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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 -
Emergency Medicine Journal : EMJ Feb 2020
Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anti-Infective Agents, Local; Chlorhexidine; Female; Hemoptysis; Hemorrhage; Humans; Palatine Tonsil; Pharyngitis; Tonsillitis
PubMed: 31980549
DOI: 10.1136/emermed-2019-209119 -
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 -
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 -
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 -
Journal of Infection in Developing... Mar 2021Pharyngitis is one of the most common diagnoses for antibiotic prescriptions worldwide. Antibiotics should be prescribed for bacterial pharyngitis to reduce its...
INTRODUCTION
Pharyngitis is one of the most common diagnoses for antibiotic prescriptions worldwide. Antibiotics should be prescribed for bacterial pharyngitis to reduce its complications. The aims of this study were to assess antibiotic prescriptions for pharyngitis cases, and their relationship with physicians' knowledge regarding its diagnosis and management.
METHODOLOGY
A cross-sectional study was conducted. First, prescriptions for pharyngitis cases using the modified Centor criteria was evaluated at primary care centers in Saudi Arabia. Second, physicians' knowledge of the modified Centor score and the diagnosis and management of pharyngitis was assessed using a self-administered questionnaire.
RESULTS
Out of 104 pharyngitis cases, 79% (n = 82) were prescribed antibiotics, of which 28% were evidence-based prescriptions. First-line antibiotics were prescribed in 34% of patients, and second-line (broad-spectrum) antibiotics such as amoxicillin/clavulanate were prescribed in half of the patients. The main significant predictors of antibiotic prescriptions were age < 3 years (odds ratio, 0.13; 95% CI, 0.02 to 0.97), tonsillar exudate (odds ratio, 21.14; 95% CI, 2.88 to 155.09), and throat erythema (odds ratio, 9.30; 95% CI, 1.18 to 73.41). Overall, physicians (n = 29) had adequate knowledge about the modified Centor score and the management of pharyngitis.
CONCLUSIONS
Most prescribed antibiotics for pharyngitis were unnecessarily prescribed; the majority being broad-spectrum antibiotics. Despite physicians' adequate knowledge of the modified Centor score and the management of pharyngitis, their practice failed to demonstrate that. Induction of the Saudi Antimicrobial Stewardship Program in the primary care centers, accessibility to diagnostic tools, and educational programs may help in reducing unnecessary antibiotic prescriptions.
Topics: Adolescent; Adult; Anti-Bacterial Agents; Antimicrobial Stewardship; Child; Child, Preschool; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Middle Aged; Pharyngitis; Practice Patterns, Physicians'; Saudi Arabia; Young Adult
PubMed: 33839717
DOI: 10.3855/jidc.12822 -
Vestnik Otorinolaringologii 2023The relevance of the problem of chronic inflammatory diseases of the pharynx is due to the significant prevalence of this pathology. Among all forms of chronic... (Review)
Review
The relevance of the problem of chronic inflammatory diseases of the pharynx is due to the significant prevalence of this pathology. Among all forms of chronic pharyngitis, the most adverse effect on the quality of life is observed in chronic athrophic pharyngitis. According to the literature, in this category of patients there are no clear criteria for assessing the functional state and morphological picture of the mucous membrane of the posterior pharyngeal wall. Most of the described signs of atrophic pharyngitis are insufficienyly informative, which necessitates further improvement of existing and possible search for new diagnostic methods. Many of the modern methods of treatment do not provide a lasting effect due to the presence of only a local effect on the altered mucous membrane of the posterior pharyngeal wall, without taking into account the changes that are caused by a violation of trophic processes in the tissue, which necessitates the search for new effective methods of treating this disease.The review article outlines modern ideas about the methods of diagnosis and treatment of chronic pharyngitis, presents promising areas in the treatment of patients with atrophic pharyngitis. In foreign countries, the term «chronic tonsillopharyngitis» is most often used. Due to the existing difference in terminology, the predominant part of the material on the problem of chronic pharyngitis is presented by domestic literature sources.
Topics: Humans; Quality of Life; Pharyngitis; Pharynx; Mucous Membrane; Chronic Disease
PubMed: 37450392
DOI: 10.17116/otorino20228803156 -
JAMA May 2024
Topics: Humans; Anti-Bacterial Agents; Pharyngitis; Streptococcal Infections; Streptococcus pyogenes; Penicillins
PubMed: 38696184
DOI: 10.1001/jama.2024.3326