; Otitis Media
PubMed: 37730165
DOI: 10.1016/j.idnow.2023.104785 -
Vestnik Otorinolaringologii 2021A description of a clinical case of oligosymptomatic pharyngitis associated with Neisseria gonorrhoeae is presented. On the example of oligosymptomatic localized...
A description of a clinical case of oligosymptomatic pharyngitis associated with Neisseria gonorrhoeae is presented. On the example of oligosymptomatic localized gonococcal pharyngitis in a sexually active young man, included in the risk group for extragenital forms of sexually transmitted infections, an advantage has been shown molecular biological diagnostic method. Study of the spectrum of microflora of the oropharynx and urethra with assessment sensitivity to antibacterial drugs of representatives of the genus Neisseria isolated during mixed infection oropharynx, demonstrated that non-pathogenic Neisseria species are resistant to cephalosporins III-IV generations. Unrecognized forms of oropharyngeal gonococcal infection, as a consequence of the complications of clinical and diagnostic identification when patients refer to an otolaryngologist or dermatovenerologist, can serve a reservoir of resistant N. gonorrhoeae and a source of intractable gonococcal infection.
Topics: Anti-Bacterial Agents; Cephalosporins; Gonorrhea; Humans; Male; Neisseria gonorrhoeae; Pharyngitis
PubMed: 33929158
DOI: 10.17116/otorino20218602185 -
Emergency Medicine Clinics of North... Feb 2019This article reviews the presentation, diagnosis, and management of common and "can't miss" infections of the oropharynx, including streptococcal pharyngitis, infectious... (Review)
Review
This article reviews the presentation, diagnosis, and management of common and "can't miss" infections of the oropharynx, including streptococcal pharyngitis, infectious mononucleosis, peritonsillar abscess, retropharyngeal abscess, and epiglottitis.
Topics: Anti-Bacterial Agents; Emergencies; Epiglottitis; Humans; Infectious Mononucleosis; Mouth Diseases; Peritonsillar Abscess; Pharyngitis; Retropharyngeal Abscess; Streptococcal Infections
PubMed: 30454781
DOI: 10.1016/j.emc.2018.09.002 -
Cancer Gene Therapy Feb 2022The incidence rate of cancer is steadily increasing all around the world, and there is an urgent need to develop novel and more effective treatment strategies. Recently,... (Review)
Review
The incidence rate of cancer is steadily increasing all around the world, and there is an urgent need to develop novel and more effective treatment strategies. Recently, bacterial therapy has been investigated as a new approach to target cancer, and is becoming a serious option. Streptococcus strains are among the most common and well-studied virulent bacteria that cause a variety of human infections. Everyone has experienced a sore throat during their lifetime, or has been asymptomatically colonized by streptococci. The ability of Streptococcus bacteria to fight cancer was discovered more than 100 years ago, and over the years has undergone clinical trials, but the mechanism is not yet completely understood. Recently, several animal models and human clinical trials have been reported. Streptococcal strains can have an intrinsic anti-tumor activity, or can activate the host immune system to fight the tumor. Bacteria can selectively accumulate and proliferate in the hypoxic regions of solid tumors. Moreover, the bacteria can be genetically engineered to secrete toxins or enzymes that can specifically attack the tumors.
Topics: Animals; Humans; Incidence; Neoplasms; Pharyngitis; Streptococcal Infections; Streptococcus
PubMed: 33753868
DOI: 10.1038/s41417-021-00308-6 -
The New England Journal of Medicine Mar 2019
Topics: Child; Female; Fever; Humans; Pharyngitis; Pharynx; Streptococcal Infections; Streptococcus pyogenes
PubMed: 30855746
DOI: 10.1056/NEJMicm1810556 -
Immunity, Inflammation and Disease Dec 2022
Topics: Humans; Pharyngitis; Anti-Inflammatory Agents
PubMed: 36444626
DOI: 10.1002/iid3.738 -
European Journal of Pediatrics Oct 2014Controversy remains about the need for antibiotic therapy of group A streptococcal (GAS) pharyngitis in high-resource settings. Guidelines on the management of GAS... (Review)
Review
UNLABELLED
Controversy remains about the need for antibiotic therapy of group A streptococcal (GAS) pharyngitis in high-resource settings. Guidelines on the management of GAS pharyngitis differ considerably, especially in children. We performed a literature search on the diagnosis and treatment of GAS pharyngitis in children and compared different guidelines with current epidemiology and the available evidence on management. Some European guidelines only recommend antibiotic treatment in certain high-risk patients, while many other, including all American, still advise antimicrobial treatment for all children with GAS pharyngitis, given the severity and re-emerging incidence of complications. Empirical antimicrobial treatment in children with sore throat and a high clinical suspicion of GAS pharyngitis will still result in significant overtreatment of nonstreptococcal pharyngitis. This is costly and leads to emerging antibiotic resistance. Early differential diagnosis between viral and GAS pharyngitis, by means of a 'rapid antigen detection test' (RADT) and/or a throat culture, is therefore needed if 'pro treatment' guidelines are used.
CONCLUSION
Large scale randomized controlled trials are necessary to assess the value of antibiotics for GAS pharyngitis in high-resource countries, in order to achieve uniform and evidence-based guidelines. The severity and the possibly increasing incidence of complications in school-aged children suggests that testing and treating proven GAS pharyngitis can still be beneficial.
Topics: Anti-Bacterial Agents; Child; Humans; Pharyngitis; Practice Guidelines as Topic; Streptococcal Infections; Streptococcus pyogenes
PubMed: 25113742
DOI: 10.1007/s00431-014-2395-2 -
Emergency Medicine Journal : EMJ Jan 2022
Topics: Humans; Mouth; Pain; Pharyngitis
PubMed: 34933908
DOI: 10.1136/emermed-2020-210936 -
Emergency Medicine Clinics of North... Feb 2019Infection of the neck is a relatively common emergency department complaint. If not diagnosed and managed promptly, it may quickly progress to a life-threatening... (Review)
Review
Infection of the neck is a relatively common emergency department complaint. If not diagnosed and managed promptly, it may quickly progress to a life-threatening infection. These infections can result in true airway emergencies that may require fiberoptic or surgical airways. This article covers common, as well as rare but emergent, presentations and uses an evidence-based approach to discuss diagnostic and treatment modalities.
Topics: Emergencies; Epiglottitis; Humans; Infections; Lemierre Syndrome; Ludwig's Angina; Mediastinitis; Neck; Parotitis; Peritonsillar Abscess; Pharyngitis; Retropharyngeal Abscess
PubMed: 30454783
DOI: 10.1016/j.emc.2018.09.003 -
Pediatric Emergency Medicine Practice Dec 2017Although group A Streptococcus (GAS) pharyngitis is the most common cause of bacterial pharyngitis in children and adolescents, many viral and bacterial infections mimic... (Review)
Review
Although group A Streptococcus (GAS) pharyngitis is the most common cause of bacterial pharyngitis in children and adolescents, many viral and bacterial infections mimic the symptoms of GAS pharyngitis. Emergency clinicians must recognize the symptomatology of GAS pharyngitis and use appropriate means of diagnosis and treatment to promote good antibiotic stewardship. This issue reviews the signs and symptoms of GAS pharyngitis, as well as associated complications, and provides recommendations for appropriate treatment that focuses on reducing the severity and duration of symptoms, reducing the incidence of nonsuppurative complications, and reducing transmission.
Topics: Anti-Bacterial Agents; Child; Child, Preschool; Female; Humans; Male; Pharyngitis; Streptococcal Infections; Streptococcus pyogenes
PubMed: 29185672
DOI: No ID Found