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1.
Einstein (Säo Paulo) ; 20: eAO6342, 2022. tab
Article in English | LILACS | ID: biblio-1364805

ABSTRACT

ABSTRACT Objective: To evaluate the importance attributed to tonsillitis by guardians and their level of knowledge about the disease, correlating their management with their schooling and socioeconomic profiles. Methods: A quantitative, descriptive and observational cross-sectional study involving students aged 5 to 17 years from state-owned and private schools. A questionnaire was applied on management of tonsillitis and knowledge about rheumatic fever, addressing demographic and socioeconomic data. Results: A total of 323 students were included, predominantly females (61.3%), from state-owned schools (77.1%), with a mean age of 9.7±0.3 years. Among the guardians, 48.6% completed high school. Among the students 75.2% had at least one episode of odynophagia in the previous 12 months. Considering the previous 2 years, 89.8% reported this symptom. There was no collection of bacteriological specimens in 67.8%, and in 83% if taking into account only the last episode, despite the search for medical care in most cases (92.6%). The use of anti-inflammatory drugs was very frequent (43.0% "always" and 42.4% "sometimes"). Among the guardians, 81.7% denied being aware of the relation between rheumatic fever and inappropriate treatment of odynophagia; 85.8% said they wished they had received more information. Conclusion: Although it is quite common in schoolchildren, tonsillitis is neglected by many guardians and health professionals, and the ignorance of its relation with rheumatic fever is practically universal, which may contribute to its high prevalence.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Students , Tonsillitis/epidemiology , Schools , Brazil/epidemiology , Cross-Sectional Studies
2.
Article in Chinese | WPRIM | ID: wpr-878951

ABSTRACT

Based on the network pharmacology and molecular docking method to explore the molecular mechanism of Shengjiang Powder in treating chronic tonsillitis in children. This research first based on the Traditional Chinese Medicine System Pharmacology(TCMSP) and the Bioinformatics Analysis Tools for Molecular Mechanism of Traditional Chinese Medicine(BATMAN-TCM), the effective active ingredients of the drugs contained in Shengjiang Powder were screened out by the pharmacokinetic(ADME) parameters, the targets were predicted, and then chronic tonsillitis disease in children targets were obtained by GeneCards database. Afterwards, the target protein names were standardized by the Uniprot database. The drug targets were matched with the disease targets to obtain the potential therapeutic targets of Shengjiang Powder. Cytoscape 3.8.0 software was used to screen out and construct the network diagram of "drug-components-core targets-disease". DAVID database and R language were used to conduct the enrichment analysis of core action targets. Finally, AutoDock software was used to conduct molecular docking between drug components with a high network medium value and core action targets. According to the findings, after standardized treatment, a total of 79 active ingredients of Shengjiang Powder were obtained; it was predicted to get 1 261 potential targets, 268 potential targets for treatment of chronic tonsillitis in children, and 29 core targets; and 81 entries of GO enrichment were determined(P<0.05), including 63 biological processes, 7 cell components, 11 molecular function items, 24 KEGG pathway enrichment items(P<0.05), mainly including cell cycle, inflammatory factors, viral infection, immune regulation and other signaling pathways. The results of molecular docking showed that main active components in Shengjiang Powder had a stable binding activity with the core targets. This study revealed the mechanism of Shengjiang Powder in the treatment of chronic tonsillitis in children, mainly by resisting virus, inhibiting inflammation, regulating immunity and other means to play a synergistic effect, so as to provide a theoretical basis for rational clinical application.


Subject(s)
Child , Drugs, Chinese Herbal , Humans , Medicine, Chinese Traditional , Molecular Docking Simulation , Powders , Tonsillitis/drug therapy
3.
Article in Spanish | LILACS, COLNAL | ID: biblio-1253869

ABSTRACT

La tuberculosis es la primera causa de mortalidad infectocontagiosa a nivel mundial. La tuberculosis pulmonar corresponde a la presentación más frecuente, sin embargo, el 15 % de los casos cursan con infección extrapulmonar, siendo raro el compromiso amigdalino. Este reporte de caso describe a un paciente de 39 años con odinofagia recurrente secundaria a amigdalitis por Mycobacterium tuberculosis, un raro caso de tuberculosis extrapulmonar. La amigdalitis es una infección leve y frecuente de la vía aérea superior, que responde adecuadamente al manejo antibiótico; sin embargo, cuadros recurrentes y prolongados, manifestaciones atípicas o pobre respuesta a la antibioticoterapia son características que obligan a la búsqueda de diagnósticos diferenciales, lo que lleva a considerar la presencia de Mycobacterium tuberculosis como agente etiológico, especialmente en países con alto índice de tuberculosis como Colombia


Tuberculosis is the leading cause of infectious mortality worldwide. The pulmonary one corresponds to the most frequent presentation, however up to 15% of tuberculosis cases present extrapulmonary involvement, tonsillar tuberculosis being rare. The following is a case report of a 39-year-old patient with recurrent odynophagia secondary to Mycobacterium tuberculosis tonsillitis, a rare form of extrapulmonary tuberculosis. Tonsillitis is a benign and extremely common infection of the upper airway. Such patients benefit from systemic antibiotics, although, recurrent episodes, prolonged odynophagia, atypical manifestations, or poor response to antimicrobial therapy forces consideration of diagnostic possibilities other than the obvious, including Mycobacterium tuberculosis as the etiological agent, especially in countries with the highest rates of tuberculosis.


