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1.
Vestn Otorinolaringol ; 86(2): 85-89, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33929158

RESUMO

A description of a clinical case of oligosymptomatic pharyngitis associated with Neisseria gonorrhoeae is presented. On the example of oligosymptomatic localized gonococcal pharyngitis in a sexually active young man, included in the risk group for extragenital forms of sexually transmitted infections, an advantage has been shown molecular biological diagnostic method. Study of the spectrum of microflora of the oropharynx and urethra with assessment sensitivity to antibacterial drugs of representatives of the genus Neisseria isolated during mixed infection oropharynx, demonstrated that non-pathogenic Neisseria species are resistant to cephalosporins III-IV generations. Unrecognized forms of oropharyngeal gonococcal infection, as a consequence of the complications of clinical and diagnostic identification when patients refer to an otolaryngologist or dermatovenerologist, can serve a reservoir of resistant N. gonorrhoeae and a source of intractable gonococcal infection.


Assuntos
Gonorreia , Faringite , Antibacterianos/uso terapêutico , Cefalosporinas , Gonorreia/diagnóstico , Gonorreia/tratamento farmacológico , Humanos , Masculino , Neisseria gonorrhoeae , Faringite/diagnóstico , Faringite/tratamento farmacológico
3.
PLoS One ; 16(3): e0247773, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33705435

RESUMO

BACKGROUND: The coronavirus infectious disease 19 (COVID-19) pandemic has resulted in significant morbidities, severe acute respiratory failures and subsequently emergency departments' (EDs) overcrowding in a context of insufficient laboratory testing capacities. The development of decision support tools for real-time clinical diagnosis of COVID-19 is of prime importance to assist patients' triage and allocate resources for patients at risk. METHODS AND PRINCIPAL FINDINGS: From March 2 to June 15, 2020, clinical patterns of COVID-19 suspected patients at admission to the EDs of Liège University Hospital, consisting in the recording of eleven symptoms (i.e. dyspnoea, chest pain, rhinorrhoea, sore throat, dry cough, wet cough, diarrhoea, headache, myalgia, fever and anosmia) plus age and gender, were investigated during the first COVID-19 pandemic wave. Indeed, 573 SARS-CoV-2 cases confirmed by qRT-PCR before mid-June 2020, and 1579 suspected cases that were subsequently determined to be qRT-PCR negative for the detection of SARS-CoV-2 were enrolled in this study. Using multivariate binary logistic regression, two most relevant symptoms of COVID-19 were identified in addition of the age of the patient, i.e. fever (odds ratio [OR] = 3.66; 95% CI: 2.97-4.50), dry cough (OR = 1.71; 95% CI: 1.39-2.12), and patients older than 56.5 y (OR = 2.07; 95% CI: 1.67-2.58). Two additional symptoms (chest pain and sore throat) appeared significantly less associated to the confirmed COVID-19 cases with the same OR = 0.73 (95% CI: 0.56-0.94). An overall pondered (by OR) score (OPS) was calculated using all significant predictors. A receiver operating characteristic (ROC) curve was generated and the area under the ROC curve was 0.71 (95% CI: 0.68-0.73) rendering the use of the OPS to discriminate COVID-19 confirmed and unconfirmed patients. The main predictors were confirmed using both sensitivity analysis and classification tree analysis. Interestingly, a significant negative correlation was observed between the OPS and the cycle threshold (Ct values) of the qRT-PCR. CONCLUSION AND MAIN SIGNIFICANCE: The proposed approach allows for the use of an interactive and adaptive clinical decision support tool. Using the clinical algorithm developed, a web-based user-interface was created to help nurses and clinicians from EDs with the triage of patients during the second COVID-19 wave.


