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The Journal of Allergy and Clinical... Jun 2023Children and adults with autoinflammatory disorders, who often experience recurrent fevers, rashes, cold-induced symptoms, conjunctivitis, lymphadenopathy, recurrent...
Children and adults with autoinflammatory disorders, who often experience recurrent fevers, rashes, cold-induced symptoms, conjunctivitis, lymphadenopathy, recurrent infections, aphthous stomatitis, and abnormal blood cell counts, may present to the allergist/immunologist because the symptoms mimic allergies and disorders of immunity. In recent years, there has been increased recognition of non-monogenic autoinflammatory disorders, including periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome and syndrome of undifferentiated recurrent fevers. For many clinical practitioners, the natural history, diagnostic criteria, differential diagnoses, and preferred therapies remain challenging because of the presumed rarity of patients and the evolving field of autoinflammation. Here, we aim to provide a practical framework for the clinical allergist/immunologist to evaluate and treat this patient population.
Topics: Humans; Child; Adult; Stomatitis, Aphthous; Lymphadenitis; Pharyngitis; Fever; Lymphadenopathy; Nasopharyngitis; Syndrome
PubMed: 36958521
DOI: 10.1016/j.jaip.2023.03.014 -
Journal of General Internal Medicine Oct 2014
Topics: Anti-Bacterial Agents; Humans; Lemierre Syndrome; Male; Pharyngitis; Young Adult
PubMed: 24841558
DOI: 10.1007/s11606-014-2879-9 -
Cutis Feb 2016Guttate psoriasis (GP) typically occurs following an acute infection such as streptococcal pharyngitis. It is thought to have a better prognosis than chronic plaque...
Guttate psoriasis (GP) typically occurs following an acute infection such as streptococcal pharyngitis. It is thought to have a better prognosis than chronic plaque psoriasis (PP). This retrospective cohort study of 79 patients with GP aims to assess the likelihood of developing PP after the first episode of GP as well as compare clinical and laboratory data in patients with GP who do and do not develop PP.
Topics: Adult; Cohort Studies; Female; Follow-Up Studies; Humans; Male; Pharyngitis; Prognosis; Psoriasis; Retrospective Studies; Streptococcal Infections
PubMed: 26919501
DOI: No ID Found -
The Cochrane Database of Systematic... Jul 2015Antibiotics are sometimes used to prevent recurrent sore throat, despite concern about resistance. However, there is conflicting primary evidence regarding their... (Review)
Review
BACKGROUND
Antibiotics are sometimes used to prevent recurrent sore throat, despite concern about resistance. However, there is conflicting primary evidence regarding their effectiveness.
OBJECTIVES
To assess the effects of antibiotics in patients with recurrent sore throat.
SEARCH METHODS
The Cochrane Ear, Nose and Throat Disorders Group (CENTDG) Trials Search Co-ordinator searched the CENTDG Trials Register; Central Register of Controlled Trials (CENTRAL 2015, Issue 5); PubMed; EMBASE; CINAHL; Web of Science; Clinicaltrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 25 June 2015.
SELECTION CRITERIA
Randomised controlled trials (RCTs) of antibiotics in adults and children suffering from pre-existing recurrent sore throat, defined as three or more sore throats in a year, examining the incidence of sore throat recurrence, with follow-up of at least 12 months post-antibiotic therapy.
DATA COLLECTION AND ANALYSIS
Two authors independently assessed trial quality and extracted data. Multiple attempts to contact the authors of one study yielded no response.
MAIN RESULTS
We identified no trials that met the inclusion criteria for the review. We discarded the majority of the references retrieved from our search following screening of the title and abstract. We formally excluded four studies following review of the full-text report.
AUTHORS' CONCLUSIONS
There is insufficient evidence to determine the effectiveness of antibiotics for preventing recurrent sore throat. This finding must be balanced against the known adverse effects and cost of antibiotic therapy, when considering antibiotics for this purpose. There is a need for high quality RCTs that compare the effects of antibiotics versus placebo in adults and children with pre-existing recurrent sore throat on the following outcomes: incidence of sore throat recurrence, adverse effects, days off work and absence from school, and the incidence of complications. Future studies should be conducted and reported according to the CONSORT statement.
Topics: Adult; Anti-Bacterial Agents; Child; Humans; Pharyngitis; Recurrence; Secondary Prevention
PubMed: 26171901
DOI: 10.1002/14651858.CD008911.pub2 -
The American Surgeon Jan 2023
Topics: Humans; Pharyngitis; Streptococcal Infections; Peritonitis; Streptococcus pyogenes; Sensitivity and Specificity
PubMed: 33131280
DOI: 10.1177/0003134820951497 -
Pediatric Annals Jun 2024The purpose of this review is to summarize the current evidence regarding the management of streptococcal pharyngitis in children. This article aims to provide a valid... (Review)
Review
The purpose of this review is to summarize the current evidence regarding the management of streptococcal pharyngitis in children. This article aims to provide a valid support to discriminate streptococcal pharyngitis from viral cases and treat it appropriately to avoid the development of complications. Differential diagnosis based only on clinical features is not always easy. For this reason, different clinical scores were created to provide an accurate diagnosis. Microbiological tests are valuable tools as well, but their use is not recommended unanimously. Concerning treatment, all guidelines agree on the drug to be used. However, doubts remain about the optimal duration of antibiotic therapy, especially in this specific historical moment as we are experiencing a peak in streptococcal infections. .