Subject(s)
Humans , Male , Adult , Tuberculosis, Pulmonary/complications , Tonsillitis/microbiology , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary/diagnostic imaging , Tonsillitis/drug therapy , Tonsillitis/diagnostic imaging , Anti-Bacterial Agents/therapeutic use
4.
Rev. méd. Minas Gerais ; 31: 31407, 2021.
Article in English, Portuguese | LILACS | ID: biblio-1291382

ABSTRACT

Objetivo: relatar e descrever a evolução satisfatória de uma Angina de Ludwig decorrente de uma infecção amigdaliana, que evoluiu para mediastinite e choque séptico. O trabalho visa detalhar os aspectos clínicos e diagnósticos desta grave doença, além da terapêutica empregada neste caso. Método: as informações foram obtidas do prontuário do paciente, bem como dos laudos dos exames de imagem realizados. A revisão da literatura foi feita na base de dados PUBMED. Considerações finais: o caso estudado relata um raro desfecho favorável de uma Angina de Ludwig que evoluiu para mediastinite, cuja taxa de mortalidade é de até 50% dos casos. A abordagem cirúrgica combinada com antibioticoterapia precoce se mostra ser a melhor conduta para estes casos.


Objective: report and describe the satisfactory evolution of Ludwig's Angina due to a tonsillary infection, which evolved to mediastinitis and sept shock. The work aims to detail the clinical and diagnostic aspects of this serious illness, in addition to the therapy used in this case. Method: the information was obtained from the patient's medical record, as well as from the reports of the imaging tests performed. The literature review was carried out in the PUBMED database. Final considerations: the case studied has great importance for the medical community, since it reports a rare favorable outcome for a case of Ludwig's Angina complicated with an mediastinitis, whose mortality is described up to 50% of the cases. The surgical approach combined with early antibiotic therapy is shown to be the best approach for these cases.


Subject(s)
Humans , Male , Middle Aged , Ludwig's Angina , Mediastinitis , Osteomyelitis , Tonsillitis , Airway Obstruction , Infections , Anti-Bacterial Agents/therapeutic use
5.
Bol. méd. postgrado ; 36(1): 32-37, jul.2020. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1119378

ABSTRACT

La amigdalectomía es uno de los procedimientos quirúrgicos más frecuentes en la actualidad especialmente en edad pediátrica. Con el objetivo de determinar las complicaciones en amigdalectomía con electrodisección y técnica clásica en pacientes pediátricos que ingresaron al Servicio Desconcentrado Hospital Pediátrico Dr. Agustín Zubillaga en el año 2017, se realizó un estudio de recolección retrospectiva de datos seleccionando 119 historias clínicas, obteniendo que 73,95% de los casos fueron intervenidos por técnica de electrodisección y 26,05% por técnica clásica. Las principales indicaciones para cirugía fueron amigdalitis a repetición e hipertrofia amigdalina. Para ambas técnicas, el tiempo quirúrgico promedio fue entre 21-40 minutos (44,32% y 48,39%, respectivamente) y la estancia hospitalaria menor de un día en 54,55% y 61,29% de los casos, respectivamente. La principal complicación intraoperatoria reportada fue la hemorragia (29,03% para la técnica clásica y 15,91% para la técnica de electrodisección). Entre las complicaciones postoperatorias, el dolor (63,64%) y la fiebre (60,23%) prevaleció en pacientes operados con electrodisección mientras que en los pacientes con técnica clásica la más frecuente fue la fiebre (61,29%). Con estos resultados, se demuestra que ambas técnicas tienen similar tiempo quirúrgico y estancia hospitalaria, pero difieren en en tipo de complicaciones(AU)


Tonsillectomy is one of the most frequent surgical procedures in our times especially in pediatric age. In order to determine the complications of electrodissection and classical tonsillectomy in pediatric patients who were admitted at the Servicio Desconcentrado Hospital Pediátrico Dr. Agustín Zubillaga in 2017, a review of 119 medical charts was performed. The results show that 73.95% of the cases had electrodissection tonsillectomy and 26.05% had classical tonsillectomy. The main indications for surgery were recurrent tonsillitis (electrodissection: 86.09% and classical: 80.65%) and tonsillar hypertrophy (electrodissection: 60.23% and classical: 35.48%). For both techniques, the mean surgical time was between 21-40 minutes (44.32% and 48.39%, respectively) and the hospital stay was less than one day (54.55% and 61.29%, each). The main intraoperative complication reported was hemorrhage (29.03% for classical versus 15.91% for electrodissection). Among the postoperative complications, pain (63.64%) and fever (60.23%) prevailed in patients with electrodissection tonsillectomy while fever was most frequent in patients with classical tonsillectomy (61.29%). These results show that both techniques have similar surgical time and hospital stay but differ in type of complications(AU)


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Postoperative Complications , Surgical Procedures, Operative , Tonsillectomy , Tonsillitis/surgery , Deglutition Disorders , Postoperative Nausea and Vomiting , Hemorrhage
6.
Rev. otorrinolaringol. cir. cabeza cuello ; 80(2): 172-177, jun. 2020. graf
Article in Spanish | LILACS | ID: biblio-1115832

ABSTRACT

En este artículo se presenta un paciente que en contexto de un cuadro amigdalino agudo bilateral con un absceso periamigdalino unilateral concomitante presenta sangrado espontáneo proveniente de la amígdala abscedada. Los signos y síntomas observados en este paciente, así como los estudios complementarios son compatibles con la entidad clínica definida como amigdalitis hemorrágica espontánea, una complicación altamente infrecuente de la amigdalitis aguda y/o crónica en nuestra época, la que solía tener una gran tasa de mortalidad y gravedad en la era preantibiótica. A continuación, se reúnen y analizan los antecedentes descritos en la literatura referidos a este cuadro, al igual que su estudio complementario requerido para definir conducta, la cual es fundamentalmente de resorte quirúrgico.