Assuntos
/diagnóstico , Sistemas de Apoio a Decisões Clínicas , Adulto , Idoso , Tosse/diagnóstico , Dispneia/diagnóstico , Feminino , Febre/diagnóstico , Cefaleia/diagnóstico , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Faringite/diagnóstico , /isolamento & purificação
4.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(2): 143-147, 2021 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-33627208

RESUMO

OBJECTIVE: To study the clinical features of children with periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome, a polygenic and multifactorial autoinflammatory disease with unknown pathogenesis. METHODS: A retrospective analysis was performed on the medical data of 13 children with PFAPA syndrome. RESULTS: All 13 children had disease onset within the age of 3 years, with a mean age of onset of (14±10) months. They all had periodic fever, with 8-18 attacks each year. The mean interictal period of fever was (30±5) days. Pharyngitis, cervical adenitis, and aphthous stomatitis were the three cardinal symptoms, with incidence rates of 100% (13/13), 85% (11/13), and 38% (5/13) respectively. There were increases in white blood cells, C-reactive protein, and erythrocyte sedimentation rate during fever. Of all the 13 children, 6 underwent whole exome sequencing and 7 underwent panel gene detection for autoinflammatory disease, and the results showed single heterozygous mutations in the MEFV gene in 6 children (46%). Recurrent fever in all children gradually returned to normal without antibiotics. Ten children were treated with a single dose of glucocorticoids, and fever was relieved after treatment. Of all the children, 4 were treated with cimetidine, among whom 2 had response; 4 children were treated with colchicine, among whom 2 had response and 2 were withdrawn from the drug due to adverse reactions. Tonsillectomy was performed for 2 children, among whom 1 was followed up for 3 years without recurrence and 1 still had recurrence. CONCLUSIONS: For children with unexplained periodic fever with early onset accompanied by pharyngitis, cervical adenitis, aphthous stomatitis, elevated inflammatory indices, and good response to glucocorticoids, PFAPA syndrome should be considered. This disorder has good prognosis, and early diagnosis can avoid the long-term repeated use of antibiotics.


Assuntos
Linfadenite , Faringite , Estomatite Aftosa , Criança , Pré-Escolar , Febre/etiologia , Humanos , Lactente , Linfadenite/diagnóstico , Faringite/diagnóstico , Faringite/tratamento farmacológico , Pirina , Estudos Retrospectivos , Estomatite Aftosa/diagnóstico , Estomatite Aftosa/tratamento farmacológico , Estomatite Aftosa/genética
5.
BMJ Case Rep ; 14(1)2021 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-33462043

RESUMO

Group A streptococcus (GAS) causes a wide variety of infections in the paediatric population, ranging from pharyngitis to rare but severe invasive diseases, such as bacterial arthritis and osteomyelitis. Dental neglect is a type of child neglect in which caregivers fail to provide adequate care and treatment for dental diseases. This results in poor oral hygiene and can lead to complications including sepsis. We report the case of a 4-year-old boy, suffering from child neglect, presenting with GAS pharyngitis and subsequent bacterial arthritis in the right ankle, osteomyelitis in the right talus and abscess in the right calcaneus. He was first treated with penicillin, which was changed to clindamycin because of a suspected drug-induced rash. He was discharged after 6 weeks of intravenous therapy when symptoms had resolved and inflammatory markers were within the normal range. The case highlights that dental neglect may present a risk for subsequent invasive infections.


Assuntos
Artrite Infecciosa/microbiologia , Higiene Bucal , Osteomielite/microbiologia , Faringite/microbiologia , Infecções Estreptocócicas/diagnóstico , Streptococcus pyogenes/isolamento & purificação , Artrite Infecciosa/diagnóstico , Pré-Escolar , Humanos , Masculino , Osteomielite/diagnóstico , Faringite/diagnóstico
6.
Sex Transm Infect ; 97(2): 118, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33328193

RESUMO

We report a five-time recurrent pharyngotonsillitis caused by group A streptococcus (GAS) after sexual contacts and had no recurrence after concurrent therapy to both partners. Although Streptococcus pyogenes (GAS) is a Gram-positive streptococcus capable of causing a recurrent pharyngotonsillitis, the recurrent GAS pharyngotonsillitis as STI has not been published.A 30-year-old man had a high fever and sore throat. He had a repeated pharyngotonsillitis caused by GAS in spite of the sufficient antimicrobial therapy after having sex with his partner, including oral penile and oral vaginal sex. In contrast, a hug and kiss alone did not precede his episodes of pharyngotonsillitis. His partner had GAS carriage on her pharynx. He had no recurrence after concurrent therapy to both partners. The recurrent GAS pharyngotonsillitis as STI has not been published. In a patient with recurrent pharyngotonsillitis caused by GAS, the sexual history and pharyngeal carrier status of the partner should be checked.


