-
Tidsskrift For Den Norske Laegeforening... Jun 2007In children with recurrent episodes of fever, the cause may be the periodic fever syndrome (PFAPA-syndrome). The condition is not uncommon, and awareness of the syndrome... (Review)
Review
BACKGROUND
In children with recurrent episodes of fever, the cause may be the periodic fever syndrome (PFAPA-syndrome). The condition is not uncommon, and awareness of the syndrome is important for avoiding unnecessary investigations and treatment. The article presents an overview of the PFAPA-syndrome.
MATERIAL AND METHODS
The overview was based on Pubmed and Medline searches and data from 22 children with PFAPA-syndrome diagnosed at Stavanger University Hospital.
RESULTS AND INTERPRETATION
In children with PFAPA-syndrome the fever occurs regularly, appears abruptly and lasts for three to five days. Typical symptoms are cervical adenitis, tonsillitis/pharyngitis or aphthous stomatitis, often accompanied by headache, abdominal pain, nausea and reduced general condition. Of the 22 children, 17 were boys. The median age of debut was 12 months, median duration of fever four days, and median time between episodes 25 days. The most common symptoms were cervical adenitis (n = 18) and tonsillitis/pharyngitis (n = 16). During episodes, all children had high fever, reduced general condition, no proved infection but typical high levels of C-reactive protein. More than half of the children had been given antibiotics on at least five occasions before the diagnosis of PFAPA-syndrome. With a typical history and clinical investigation, the need for further investigations is limited. The diagnosis must be considered in children younger than five years of age with periodic fever without signs of airway infection. When PFAPA-syndrome is suspected, the child should be referred to a paediatrician. There is no evidence-based treatment for PFAPA-syndrome, but tonsillectomy is considered to have an effect.
Topics: Child, Preschool; Diagnosis, Differential; Female; Fever; Fever of Unknown Origin; Humans; Infant; Lymphadenitis; Male; Periodicity; Pharyngitis; Prognosis; Recurrence; Stomatitis, Aphthous; Syndrome; Tonsillitis
PubMed: 17571105
DOI: No ID Found -
Annals of the Royal College of Surgeons... Jul 2011Peritonsillar abscess (PTA) is a common condition with a complicated aetiology. PTA after tonsillectomy is rare. This literature review of PTA in the absence of tonsil... (Review)
Review
INTRODUCTION
Peritonsillar abscess (PTA) is a common condition with a complicated aetiology. PTA after tonsillectomy is rare. This literature review of PTA in the absence of tonsil tissue aims to collate experience of these cases and examine the wider implications for understanding the aetiology of PTA formation.
METHODS
A structured literature review was performed using Ovid MEDLINE®. Keywords 'quinsy' or 'peritonsillar abscess' were combined with 'tonsillectomy'.
RESULTS
The search resulted in 212 citations and the identification of 11 cases of PTA formation in the absence of tonsil tissue. The most common indication for tonsillectomy was recurrent tonsillitis or PTA. Nine patients had no interval peritonsillar infection (ie a peritonsillar infection after a tonsillectomy) prior to presenting with the PTA. The mean interval between tonsillectomy and PTA was 16 years. All patients were managed either by incision and drainage or by needle aspiration with or without antibiotics.
CONCLUSIONS
PTA in the absence of tonsil tissue is rare. Potential sources of infection include congenital branchial fistulas, Weber's glands and dental disease. These alternatives should also be considered in patients presenting with PTA formation in the absence of concurrent tonsillitis and may influence management decisions.
Topics: Adolescent; Adult; Anti-Bacterial Agents; Drainage; Female; Humans; Male; Middle Aged; Peritonsillar Abscess; Pharyngitis; Time Factors; Tonsillectomy; Young Adult
PubMed: 21943456
DOI: 10.1308/003588411X579793 -
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 -
Anaesthesia May 1999Sore throat is a common postoperative complaint, occurring most often following tracheal intubation. Factors such as tracheal-tube size and cuff design have been shown... (Review)
Review
Sore throat is a common postoperative complaint, occurring most often following tracheal intubation. Factors such as tracheal-tube size and cuff design have been shown to be important causative factors. Routine tracheal intubation for elective surgical procedures can result in pathological changes, trauma and nerve damage which may also account for postoperative throat symptoms. Sore throat following the use of a laryngeal mask appears to be related to the technique of insertion but the contribution of intracuff pressure remains to be clarified. It would appear, however, that high intracuff pressure is associated with nerve palsies due to neuropraxia and nerve compression. Careful insertion techniques for both the tracheal tube and laryngeal mask are of paramount importance in the prevention of airway trauma and postoperative sore throat.
