[Consensus document on the diagnosis and treatment of acute tonsillopharyngitis]. / Documento de consenso sobre el diagnóstico y tratamiento de la faringoamigdalitis aguda.

Acute tonsillopharyngitis is one of the most common childhood diseases. Viruses are the most frequent origin. Group A Streptococcus (Streptococcus pyogenes) is the main bacterial cause. A culture or a rapid antigen-detection test of a throat-swab specimen should only be done on the basis of clinical scores, in order to avoid over-diagnosis of bacterial origin and unnecessary antibiotic prescription. The objectives of treatment are: the reduction of symptoms, reduce the contagious period, and prevent local suppurative and systemic complications. Ideally, only confirmed cases should receive antibiotics. If there is no possibility to perform a rapid antigen-detection test, or in some cases if the result is negative, it is recommended to perform a culture and, if there is high suspicious index, to prescribe antibiotics. Penicillin is the treatment of choice, although amoxicillin is also accepted as the first option. Amoxicillin/clavulanate is not indicated in any case as empirical treatment. Macrolides are not a first choice antibiotic, and should be reserved for those patients with immediate penicillin allergy reaction or for the treatment of streptococcal carriers. It is of primordial importance to adapt the prescribing of antibiotics to the scientific evidence.

[Scrotal trauma in childhood]. / Traumatismos escrotales en la infancia.

Scrotal trauma has increase in frequency during recent years, largely as the result of sporting activities, physical aggressions and road accidents. Its importance lies in the likelihood of associated lesions of the testis and the spermatic cord. We report 41 cases of scrotal trauma. Thirty-seven cases were non-penetrating and four were penetrating (including a case of traumatic rupture of the testis). Nonsurgical treatment was applied in 30 cases (73.1%) and surgical treatment in 11 (26.8%). The diagnostic techniques employed included ultrasonography in 19 cases, gammagraphy in 10 cases, Doppler-effect ultrasonography in 2 cases and CAT in 2 cases. The decision to operate should be based on the clinical findings. Follow-up studies over 8-60 months were satisfactory in all cases, with no cases of testicular atrophy detected.