Assuntos
Faringite/microbiologia , Doenças Sexualmente Transmissíveis/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus pyogenes/patogenicidade , Adulto , Antibacterianos/uso terapêutico , Portador Sadio/tratamento farmacológico , Portador Sadio/microbiologia , Feminino , Humanos , Masculino , Faringite/diagnóstico , Faringite/tratamento farmacológico , Faringe/microbiologia , Recidiva , Comportamento Sexual , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/tratamento farmacológico , Doenças Sexualmente Transmissíveis/transmissão , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/transmissão , Streptococcus pyogenes/isolamento & purificação , Resultado do Tratamento
7.
Adv Ther ; 38(2): 1078-1093, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33315168

RESUMO

INTRODUCTION: Analogies or differences of periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome in children and adults are barely known. The aim of our study was to compare the overall characteristics of a large cohort of patients, both children and adults, diagnosed with PFAPA syndrome. METHODS: In the last decade, we identified 120 children and 63 adults with periodically recurring fevers, who fulfilled the criteria for PFAPA diagnosis. The two subcohorts were analyzed according to demographic features, clinical manifestations, laboratory data, and responses to therapies. RESULTS: The mean age of onset was 2.4 ± 1.5 and 19.7 ± 10.3 years, respectively, in children and adults, while attacks occurred every 3.8 ± 0.8 and every 4.3 ± 2.3 weeks, respectively, in children and adults. A higher prevalence of exudative pharyngitis was observed in children (58.8%), and the majority of children had only two cardinal signs during flares. In adults, there was a higher interpersonal variability of the intercritical periods. Inflammatory markers measured during non-febrile periods were normal in children but altered in the totality of adults during febrile periods. A strong efficacy of corticosteroids in controlling the pediatric syndrome was observed, but response rates to steroids were less brilliant in adults. Colchicine and interleukin-1 inhibitors were used in the management of the steroid-resistant adult syndrome. Conversely, tonsillectomy was performed in a very low number of children, but was effective in 60.7% of adults when treated after 16 years. The mean age of disappearance of PFAPA symptoms has been 6.4 ± 2.4 years in children, while only 27% of adults have shown a complete drug-free symptom regression. CONCLUSIONS: A linear conformity of the PFAPA syndrome has been observed between pediatric and adult patients. PFAPA symptoms tended to disappear with no sequelae in 94.1% of children, while the disease was still active in almost 3/4 of adults at the time of our assessment.


Assuntos
Linfadenite , Faringite , Estomatite Aftosa , Tonsilectomia , Adulto , Criança , Pré-Escolar , Febre/diagnóstico , Febre/tratamento farmacológico , Febre/epidemiologia , Humanos , Lactente , Linfadenite/diagnóstico , Linfadenite/tratamento farmacológico , Linfadenite/epidemiologia , Faringite/diagnóstico , Faringite/tratamento farmacológico , Faringite/epidemiologia , Estomatite Aftosa/diagnóstico , Estomatite Aftosa/tratamento farmacológico , Estomatite Aftosa/epidemiologia
9.
Vestn Otorinolaringol ; 85(5): 65-70, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33140937

