[Infectious mononucleosis in practice of otorhinolaryngologist]. / Infektsionnyi mononukleoz v praktike vracha-otorinolaringologa.

Infectious mononucleosis (IM) is an acute viral infection that usually occurs with fever, acute tonsillitis, affects lymph nodes, liver, spleen, and with specific changes in the hemogram. One of the most frequent symptoms of the disease is sore throat which leads people to otorhinolaryngologist. Several pathogens may be the cause of IM, but Epstein-Barr virus(EBV) plays a key role. EBV is a γ-herpes virus and about 90% of world`s population is infected with this one. Severe IM can lead to potential life-threating conditions, for example upper airway obstruction, spleen rupture. In addition to acute IM, EBV-infection can lead to a number of neoplastic and autoimmune diseases. Due to the non-specificity of IM symptoms and the emerging difficulties in laboratory and serological diagnosis of this disease, the problem of timely diagnosis and treatment in this category of patients remains very relevant.

[Conservative therapy and surgical treatment of chronic tonsillitis in the children].

The objective of the present study was to undertake the statistical analysis of the methods employed to treat tonsillitis in the children with a view to optimizing adequate dispensary observation, planned conservative therapy and surgical treatment of the patients presenting with chronic tonsillitis. The analysis of the excerpts from the annual reports presented by the head of the otorhinolaryngological department of the Children's City Clinical Hospital No 9 involved the patients admitted for the pre-planned and urgent treatment of paratonsillar abscess between 1990 and 2010. It was shown that the number of children with paratonsillar abscess increased during this period from 5.8 to 12.0%. At the same time, the number of such patients undergoing surgery for the treatment of toxico-allergic forms (TAF-I and TAF-II) decreased from 26.7 to 8.7-11.6% of their total number admitted to the department for the treatment of pharyngeal pathology. These diseases developed in the children frequently ill with chronic tonsillitis after its recurrent exacerbations. Importantly, all these children were registered in the dispensaries of district out-patient clinics at the places of residence and repeatedly underwent courses of conservative therapy of chronic tonsillitis that either resulted in the temporary improvement of their health conditions or produced no effect whatever. Nevertheless, no district otorhinolaryngologist recommended tonsillectomy to a child with chronic tonsillitis. It is concluded that adequate regular medical check-ups in combination with the planned courses of conservative treatment and hospitalization of the patients in due time for the surgical treatment (tonsillectomy) permit to reduce the frequency of complications of such an insidious disease as chronic tonsillitis.

[The role of microflora in etiology of chronic tonsillitis].

Analysis of the results of a bacteriological study involving 218 patients with various forms of chronic tonsillitis (CT) has demonstrated that they were significantly different in terms of the seeding rate of beta-hemolytic group A Streptococci (BHAS). Specifically, these microorganisms were detected in patients with paratonsillar abscess 2.5 times as frequently as in those with uncomplicated forms of chronic tonsilitis. In other words, the former group is at risk of developing such concomitant diseases as post-streptococcal rheumocarditis, glomerulonephritis, and polyarthritis. It was shown that BHAS are capable of forming a biological film at the surface of abiogenic carriers in vitro which may be a principal cause of chronic and recurring tonsillitis.

[The role of bacteriological examination in diagnosis of chronic tonsillitis].

A bacteriological examination was made in 105 patients with various forms of chronic tonsillitis. Eighteen cultures of beta-hemolytic streptococcus (BHSA) were isolated from 36 patients with paratonsillar abscesses. BHSA seeding in paratonsillar abscess was 50.0%. Eight BHSA cultures were isolated from 69 patients with chronic tonsillitis. BHSA seeding in chronic tonsillitis was 11.6%. Adequate set of culture media for BHSA growth was optimized. The technique of the sample collection from tonsillar lacunes was improved. The significance of bacteriological diagnosis of chronic tonsillitis increases considerably due to optimization of out- and intralaboratory tests at the preanalytic stage of the study.