Topics: Humans; Intubation, Intratracheal; Laryngeal Masks; Pharyngitis
PubMed: 10995141
DOI: 10.1046/j.1365-2044.1999.00780.x -
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 -
Journal of Clinical Laboratory Analysis Jun 2023We aimed to investigate the difference between PFAPA and streptococcal tonsillitis (Strep Pharyngitis) by using blood parameters. We want to evaluate the relationship...
BACKGROUND
We aimed to investigate the difference between PFAPA and streptococcal tonsillitis (Strep Pharyngitis) by using blood parameters. We want to evaluate the relationship between periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrome, and tonsillitis by using NLR.
METHODS
The data of 141 pediatric patients who had applied to our clinic between October 2016 and March 2019 and were diagnosed with PFAPA syndrome and tonsillitis were reviewed from hospital records. The demographic data of the study group were recorded, as were their WBC, neutrophil, and lymphocyte counts, NLR, and MPV values, which are obtained by proportioning these two counts.
RESULTS
CRP and ESR values were significantly higher in the PFAPA group (p = 0.026 and p < 0.001, respectively). No significant difference was determined between the groups in terms of platelet count or lymphocyte count. Receiver operating curve analyses were calculated. The AUC was 0.713 ± 0.04 according to age, and the CRP was 0.607 ± 0.04 (95% confidence interval). Using a cutoff point of >49 months for age, the sensitivity was 0.71 and the specificity was 0.67.
CONCLUSION
With simple laboratory parameters, PFAPA syndrome can be differentiated from a diagnosis of tonsillitis. This may reduce the costs associated with unnecessary antibiotic use. However, these findings still need to be confirmed by other future studies.
Topics: Child; Humans; Stomatitis, Aphthous; Pharyngitis; Fever; Tonsillitis; Lymphadenitis; Syndrome
PubMed: 37428978
DOI: 10.1002/jcla.24934 -
Canadian Family Physician Medecin de... Jul 2011
Topics: Acute Disease; Adolescent; Anti-Bacterial Agents; Diagnosis, Differential; Follow-Up Studies; Humans; Male; Pharyngitis; Streptococcal Infections
PubMed: 21753103
DOI: No ID Found -
Clinical Infectious Diseases : An... Sep 1997This is the second in a series of practice guidelines commissioned by the Infectious Diseases Society of America through its Practice Guidelines Committee. The purpose... (Review)
Review
This is the second in a series of practice guidelines commissioned by the Infectious Diseases Society of America through its Practice Guidelines Committee. The purpose of these guidelines is to provide assistance to clinicians when making decisions on treating the conditions specified in each guideline. The targeted providers are pediatricians, family practitioners, and internists. The targeted patients and setting for the acute pharyngitis guideline are pediatric, adolescent, and adult outpatients with a complaint of sore throat. Funding was provided by the IDSA. Panel members represented experts in adult and pediatric infectious diseases. The guidelines are evidence-based. A standard ranking system was used for the strength of the recommendations and the quality of the evidence cited in the literature reviewed. The document has been subjected to external review by peer reviewers as well as by the Practice Guidelines Committee and was approved by the IDSA Council. An executive summary, algorithms, and tables highlight the major recommendations. Indicators of quality will assist in guideline implementation. The guideline will be listed on the IDSA home page at http://www.idsociety.org.
Topics: Adolescent; Adult; Anti-Bacterial Agents; Antigens, Bacterial; Bacterial Infections; Child; Cost-Benefit Analysis; Diagnosis, Differential; Humans; Pharyngitis; Pharynx; Recurrence; Societies, Medical; Streptococcal Infections; Streptococcus pyogenes; United States; Virus Diseases
PubMed: 9314443
DOI: 10.1086/513768