RESUMO

The purpose of the study. To establish the effectiveness of symptom reduction and preventive action of the herbal drug Tonsilgon N (HD) as monotherapy for exacerbations of chronic tonsillitis/pharyngitis in adult patients. MATERIAL AND METHODS: The study included 60 adult male and female patients aged 18 to 60 years with an established diagnosis of acute tonsillopharyngitis. In total, each patient underwent 5 visits. Visit 1 - enrollment in the study and beginning of HD monotherapy, Visit 2 - on Day 7, Visit 3 - on Day 14 and completion of HD monotherapy, Visit 4 - on Day 60 and Visit 5 - on Day 180. The diagnosis of the disease and the examination of the patient was carried out on the basis of anamnesis, general clinical and ENT examination, palpation of regional lymph nodes. The severity of the clinical signs was evaluated on the basis of the symptom score. The general condition of the patient was also evaluated using a visual analogue scale (VAS) and the number of exacerbations of tonsillopharyngitis during the observation period. RESULTS: The number of exacerbations of chronic tonsillitis and episodes of ATP for 6 months after the end of treatment decreased 4.8 times compared to the previous period. During the course of treatment (14 days), complaints of patients with ATP (general health and/or fatigue, pain when swallowing, headache, cough, burning sensation, a lump in the throat, hoarseness, pain and dryness in the throat, difficulty swallowing) had a pronounced tendency to regression. Improvement was also noted on examination and clinical evaluation. According to the results of the analysis of the evaluation of general condition according to the VAS (according to the standard technique in cm), there was a significant improvement both during the treatment period by 2.2 times, and during the observation period (180 days) from the period of Visit 2 to Visit 4 by 31.3 times. CONCLUSION: The use of HD as monotherapy for non-streptococcal ATP has shown its high efficiency. The possibility of using Tonsilgon N was shown as a prophylactic agent that reduces the number of exacerbations of inflammatory diseases in the pharynx during the period after the treatment course.


Assuntos
Faringite , Infecções Estreptocócicas , Tonsilite , Adolescente , Adulto , Feminino , Medicina Herbária , Humanos , Masculino , Pessoa de Meia-Idade , Faringite/diagnóstico , Faringite/tratamento farmacológico , Streptococcus pyogenes , Tonsilite/diagnóstico , Tonsilite/tratamento farmacológico , Adulto Jovem
10.
Aten. prim. (Barc., Ed. impr.) ; 52(9): 637-644, nov. 2020. graf, tab
Artigo em Inglês | IBECS | ID: ibc-198440

RESUMO

OBJECTIVE: This study was aimed at evaluating the appropriateness of use and interpretation of rapid antigen detection testing (RADT) and antibiotic prescribing for acute pharyngitis six years after a multifaceted intervention. DESIGN: Before-and-after audit-based study. LOCATION: Primary care centres in eight autonomous Communities. PARTICIPANTS: General practitioners (GP) who had participated in the HAPPY AUDIT intervention study in 2008 and 2009 were invited to participate in a third audit-based study six years later (2015). METHOD: RADTs were provided to the participating practices and the GPs were requested to consecutively register all adults with acute pharyngitis. A registration form specifically designed for this study was used. RESULTS: A total of 121 GPs out of the 210 who participated in the first two audits agreed to participate in the third audit (57.6%). They registered 3394 episodes of pharyngitis in the three registrations. RADTs were used in 51.7% of all the cases immediately after the intervention, and in 49.4% six years later. Antibiotics were prescribed in 21.3% and 36.1%, respectively (P < .001), mainly when tonsillar exudates were present, and in 5.3% and 19.2% of those with negative RADT results (P < .001). On adjustment for covariables, compared to the antibiotic prescription observed just after the intervention, significantly more antibiotics were prescribed six years later (odds ratio: 2.24, 95% confidence interval: 1.73-2.89). CONCLUSIONS: This study shows that that the long-term impact of a multifaceted intervention, focusing on the use and interpretation of RADT in patients with acute pharyngitis, is reducing


OBJETIVO: Evaluar la adecuación del uso e interpretación de las técnicas antigénicas rápidas (TAR) y la prescripción antibiótica en la faringitis aguda 6 años después de haber realizado una intervención multifacética. DISEÑO: Estudio antes-después basado en una auditoria. EMPLAZAMIENTO: Centros de salud en 8 comunidades autónomas. PARTICIPANTES: Se invitaron a médicos de familia (MF) que ya habían participado en el estudio de intervención HAPPY AUDIT en 2008 y 2009 a un nuevo AUDIT 6 años después (2015). MÉTODO: Se proporcionaron TAR a los centros participantes, y se pidió a los MF que registraran consecutivamente a todos los adultos con faringitis aguda. Usamos un registro diseñado específicamente para este estudio. RESULTADOS: Ciento veintiuno MF de los 210 que participaron en los primeros registros (57,6%) aceptaron a participar en el tercer registro. Se registraron 3.394 episodios de faringitis agudas en las 3 auditorías. Se usaron TAR en el 51,7% de los casos inmediatamente después de la intervención y en el 49,4%, 6 años después. Se prescribieron antibióticos en el 21,3%y 36,1%, respectivamente (p < 0,001), principalmente cuando había exudado amigdalar y en el 5,3 y 19,2% de los resultados de TAR negativos (p < 0,001). Después de ajustar por las distintas covariables, comparado con la prescripción antibiótica observada justo después de la intervención, prescribieron significativamente más antibióticos 6 años más tarde (odds ratio: 2,24 [IC 95%: 1,73-2,89]). CONCLUSIONES: Este estudio muestra que se reduce el impacto de una intervención multifacética a largo plazo enfocada al uso e interpretación de TAR en pacientes con faringitis aguda