Topics: Humans; Pharyngitis; Streptococcal Infections; Child; Anti-Bacterial Agents; Streptococcus pyogenes; Diagnosis, Differential
PubMed: 38852075
DOI: 10.3928/19382359-20240407-08 -
Annals of Internal Medicine Jun 2015
Topics: Female; Fusobacterium Infections; Humans; Male; Pharyngitis; Pneumonia, Mycoplasma; Streptococcal Infections
PubMed: 26075768
DOI: 10.7326/L15-5099-3 -
World Neurosurgery Dec 2023Spinal epidural abscesses (SEA) require prompt diagnosis to avoid devastating consequences. Here, we discuss the case of a healthy 20-year-old college student-with a...
Spinal epidural abscesses (SEA) require prompt diagnosis to avoid devastating consequences. Here, we discuss the case of a healthy 20-year-old college student-with a recent diagnosis of strep pharyngitis-who presented with neck pain, fever, and a neurologic deficit-the most common symptoms of SEA. Magnetic resonance imaging revealed a T1-postcontrast, peripherally enhancing epidural collection from C3-T5 with associated cord compression and T3 osteomyelitis. The patient was treated with emergent skip hemilaminectomies for abscess evacuation. Surgical cultures grew Fusobacterium necrophorum, a highly unusual pathogen in SEA. It is an oral anaerobe that translocated through the mucosa in the setting of strep pharyngitis. We treated the patient with ceftriaxone for 6 weeks. The patient had a full neurologic recovery and remains without recurrence of infection 11 months postoperatively. Healthy patients without obvious risk factors may present with SEA, highlighting the need for atypical cases such as these to be brought to clinicians' attention.
Topics: Humans; Young Adult; Adult; Epidural Abscess; Laminectomy; Magnetic Resonance Imaging; Spinal Cord Compression; Pharyngitis
PubMed: 37741329
DOI: 10.1016/j.wneu.2023.09.033 -
RoFo : Fortschritte Auf Dem Gebiete Der... Jan 2020
Topics: Anti-Bacterial Agents; Follow-Up Studies; Humans; Jugular Veins; Lemierre Syndrome; Male; Pharyngitis; Pulmonary Embolism; Tomography, X-Ray Computed; Tonsillitis; Ultrasonography; Young Adult
PubMed: 31370089
DOI: 10.1055/a-0982-3465 -
MSphere Oct 2023Sore throat is one of the most common complaints encountered in the ambulatory clinical setting. Rapid, culture-independent diagnostic techniques that do not rely on...
Sore throat is one of the most common complaints encountered in the ambulatory clinical setting. Rapid, culture-independent diagnostic techniques that do not rely on pharyngeal swabs would be highly valuable as a point-of-care strategy to guide outpatient antibiotic treatment. Despite the promise of this approach, efforts to detect volatiles during oropharyngeal infection have yet been limited. In our research study, we sought to evaluate for specific bacterial volatile organic compounds (VOC) biomarkers in isolated cultures , in order to establish proof-of-concept prior to initial clinical studies of breath biomarkers. A particular challenge for the diagnosis of pharyngitis due to is the likelihood that many metabolites may be shared by and other related oropharyngeal colonizing bacterial species. Therefore, we evaluated whether sufficient metabolic differences are present, which distinguish the volatile metabolome of Group A streptococci from other streptococcal species that also colonize the respiratory mucosa, such as and . In this work, we identified 27 discriminatory VOCs (-values < 0.05), composed of aldehydes, alcohols, nitrogen-containing compounds, hydrocarbons, ketones, aromatic compounds, esters, ethers, and carboxylic acid. From this group of volatiles, we identify candidate biomarkers that distinguish from other species and establish highly produced VOCs that indicate the presence of , supporting future breath-based diagnostic testing for streptococcal pharyngitis. IMPORTANCE Acute pharyngitis accounts for approximately 15 million ambulatory care visits in the United States. The most common and important bacterial cause of pharyngitis is , accounting for 15%-30% of pediatric pharyngitis. Distinguishing between bacterial and viral pharyngitis is key to management in US practice. The culture of a specimen obtained by a throat swab is the standard laboratory procedure for the microbiologic confirmation of pharyngitis; however, this method is time-consuming, which delays appropriate treatment. If left untreated, pharyngitis may lead to local and distant complications. In this study, we characterized the volatile metabolomes of and other related oropharyngeal colonizing bacterial species. We identify candidate biomarkers that distinguish from other species and provide evidence to support future breath-based diagnostic testing for streptococcal pharyngitis.
Topics: Humans; Child; Streptococcus pyogenes; Streptococcal Infections; Pharyngitis; Anti-Bacterial Agents; Biomarkers
PubMed: 37791788
DOI: 10.1128/msphere.00194-23