In this article we report a patient who, in the context of a bilateral acute tonsillar condition with a concomitant unilateral peritonsillar abscess presents spontaneous bleeding from the abscessed tonsil. The clinical features observed in our patient, as well as the complementary studies are all compatible with the clinical entity known as spontaneous tonsil hemorrhage, a highly rare complication of acute and/or chronic tonsillitis in our time, which used to have major severity and mortality rate in the pre-antibiotic era. Following next, we gather and analyze the information described in literature referred to this affliction, as well as the complementary tests required to define its fundamentally surgical management.


Subject(s)
Humans , Male , Young Adult , Tonsillitis/complications , Hemorrhage/etiology , Tonsillectomy , Tonsillitis/surgery , Tonsillitis/diagnostic imaging , Tomography, X-Ray Computed , Abscess
7.
Article in Chinese | WPRIM | ID: wpr-828446

ABSTRACT

This study is a randomized controlled trial of Reyanning Mixture in the treatment of acute tonsillitis. According to the ratio of 1∶1∶1, a total of 144 patients were randomly divided into Reyanning Mixture group(RYN), Reyanning Mixture+Amoxicillin Capsules group(RYN+Amoxil) and Amoxicillin Capsules group(Amoxil), with 48 cases in each group, in order to evaluate the efficacy and safety of RYN alone or combined with Amoxil in the treatment of acute tonsillitis, and provided high-quality evidences for treatment of infectious diseases with traditional Chinese medicine and reduced use of antibiotics. The dosage of RYN was 20 mL, 3 times a day, 100 mL/bottle, oral for 7 days, and Amoxil dosage was 0.5 g, 3 times a day, 0.5 g×12 tablets/plate, oral for 7 days. A total of 144 cases were included, 3 cases were excluded(1 case was mistakenly included, 2 cases did not take drugs after inclu-ded), and a total of 141 cases were included in the full analysis set(FAS). The results showed statistical differences in the recovery time of the disease, the disappearance rate of fever on the 3 rd day and the disappearance rate of tonsillar redness and swelling between RYN and Amoxil. There were statistical differences in the cure rate of disease, recovery time of disease, body temperature recovery time, fever disappearance rate on the 3 rd day, pharynx swelling and pain disappearance rate and tonsil swelling disappearance rate between the RYN+Amoxil and Amoxil, but with no significant difference in the above aspects compared with RYN. The DDD of antibiotic use in RYN+Amoxil was significantly lower than that in Amoxil(P<0.01). According to the findings, when RYN was used alone in the treatment of acute tonsillitis, it was superior to Amoxil in time of recovery, short-term improvement of fever and redness and swelling of tonsil. Compared with RYN+Amoxil, there was no difference in cure rate of disease, recovery time of disease, body temperature recovery time, short-term improvement of fever, swelling of pharynx and swelling of tonsil, with a better efficacy than Amoxil. The clinical effect of RYN was similar to that of combined Amoxil in the treatment of acute tonsillitis, and RYN was superior to Amoxil in the time of recovery, short-term improvement of fever and redness and swelling of tonsil, with no adverse event or adverse reaction. RYN+Amoxil can significantly reduce the DDD value of antibiotics in the treatment of acute tonsillitis, with significant clinical advantages over Amoxil.


Subject(s)
Anti-Bacterial Agents , Therapeutic Uses , Double-Blind Method , Drugs, Chinese Herbal , Fever , Drug Therapy , Humans , Tonsillitis , Drug Therapy
8.
Arch. argent. pediatr ; 117(3): 297-300, jun. 2019. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1001206

ABSTRACT

El absceso periamigdalino es la complicación más frecuente de la amigdalitis aguda bacteriana, definido como la presencia de pus entre la cápsula periamigdalina y el músculo constrictor superior de la faringe. Habitualmente, su presentación es unilateral; es rara su afectación bilateral. Es más frecuente en adultos y poco común en niños. Cuando es bilateral, el paciente presenta odinofagia, trismus, sialorrea, fiebre y voz gutural, síntomas que comparte con el absceso unilateral, pero, en el examen físico, se evidencia abombamiento de ambos pilares anteriores, edema de úvula y paladar blando, sin asimetrías de las estructuras faríngeas. Se requiere un alto nivel de sospecha clínica para lograr el diagnóstico temprano. El manejo de la vía aérea, que podría ser dificultoso, es un aspecto importante en el tratamiento. Se presenta el caso clínico de un niño con absceso periamigdalino bilateral; se describe el proceso diagnóstico y terapéutico.


Peritonsillar abscess is the most common complication of acute bacterial tonsillitis, defined as the presence of purulent exudate between the peritonsillar capsule and the superior constrictor muscle of the pharynx. Usually, its presentation is unilateral; its bilateral involvement is rare. It is more common in adults, being uncommon in children. Clinically, it presents odynophagia, trismus, sialorrhea, fever, guttural voice, symptoms that it shares with the unilateral abscess, evidencing in the physical examination bulging of both anterior pillars, edema of the uvula and soft palate, but without asymmetries of pharyngeal structures. A high level of clinical suspicion is required to achieve early diagnosis. The management of the airway, which could be difficult, is an important aspect in the treatment. It is reported the clinical case of a child with bilateral peritonsillar abscess, the diagnostic and therapeutic process.