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Faringite/diagnóstico , Faringite/tratamento farmacológico , Testes Imediatos , Antibacterianos/uso terapêutico , Testes Imunológicos/métodos , Doença Aguda , Faringite/microbiologia , Antígenos de Bactérias/análise , Resultado do Tratamento , Fatores de Tempo
11.
BMC Infect Dis ; 20(1): 782, 2020 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-33081701

RESUMO

BACKGROUND: Primary herpetic gingivostomatitis (PHGS) in children, though usually self-limited, might mimic bacterial and enteroviral pharyngitis clinically. We conducted a study to define the clinical features of PHGS in children. METHODS: Between January 2012 and December 2016, 282 inpatients aged less than 19 years with cell culture-confirmed herpes simplex virus (HSV) infection in a medical center were identified from the virologic laboratory logbook. Clinical data were retrospectively collected. RESULTS: Among the 282 inpatients, 185 cases were considered as PHGS and were included for analysis. Fever was present in 99.5%. The mean duration of fever was 5.11 days (±2.24) with the longest being 17 days. Common oral manifestations included oral ulcers (84.3%), which equally resided in the anterior and posterior part of the oral cavity (65.4% vs. 63.2%), gum swelling and/or bleeding (67.6%), and exudate coated tonsils (16.8%). Leukocytosis (WBC count > 15,000/uL3) was noted in 52 patients (28.1%) and a serum C-reactive protein level > 40 mg/L in 55 patients (29.7%). Fixty-five patients (35%) were diagnosed with PHGS on admission and were significantly more likely to have ulcers over the anterior oral cavity (76.1% vs. 26.7%) and gum swelling/bleeding (76.2% vs. 7.5%, p-value all < 0.001) on admission and were significantly less likely to receive antibiotic treatment (16.9 vs. 36.7%, p-value < 0.01) than others. Forty-six patients (25%) undiagnosed as PHGS on discharge were significantly more likely to have exudate coated on the tonsils, to receive antibiotic treatment and significantly less likely to have gum swelling/bleeding and oral ulcers (all p-values < 0.01). CONCLUSIONS: Meticulously identifying specific oral manifestations of gum swelling/bleeding and ulcers over the anterior oral cavity in children can help making the diagnosis of PHGS earlier and subsequently reduce unnecessary prescription of antibiotics.


Assuntos
Gengivite/diagnóstico , Herpes Simples/diagnóstico , Herpesvirus Humano 1/imunologia , Úlceras Orais/diagnóstico , Faringite/diagnóstico , Estomatite Herpética/diagnóstico , Tonsilite/diagnóstico , Adolescente , Antibacterianos/uso terapêutico , Proteína C-Reativa/análise , Criança , Pré-Escolar , Diagnóstico Diferencial , Diagnóstico Precoce , Feminino , Febre , Herpes Simples/tratamento farmacológico , Herpes Simples/virologia , Herpesvirus Humano 1/isolamento & purificação , Humanos , Lactente , Leucocitose , Masculino , Estudos Retrospectivos , Estomatite Herpética/tratamento farmacológico , Estomatite Herpética/virologia
12.
Infection ; 48(5): 715-722, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32734556

RESUMO

OBJECTIVE: To investigate the prognostic value of serum amyloid A (SAA) in the patients with Corona Virus Disease 2019 (COVID-19). METHODS: The medical data of 89 COVID-19 patients admitted to Renmin Hospital of Wuhan University from January 3, 2020 to February 26, 2020 were collected. Eighty-nine cases were divided into survival group (53 cases) and non-survival group (36 cases) according to the results of 28-day follow-up. The SAA levels of all patients were recorded and compared on 1 day after admission (before treatment) and 3 days, 5 days, and 7 days after treatment. The ROC curve was drawn to analyze the prognosis of patients with COVID-19 by SAA. RESULTS: The difference of comparison of SAA between survival group and non-survival group before treatment was not statistically significant, Z1 = - 1.426, P = 0.154. The Z1 values (Z1 is the Z value of the rank sum test) of the two groups of patients at 3 days, 5 days, and 7 days after treatment were - 5.569, - 6.967, and - 7.542, respectively. The P values were all less than 0.001, and the difference was statistically significant. The ROC curve results showed that SAA has higher sensitivity to the prognostic value of 1 day (before treatment), 3 days, 5 days, and 7 days after treatment, with values of 0.806, 0.972, 0.861, and 0.961, respectively. Compared with SAA on the 7th day and C-reactive protein, leukocyte count, neutrophil count, lymphocyte count, and hemoglobin on the 7th day, the sensitivities were: 96.1%, 83.3%, 88.3%, 83.3%, 67.9%, and 83.0%, respectively, of which SAA has the highest sensitivity. CONCLUSION: SAA can be used as a predictor of the prognosis in patients with COVID-19.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/diagnóstico , Tosse/diagnóstico , Febre/diagnóstico , Faringite/diagnóstico , Pneumonia Viral/diagnóstico , Proteína Amiloide A Sérica/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , China , Infecções por Coronavirus/sangue , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/fisiopatologia , Tosse/sangue , Tosse/mortalidade , Tosse/fisiopatologia , Feminino , Febre/sangue , Febre/mortalidade , Febre/fisiopatologia , Hemoglobinas/metabolismo , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Pandemias , Faringite/sangue , Faringite/mortalidade , Faringite/fisiopatologia , Pneumonia Viral/sangue , Pneumonia Viral/mortalidade , Pneumonia Viral/fisiopatologia , Prognóstico , Curva ROC , Estudos Retrospectivos , Índice de Gravidade de Doença , Análise de Sobrevida
13.
Microbes Infect ; 22(9): 481-488, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32561409

RESUMO

Clinical descriptions about influenza-like illnesses (ILI) in COVID-19 seem non-specific. We aimed to compare the clinical features of COVID-19 and influenza. We retrospectively investigated the clinical features and outcomes of confirmed cases of COVID-19 and influenza in Nord Franche-Comté Hospital between February 26th and March 14th 2020. We used SARS-CoV-2 RT-PCR and influenza virus A/B RT-PCR in respiratory samples to confirm the diagnosis. We included 124 patients. The mean age was 59 (±19 [19-98]) years with 69% female. 70 patients with COVID-19 and 54 patients with influenza A/B. Regarding age, sex and comorbidities, no differences were found between the two groups except a lower Charlson index in COVID-19 group (2 [±2.5] vs 3 [±2.4],p = 0.003). Anosmia (53% vs 17%,p < 0.001), dysgeusia (49% vs 20%,p = 0.001), diarrhea (40% vs 20%,p = 0.021), frontal headache (26% vs 9%,p = 0.021) and bilateral cracklings sounds (24% vs 9%,p = 0.034) were statistically more frequent in COVID-19. Sputum production (52% vs 29%,p = 0.010), dyspnea (59% vs 34%,p = 0.007), sore throat (44% vs 20%,p = 0.006), conjunctival hyperhemia (30% vs 4%,p < 0.001), tearing (24% vs 6%,p = 0.004), vomiting (22% vs 3%,p = 0.001) and rhonchi sounds (17% vs 1%,p = 0.002) were more frequent with influenza infection. We described several clinical differences which can help the clinicians during the co-circulation of influenza and SARS-CoV-2.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/diagnóstico , Vírus da Influenza A/patogenicidade , Vírus da Influenza B/patogenicidade , Influenza Humana/diagnóstico , Pneumonia Viral/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/virologia , Diagnóstico Diferencial , Diarreia/diagnóstico , Diarreia/fisiopatologia , Diarreia/virologia , Disgeusia/diagnóstico , Disgeusia/fisiopatologia , Disgeusia/virologia , Dispneia/diagnóstico , Dispneia/fisiopatologia , Dispneia/virologia , Feminino , França , Cefaleia/diagnóstico , Cefaleia/fisiopatologia , Cefaleia/virologia , Humanos , Influenza Humana/fisiopatologia , Influenza Humana/virologia , Masculino , Pessoa de Meia-Idade , Transtornos do Olfato/diagnóstico , Transtornos do Olfato/fisiopatologia , Transtornos do Olfato/virologia , Pandemias , Faringite/diagnóstico , Faringite/fisiopatologia , Faringite/virologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/virologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Vômito/diagnóstico , Vômito/fisiopatologia , Vômito/virologia
14.
Medicine (Baltimore) ; 99(21): e20221, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32481292