Subject(s)
Humans , Male , Child , Adolescent , Sialorrhea , Bacterial Infections , Trismus , Tonsillitis , Abscess
9.
Rev. otorrinolaringol. cir. cabeza cuello ; 79(2): 221-228, jun. 2019. tab
Article in Spanish | LILACS | ID: biblio-1014441

ABSTRACT

RESUMEN Durante el embarazo ocurren una serie de cambios, como edema y disminución de la actividad ciliar en la mucosa respiratoria alta, que pueden favorecer la aparición de síntomas y patologías del área otorrinolaringológica. La eficacia de los tratamientos farmacológicos en la rinitis del embarazo es pobre. El tratamiento de primera línea de la rinitis alérgica son los corticoides intranasales. Existe evidencia sobre la seguridad en el embarazo para furoato de fluticasona, mometasona y budesonida intranasal. El tratamiento del resfrio común está enfocado en el manejo sintomático, los antinflamatorios no esteroidales están contraindicados. En rinosinusitis aguda bacteriana la amoxicilina es de primera línea. En rinosinusitis crónica el manejo quirúrgico está reservado sólo para las complicaciones. Tanto la otitis media aguda como la amigdalitis aguda deben ser tratadas con antibióticos sólo si se sospecha origen bacteriano, el esquema de primera linea es amoxicilina y en caso de alergias se debe usar cefpodoxime o azitromicina. En caso de otorrea no existe evidencia sobre la seguridad de las gotas de antibióticos ótico durante el embarazo. Múltiples medicamentos utilizados habitualmente en otorrinolaringologia no pueden ser usados durante el embarazo. Se debe privilegiar la seguridad materno fetal, utilizando aquellos medicamentos con seguridad demostrada.


ABSTRACT During pregnancy a series of changes occur, such as edema and decreased ciliary activity in the upper respiratory mucosa, which may favor the appearance of symptoms and pathologies of the otorhinolaryngological area. The efficacy of pharmacological treatments in rhinitis of pregnancy is poor. The first-line treatment of allergic rhinitis is intranasal corticosteroids. There is evidence on safety in pregnancy for fluticasone furoate, mometasone and intranasal budesonide. The treatment of the common cold is focused on symptomatic management, nonsteroidal anti-inflammatory drugs are contraindicated. In acute bacterial rhinosinusitis, amoxicillin is first-line. In chronic rhino-sinusitis in surgical management is reserved only for complications. Both acute otitis media and acute tonsillitis should be treated with antibiotics only if bacterial origin is suspected, the first-line treatment is amoxicillin, in the case of allergies, cefpodoxime or azithromycin should be used. In case of otorrhea there is no evidence on the safety of otic antibiotic drops during pregnancy. Conclusion: multiple medications commonly used in otorhinolaryngology cannot be used during pregnancy. Maternal and fetal safety should be privileged, using those medications with proven safety.


Subject(s)
Humans , Female , Pregnancy , Otorhinolaryngologic Diseases/drug therapy , Pregnancy Complications/drug therapy , Otitis Media/drug therapy , Sinusitis/drug therapy , Tonsillitis/drug therapy , Rhinitis/drug therapy
10.
Prensa méd. argent ; 105(3): 124-129, may 2019. tab
Article in English | LILACS, BINACIS | ID: biblio-1025415

ABSTRACT

Streptococcus pyogenes is the most common cause of bacterial tonsillopharyngitis with a sore throat in children;it can also cause weakening sicknesses such as rheumatic beart disease and other suppurative sequelae; peritonsillar abscess and lymphadenitis. The present study was conducted to determine the occurrence of Streptococcus pyogenes organism and their antibiotics susceptibility usually used to treat tonsilitis in children. From the period 2015-2016, 210 swabs were collected from children complaining of acute tonsillitis who presented to the outpatient department of Al-Karama teaching hospital, Baghdad, Iraq. The results revelated that fortuy-one isolates (19,5%) cases were positive culture for S. pyogenes. The residual results; other organisms, mixed culture and negatively cultured were excluded form the study. The incidence of treptococcus pyogenes tonsillitis was most prvalent in the age group 5-7 years 25 (23.8%) and the lowest in the age group 14-16 years 1 (10%). The isolates showed the frequency resistance percentage to: azithromycin 26 (63.4%), erythromycin 24 (58.5%), clarithromycin 19 (46.3%), 6 (14.6%) toAmoxiclillin + Clavulanic acid (Augmentin) and Clindamycin 5 (12.2%). while some isolates showed the lowest resistance percentage to Cefotaxime 3 (7.3%). S. pyogenes were frequently sensitive to Clindamycin 36 (87.8%), Cefotaxime 32 (78%) and Amoxicillin/clavulanic acid 31 (75.6%). Streptococcal infections are a considerable problem in medical and health centers. The incidence of Streptococcus pyogenes tonsillitis was the most dominant in the age group 5-7 years and antibiotics Clindamycin, Cefotaxime, and Augmentin are more effective against these bacteria in patients with recurrent tonsillitis. The early diagnosis, appropriate infection control easures, and guidelines are needed to prevent the spread of the infections ant the development of complications among patients


Subject(s)
Humans , Child , Streptococcus pyogenes/pathogenicity , Tonsillitis , Early Diagnosis , Disease Susceptibility , Anti-Bacterial Agents/isolation & purification
11.
Rev. habanera cienc. méd ; 18(2): 241-253, mar.-abr. 2019. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1014166

ABSTRACT

Introducción: Las lesiones en la cavidad oral son con frecuencia las primeras evidencias clínicas de la infección por VIH. Una amigdalitis hemorrágica debe hacer sospechar, entre otras causas, que exista un Sarcoma de Kaposi (SK). El SK, considerada una enfermedad marcadora de sida en la infección por VIH, afecta, fundamentalmente, la piel y con frecuencia la mucosa de la cavidad oral. Objetivo: identificar una amigdalitis hemorrágica como forma de presentación de un Sarcoma de Kaposi asociado al VIH Presentación del caso: Paciente masculino de 22 años, que consulta por odinofagia y disfagia. En la faringoscopìa se observan amígdalas hipertróficas y de aspecto hemorrágicas. Se sospecha causa sistémica, entre ellas la infección por VIH. Se confirma debut clínico de sida por SK con lesiones predominantes de cavidad oral incluyendo las amígdalas. Conclusiones: Las características hemorrágicas de una amigdalitis permitieron sospechar el diagnóstico infección por VIH con Sarcoma de Kaposi predominante en cavidad oral(AU)


Introduction: Lesions in the oral cavity can be the first clinical evidences of HIV infection. Hemorrhagic tonsillitis should be suspicious of a Kaposi's sarcoma, among other causes. Kaposi's sarcoma (KS) is considered a marker of AIDS in HIV infection, which mainly affects the skin, but often acts upon the mucosa of the oral cavity. Objective: To identify hemorrhagic tonsillitis as a form of presentation of Kaposi's sarcoma associated to HIV. Case presentation: A 22-year-old male patient comes to the doctor´s office complaining of odynophagia and dysphagia. Hypertrophic tonsils of hemorrhagic aspect are observed in the laryngoscopy. Systemic cause is suspected, mainly, an HIV infection. A clinical onset of AIDS as a result of KS with predominant lesions in the oral cavity including the tonsils is confirmed. Conclusions: The hemorrhagic characteristics of tonsillitis leads to a presumptive diagnostic of HIV infection with a Kaposi's sarcoma occurring predominantly in the oral cavity(AU)


Subject(s)
Humans , Male , Adult , Sarcoma, Kaposi/complications , Tonsillitis/blood , HIV Infections/complications
12.
Rev. Soc. Bras. Clín. Méd ; 17(1): 38-40, jan.-mar. 2019.
Article in Portuguese | LILACS | ID: biblio-1026183

ABSTRACT

A pericardite é um processo inflamatório do pericárdio de múltiplas causas, sendo a infecção viral a mais comum. O infarto agudo do miocárdio é um dos principais diagnósticos diferenciais. O objetivo deste artigo foi relatar um caso de pericardite aguda com supradesnivelamento de segmento ST. Os dados foram coletados em um hospital de ensino do Estado de Minas Gerais. O paciente era do sexo masculino, tinha 24 anos e era negro. Foi encaminhado ao serviço médico terciário devido à hipótese de síndrome coronariana aguda com supradesnivelamento do segmento ST. Nos exames do serviço médico de origem, apresentava supradesnivelamento do segmento ST de caráter difuso simultaneamente em paredes inferior e anterior, e alteração da isoenzima MB da creatina quinase de 100ng/mL e troponina I de 21ng/mL. No momento da admissão, encontrava-se em bom estado geral, afebril, estável hemodinamicamente e sem queixa de dor. Referiu que 4 dias antes da admissão, apresentou febre, mal-estar geral, odinofagia e tratamento de amigdalite. Os exames da admissão demonstravam ritmo sinusal, frequência cardíaca de 75bpm, supradesnivelamento de ST em D2, D3, aVF, V1 a V6, isoenzima MB da creatina quinase de 152ng/mL, troponina I de 1,28ng/mL, hemograma normal; ecocardiograma mostrou pericárdio de aspecto anatômico normal e fração de ejeção de 64%. O diagnóstico foi de pericardite aguda de provável etiologia infecciosa. O tratamento foi realizado com ibuprofeno por 7 dias e colchicina por 3 meses. Paciente evoluiu com alta hospitalar após 5 dias. O diagnóstico correto proporcionou a condução adequada do caso, permitindo a redução dos custos hospitalares e eliminando riscos de procedimentos desnecessários. (AU)


Pericarditis is an inflammatory process of the pericardium of multiple causes, being the most common viral infection. Acute myocardial infarction is one of the main differential diagnoses. The objective of this article was to report a case of acute pericarditis with ST-segment elevation. Data were collected at a teaching hospital in the state of Minas Gerais. The patient was a man of 24 years, black. He was referred to the tertiary medical service due to the hypothesis of Acute Coronary Syndrome with ST-segment elevation. In the tests from the medical service of origin, there was diffuse ST-segment elevation, simultaneously on lower and anterior walls, and a change in the Creatinine Kinase MB Isoenzyme of 100ng/ml, and troponin I of 21ng/ml. At the time of admission, he was in good general condition, afebrile, hemodynamically stable, with no complaint of pain. He said that 4 days before admission he had fever, malaise, odynophagia, and treatment for tonsillitis. The admission tests showed sinus rhythm, heart rate of 75bpm, ST-elevation in D2, D3, aVF, V1 to V6, MB isoenzyme of creatine kinase of 152ng/ml, troponin I of 1.28ng/ml, normal complete blood count; echocardiogram showed pericardium of normal anatomical aspect and ejection fraction of 64%. The diagnosis was acute pericarditis of probable infectious etiology. Treatment was performed with ibuprofen for seven days, and colchicine for three months. The patient was discharged from hospital after 5 days. The correct diagnosis provided adequate case management, allowing for reduced hospital costs, and eliminating risks of unnecessary procedures. (AU)


Subject(s)
Humans , Male , Adult , Pericarditis/diagnosis , ST Elevation Myocardial Infarction/diagnosis , Penicillin G Benzathine/therapeutic use , Pericarditis/drug therapy , Pericarditis/diagnostic imaging , Troponin/blood , Chest Pain , Echocardiography , Deglutition Disorders , Tonsillitis/diagnosis , Tonsillitis/drug therapy , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Colchicine/therapeutic use , Ibuprofen/therapeutic use , Diagnosis, Differential , Electrocardiography , Creatine Kinase, MB Form/blood , Acute Coronary Syndrome/diagnosis , Fever , Hospitalization , Anti-Bacterial Agents/therapeutic use
13.
Rev. bras. med. fam. comunidade ; 14(41): 2025-2025, fev. 2019. ilus, tab
Article in Spanish | LILACS, ColecionaSUS | ID: biblio-1049864