RESUMO

RATIONALE: Behcets disease (BD) is a type of chronic systemic vasculitis that typically manifests as a mucocutaneous disease with orogenital ulcers, skin damage, and uveitis. The clinical diagnosis is often difficult because of the diversity of organs that may be involved and lack of specific pathological diagnosis. PATIENT CONCERNS: A 26-year-old woman presented as a nearly 2-week history of hoarseness with throat pain. DIAGNOSES: In the present case, Fiber laryngoscopy showed multiple ulcers involving the epiglottic tubercle, bilateral false vocal cord, middle area of the left vocal cord, and full length of the right vocal cord. Multidisciplinary physicians combined the patients clinical manifestations and pathological findings to make the Behcets disease diagnosis. INTERVENTIONS: As the diagnosis confirmed, immediately began appropriate medical therapy (prednisolone at 30 mg once per day and thalidomide at 50 mg once per night in a month). OUTCOMES: The ulcer on the right vocal cord disappeared but left a scar. Therefore, the patient experienced only partial recovery from the hoarseness. LESSONS: Behcets disease can cause damage to multiple organs. Although the combination of vocal cord ulcers and hoarseness is rare in patients with BD and has not been previously reported to date, such patients should be treated with caution in clinical practice.


Assuntos
Síndrome de Behçet/complicações , Rouquidão/etiologia , Faringite/etiologia , Prega Vocal/patologia , Adulto , Síndrome de Behçet/diagnóstico por imagem , Síndrome de Behçet/tratamento farmacológico , Quimioterapia Combinada/métodos , Feminino , Glucocorticoides/administração & dosagem , Glucocorticoides/uso terapêutico , Humanos , Imunossupressores/administração & dosagem , Imunossupressores/uso terapêutico , Laringoscopia/métodos , Faringite/diagnóstico , Prednisolona/administração & dosagem , Prednisolona/uso terapêutico , Talidomida/administração & dosagem , Talidomida/uso terapêutico , Resultado do Tratamento , Prega Vocal/diagnóstico por imagem
16.
Infection ; 48(5): 687-694, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32390091