ABSTRACT

Objetivo: Describir el uso irracional de antibióticos en base a criterios de McIsaac (criterios de Centor modificados por McIsaac), en una unidad de salud de primer nivel de atención. Métodos: Se realizó un estudio descriptivo transversal con los registros de pacientes de 3 a 19 años atendidos en el servicio de emergencia (246), con los diagnósticos de faringitis aguda, amigdalitis aguda, e infecciones respiratorias superiores agudas de múltiples sitios y sin especificar. Se estableció como prescripción inadecuada si el facultativo indicó antibióticos con un puntaje menor o igual a 1 sobre 5 puntos o si no prescribió antibióticos con puntaje mayor o 4 sobre 5 puntos. Resultados: Se estimó 24,29% de uso inadecuado de antibióticos de los registros de emergencia. Se prescribió antibióticos en 160 pacientes, de los cuales se encontró que, amoxicilina fue el más utilizado (61,87%); seguido de benzilpenicilina benzatina (28,12%) y en tercer lugar macrólidos (8,12%). Conclusión: En la unidad de primer nivel analizada se encontró que el uso inadecuado de antibióticos es superior a la prevalecía estimada de faringoamigdalitis estreptocócica para el grupo de edad estudiado. Por esto, es imperativo que se tomen las medidas necesarias a nivel institucional y comunitario para lograr su reducción y evitar las complicaciones que se derivan de esta.


Objetivo: Descrever o uso irracional de antibióticos com base nos critérios de McIsaac (critérios de Centor modificados por McIsaac), em uma unidade de saúde de primeiro nível de atenção. Métodos: Foi realizado um estudo descritivo transversal com os prontuários de pacientes de 3 a 19 anos atendidos no serviço de emergência (246), com diagnóstico de faringite aguda, amigdalite aguda, e infecções respiratórias superiores agudas de múltiplos locais e sem especificação. Estabeleceu-se como uma prescrição inadequada se o médico indicou antibióticos com um escore menor ou igual a 1 de 5 pontos ou se ele não prescreveu antibióticos com um escore maior ou igual a 4 de 5 pontos. Resultados: O uso inadequado de antibióticos foi estimado em 24,29% dos prontuários de emergência. Antibióticos foram prescritos em 160 pacientes, dos quais constatou-se que a amoxicilina foi a mais utilizada (61,87%); em segundo, a penicilina benzatina (28,12%); e, em terceiro lugar, os macrolídeos (8,12%). Conclusão: Na unidade de primeiro nível analisada foi encontrado que o uso de antibióticos é superior à prevalência de faringite estreptocócica estimada para a faixa etária estudada. Então, é imperativo que a nível institucional e comunitário sejam tomadas as medidas necessárias para sua redução e evitar as complicações resultantes.


Objective: To describe the irrational use of antibiotics based on McIsaac criteria (Centor criteria modified by McIsaac), in a primary care facility. Methods: A cross-sectional descriptive study was conducted with the medical record of patients from 3 to 19 years old, treated in the emergency department (246), with the diagnoses of acute pharyngitis, acute tonsillitis, and acute upper respiratory infections from multiple sites and not specified. It was established as an inappropriate prescription if the physician indicated antibiotics with a score less than or equal to 1 out of 5 points or if he did not prescribe antibiotics with a score greater than or equal to 4 out of 5 points. Results: Inadequate use of antibiotics was found in 24.29% of emergency records. Antibiotics were prescribed in 160 patients, of which, amoxicillin was the most used (61.87%); followed by benzathine penicillin (28.12%) and in third place macrolides (8.12%). Conclusion: In the first level unit analyzed, it was found that the inappropriate use of antibiotics is superior to the estimated prevalence of streptococcal pharyngitis for the age group studied. Therefore, it is imperative that the necessary measures are taken at the institutional and community level to achieve its reduction and avoid the complications that result from it.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Streptococcal Infections , Pharyngeal Diseases , Pharyngitis , Tonsillitis , Drug Utilization , Inappropriate Prescribing
14.
Braz. j. infect. dis ; 23(1): 8-14, Jan.-Feb. 2019. tab, graf
Article in English | LILACS | ID: biblio-1001504

ABSTRACT

ABSTRACT Introduction: Bacterial tonsillitis is an upper respiratory tract infection that occurs primarily in children and adolescents. Staphylococcus aureus is one of the most frequent pathogens in the etiology of tonsillitis and its relevance is due to its antimicrobial resistance and persistence in the internal tissues of the tonsils. Tonsillectomy is indicated in cases of recurrent tonsillitis after several failures of antibiotic therapy. Material and methods: In this study we evaluated 123 surgically removed tonsils from patients who had history of recurrent tonsillitis. The tonsils were submitted to microbiological analysis for detection of S. aureus. The isolates were identified by PCR for femA gene. Antimicrobial susceptibility of the isolates was determined by disk diffusion tests. All isolates were submitted to PCR to detect mecA and Panton-Valentine leucocidin (PVL) genes. The genetic similarity among all isolates was determined by pulsed field gel electrophoresis. Results: Sixty-one S. aureus isolates were obtained from 50 patients (40.7%) with mean age of 11.7 years. The isolates showed high level resistance to penicillin (83.6%), 9.8% had inducible MLSb phenotype, and 18.0% were considered multidrug resistant (MDR). mecA gene was detected in two isolates and the gene coding for PVL was identified in one isolate. The genetic similarity analysis showed high diversity among the isolates. More than one genetically different isolate was identified from the same patient, and identical isolates were obtained from different patients. Conclusions: MDR isolates colonizing tonsils even without infection, demonstrate persistence of the bacterium and possibility of antimicrobial resistance dissemination and recurrence of infection. A specific clone in patients colonized by S. aureus was not demonstrated.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Young Adult , Staphylococcal Infections/microbiology , Staphylococcus aureus/isolation & purification , Staphylococcus aureus/genetics , Tonsillitis/microbiology , Staphylococcus aureus/drug effects , Tonsillectomy/methods , Tonsillitis/surgery , Polymerase Chain Reaction , Cross-Sectional Studies , Electrophoresis, Gel, Pulsed-Field , Drug Resistance, Multiple, Bacterial/drug effects , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Methicillin-Resistant Staphylococcus aureus/drug effects , Anti-Bacterial Agents/pharmacology
15.
Rev. odontol. UNESP (Online) ; 48: e20190029, 2019. graf, ilus
Article in English | LILACS, BBO | ID: biblio-1020751

ABSTRACT

Abstract Introduction Streptococcus salivarius is a dominant oral species and the best suitable candidate for probiotic of the oral cavity. Since Streptococcus salivarius is able to produce bacteriocins against Streptococcus pyogenes interest has been focused on the use of it as a probiotic to avoid sore throats by Streptococcus pyogenes. Objective This study is for selecting Streptococcus salivarius strains for potential use as probiotics for the oral mucosa, that is, production of bacteriocin against Streptococcus pyogenes and the ability to bind to KB cells. Material and method Tongue material from 45 students was collected and seeded on Mitis Salivarius Agar plaques. The strains were tested by the production of bacteriocin-like substances (BLIS) against S. pyogenes, biochemically and PCR for identification of S. salivarius. The best strains were tested for adherence to KB cells. Briefly, S. salivarius strains were cultured in broth, washed and suspended at 108cells/ml. KB cells were inoculated into plaques, washed and incubated with the bacteria, for adhesion. These were washed for lysis of the KB cells and release bacteria for determination of CFU. Result The bacteriocin test showed that 133 strains presented inhibition of S. pyogenes. The samples tested for adhesion to KB cells, presented different profiles and only three strains presenting high adhesion capacity. Conclusion The selection of strains of Streptococcus salivarius with high inhibitory activity against Streptococcus pyogenes, as well as adherence to KB cells leads us to the next future step, that is, to use the best strains for in vivo colonization tests


Resumo Introdução Streptococcus salivarius é uma espécie dominante na cavidade bucal e tem sido indicada como um ótimo candidato para uso como probiótico. Visto que a espécie Streptococcus salivarius é capaz de produzir bacteriocinas contra Streptococcus pyogenes, desenvolveu-se interesse no uso desse microrganismo como probiótico, para evitar amigdalites causadas por Streptococcus pyogenes. Objetivo A pesquisa em questão tem o objetivo de selecionar cepas de Streptococcus salivarius para seu uso potencial como probióticos na cavidade bucal, ou seja, produção de bacteriocinas contra Streptococcus pyogenes e habilidade de aderência à células KB. Material e método Coletou-se material de língua de 45 estudantes e semeou-se em placas de ágar Mitis Salivarius. As amostras foram testadas para verificar a produção de substâncias semelhantes à bacteriocina (BLIS) contra S. pyogenes, bioquimicamente e através de PCR para identificação de S. salivarius. As melhores cepas foram testadas quanto aderência à células KB. Resumidamente, as cepas de S. salivarius foram cultivadas em caldo, lavadas e suspensas à correspondência de 108 cels/ml. As células KB foram inoculadas em placas, lavadas e incubadas com as bactérias, para adesão. Estas foram lavadas para lise das células KB e liberação das bactérias para determinação de UFC. Resultado O teste de bacteriocina, mostrou que 133 cepas apresentaram atividade inibitória contra Streptococcus pyogenes. As cepas testadas para aderência à células KB, apresentaram diferentes perfis e somente três com alta capacidade de adesão. Conclusão: A seleção de cepas de Streptococcus salivarius com alta atividade inibitória contra Streptococcus pyogenes, bem como aderência a células KB, pode nos levar ao próximo passo, ou seja, o uso das melhores cepas para o estudo de colonização in vivo.


Subject(s)
Bacteriocins , Bacterial Adhesion , KB Cells , Probiotics/therapeutic use , Streptococcus salivarius , Streptococcus pyogenes , Tonsillitis/prevention & control , Antibiosis
16.
Kosin Medical Journal ; : 78-82, 2019.
Article in English | WPRIM | ID: wpr-760458

ABSTRACT

A 56-year-old female presented with clinical features of acute tonsillitis with subsequent cervical lymphadenitis. After taking empirical antibiotics for 1 week, the acute infection symptoms and signs were resolved. However, an asymmetric enlargement of the left palatine tonsil with ipsilateral neck swelling remained. Subsequent tonsillectomy and lymph node excisional biopsy were performed due to the possibility of malignancy. The patient was eventually diagnosed as malignant lymphoma according to pathological confirmation. We demonstrate the diagnostic challenges in such a rare case and emphasize the importance of differentiating malignant lymphoma from an atypically presenting acute infectious disease.


Subject(s)
Anti-Bacterial Agents , Biopsy , Communicable Diseases , Female , Humans , Lymph Node Excision , Lymphadenitis , Lymphoma , Middle Aged , Neck , Palatine Tonsil , Tonsillectomy , Tonsillitis
17.
S. Afr. fam. pract. (2004, Online) ; 61(4): 19-21, 2019. tab
Article in English | AIM | ID: biblio-1270102

ABSTRACT

Acute sore throat is a common complaint encountered by medical practitioners and health care workers routinely. The disease is mostly caused by viral infections of the upper respiratory tract and is usually self limiting. Symptoms rarely exceed two weeks, irrespective of the cause. Group A beta-haemolytic streptococci accounts for the majority of bacterial instances of tonsillopharyngitis. Clinical examination is not always adequate to diagnose bacterial infections, resulting in the irrational and over-prescribing of antibiotics, especially in upper respiratory tract infections, contributing to communal antimicrobial bacterial resistance. A few scoring systems are available to assist physicians in deciding on the aetiology without resorting to unnecessary laboratory investigations. This article briefly reviews the scoring systems and antimicrobial management of streptococcal throat infections


Subject(s)
Fever , Pharyngitis , South Africa , Tonsillitis
19.
Braz. j. otorhinolaryngol. (Impr.) ; 84(3): 265-279, May-June 2018. tab, graf
Article in English | LILACS | ID: biblio-951826

ABSTRACT

Abstract Introduction: Bacterial resistance burden has increased in the past years, mainly due to inappropriate antibiotic use. Recently it has become an urgent public health concern due to its impact on the prolongation of hospitalization, an increase of total cost of treatment and mortality associated with infectious disease. Almost half of the antimicrobial prescriptions in outpatient care visits are prescribed for acute upper respiratory infections, especially rhinosinusitis, otitis media, and pharyngotonsillitis. In this context, otorhinolaryngologists play an important role in orienting patients and non-specialists in the utilization of antibiotics rationally and properly in these infections. Objectives: To review the most recent recommendations and guidelines for the use of antibiotics in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, adapted to our national reality. Methods: A literature review on PubMed database including the medical management in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, followed by a discussion with a panel of specialists. Results: Antibiotics must be judiciously prescribed in uncomplicated acute upper respiratory tract infections. The severity of clinical presentation and the potential risks for evolution to suppurative and non-suppurative complications must be taken into 'consideration'. Conclusions: Periodic revisions on guidelines and recommendations for treatment of the main acute infections are necessary to orient rationale and appropriate use of antibiotics. Continuous medical education and changes in physicians' and patients' behavior are required to modify the paradigm that all upper respiratory infection needs antibiotic therapy, minimizing the consequences of its inadequate and inappropriate use.


Resumo Introdução: A resistência bacteriana a antibióticos nos processos infecciosos é um fato crescente nos últimos anos, especialmente devido ao seu uso inapropriado. Ao longo dos anos vem se tornando um grave problema de saúde pública devido ao prolongamento do tempo de internação, elevação dos custos de tratamento e aumento da mortalidade relacionada às doenças infecciosas. Quase a metade das prescrições de antibióticos em unidades de pronto atendimento é destinada ao tratamento de alguma infecção de vias aéreas superiores, especialmente rinossinusites, otite média aguda supurada e faringotonsilites agudas, sendo que uma significativa parcela dessas prescrições é inapropriada. Nesse contexto, os otorrinolaringologistas têm um papel fundamental na orientação de pacientes e colegas não especialistas, para o uso adequado e racional de antibióticos frente a essas situações clínicas. Objetivos: Realizar uma revisão das atuais recomendações de utilização de antibióticos nas otites médias, rinossinusites e faringotonsilites agudas adaptadas à realidade nacional. Método: Revisão na base PubMed das principais recomendações internacionais de tratamentos das infecções de vias aéreas superiores, seguido de discussão com um painel de especialistas. Resultados: Os antibióticos devem ser utilizados de maneira criteriosa nas infecções agudas de vias aéreas superiores não complicadas, a depender da gravidade da apresentação clínica e dos potenciais riscos associados de complicações supurativas e não supurativas. Conclusões: Constantes revisões a respeito do tratamento das principais infecções agudas são necessárias para que sejam tomadas medidas coletivas no uso racional e apropriado de antibióticos. Somente com orientação e transformações no comportamento de médicos e pacientes é que haverá mudanças do paradigma de que toda infecção de vias aéreas superiores deva ser tratada com antibióticos, minimizando por consequência os efeitos de seu uso inadequado.


Subject(s)
Humans , Respiratory Tract Infections/drug therapy , Practice Patterns, Physicians'/statistics & numerical data , Inappropriate Prescribing/statistics & numerical data , Anti-Bacterial Agents/administration & dosage , Otitis Media/drug therapy , Sinusitis/drug therapy , Pharyngitis/drug therapy , Tonsillitis/drug therapy , Rhinitis/drug therapy , Acute Disease
20.
Buenos Aires; Médica Panamericana; 2018. 162 p. ilus, tab.
Monography in Spanish | LILACS | ID: biblio-911985

ABSTRACT

Las enfermedades de la vía aérea superior en la infancia constituyen la causa más frecuente de consulta al pediatra y abarcan una diversidad de trastornos cuyo abordaje preciso y oportuno es fundamental. En este nuevo volumen de las Series de Pediatría Garrahan: El niño con problemas de la vía aérea superior se han reunido pediatras con amplia experiencia en el área ambulatoria del Hospital y prestigiosos especialistas en otorrinolaringología pediátrica para resumir y actualizar las claves en el manejo integral de esta problemática. Entre sus características se destacan: El estudio detallado de las patologías clínicas más frecuentes, como otitis media aguda, rinosinusitis, estridor, tos crónica, hipoacusia y faringoamigdalitis, y de las indicaciones de amigdalectomía o adenoidectomía. El abordaje, a través de casos clínicos y de manera dinámica, con la secuencia de presentación clínica, los estudios de diagnósticos, el tratamiento y la evolución de los niños con estas patologías y sus complicaciones. El cierre de cada capítulo con un recordatorio de puntos clave y lecturas recomendadas y, además, material complementario como videos o descripción de procedimientos disponibles en el sitio web. Comparte y transmite una modalidad de trabajo propia del hospital, con base en el rol central del pediatra como coordinador de la atención interdisciplinaria en el marco de su tarea cotidiana junto a los niños y sus familias. Una obra actualizada y práctica que aporta información científica y experiencia de los profesionales de una institución de prestigio. Este tomo y las Series de Pediatría, en su conjunto, serán de gran utilidad para todos aquellos miembros del equipo de salud que atienden y cuidan niños, dondequiera que trabajen al servicio de la salud infantil.


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Otitis Media , Sinusitis , Tonsillectomy , Adenoidectomy , Pharyngitis , Tonsillitis , Respiratory Sounds , Cough , Hearing Loss
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