RESUMO

PURPOSE: We aimed to report the clinical characteristics of 194 cases coronavirus disease-19 (COVID-19) in Huanggang, Hubei and Taian, Shandong. METHODS: We retrospectively investigated the clinical, laboratory characteristics and CT imaging of confirmed cases of COVID-19 from January 22 to February 28, 2020 in Huanggang Central Hospital and The Second Affiliated Hospital of Shandong First Medical University. Real time PCR was used to detect the new coronavirus in respiratory samples. Immunohistochemical staining was used to detect the expressions of ACE2 in tissues. RESULTS: Among the 194 patients infected with COVID-19, 108 patients were male, with a median age of 48.3 years. The average preclinical period was 7.44 day. Except for 37 severe or critically ill patients, the rest of the 157 patients exhibited mild or moderate symptoms. 190 (97.94%) patients were confirmed during the three times nucleic acid test. The main clinical symptom of the patients were fever, sore throat and cough, which accounted for 146 cases (75.26%), 98 (50.52%) and 86 cases (44.33%), respectively. 30 patients (15.46%) showed liver dysfunction. Imaging examination showed that 141 patients (72.68%) showed abnormal density shadow, while 53 cases (27.32%) had no obvious abnormality in the parenchyma of both lungs. Up to now, 109 cases have been discharged from the hospital, and 9 patients died. The ACE2 expression levels were up-regulated in patients of severe type and critically ill type. CONCLUSION: Clinical symptoms, laboratory tests and CT imaging should be combined for comprehensive analysis to diagnose COVID-19. ACE2 may be the receptor of COVID-19.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/fisiopatologia , Tosse/fisiopatologia , Febre/fisiopatologia , Peptidil Dipeptidase A/genética , Faringite/fisiopatologia , Pneumonia Viral/fisiopatologia , Adolescente , Adulto , Idoso , Betacoronavirus/genética , Biomarcadores/metabolismo , China , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/virologia , Tosse/diagnóstico , Tosse/mortalidade , Tosse/virologia , Feminino , Febre/diagnóstico , Febre/mortalidade , Febre/virologia , Expressão Gênica , Humanos , Período de Incubação de Doenças Infecciosas , Masculino , Pessoa de Meia-Idade , Pandemias , Peptidil Dipeptidase A/metabolismo , Faringite/diagnóstico , Faringite/mortalidade , Faringite/virologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/mortalidade , Pneumonia Viral/virologia , Prognóstico , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Índice de Gravidade de Doença , Análise de Sobrevida , Tomografia Computadorizada por Raios X
17.
Sex Transm Infect ; 96(6): 402-407, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32447324

RESUMO

OBJECTIVES: Test of cure (TOC) for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) infection is an important tool in the public health management of STIs. However, there are limited data about the optimal time to perform TOC using nucleic acid amplification tests (NAATs) for NG and CT infections. A study was performed to assess the feasibility of a larger study to determine the optimal time to TOC using NAATS. METHODS: The Sexually Transmitted Bacteria Reference Unit at Public Health England undertook testing of gonococcal and chlamydial nucleic acids within neat urine stored in different conditions over 25 days to provide evidence of the stability of the nucleic acid prior to recruitment. Individuals diagnosed with uncomplicated NG or CT infection were recruited from three sexual health clinics. Individuals were asked to return nine self-taken samples from the site of infection over a course of 35 days. Survival analyses of time to first negative NAAT result for NG and CT infection and univariate regression analysis of factors that affect time to clearance were undertaken. RESULTS: At room temperature, chlamydial DNA in urine is stable for up to 3 weeks and gonococcal DNA for up to 11 days. We analysed data for 147 infections (81 NG and 66 CT). The median time to clearance of infection was 4 days (IQR 2-10 days) for NG infection and 10 days (IQR 7-14 days) for CT infection. Vaginal CT infections took longer to clear (p=0.031). NG infection in men who have sex with men took longer to clear (p=0.052). CONCLUSION: Chlamydial and gonococcal nucleic acids are stable in urine before addition of preservatives, longer than recommended by the manufacturer. The TOC results suggest that it may be possible to undertake TOC for NG and CT infections earlier than current guidelines suggest and that anatomical site of infection may affect time to clearance of infection.


Assuntos
Antibacterianos/uso terapêutico , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/tratamento farmacológico , Gonorreia/diagnóstico , Gonorreia/tratamento farmacológico , Adulto , Idoso , Azitromicina/uso terapêutico , Ceftriaxona/uso terapêutico , Chlamydia trachomatis/genética , Doxiciclina/uso terapêutico , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neisseria gonorrhoeae/genética , Técnicas de Amplificação de Ácido Nucleico , Faringite/diagnóstico , Faringite/tratamento farmacológico , Proctite/diagnóstico , Proctite/tratamento farmacológico , Reação em Cadeia da Polimerase em Tempo Real , Fatores de Tempo , Resultado do Tratamento , Uretrite/diagnóstico , Uretrite/tratamento farmacológico , Vulvovaginite/diagnóstico , Vulvovaginite/tratamento farmacológico , Adulto Jovem
18.
J Pediatr Adolesc Gynecol ; 33(4): 429-431, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32224248

RESUMO

BACKGROUND: Periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrome is a cyclic autoinflammatory disease generally diagnosed in childhood. There have been studies suggesting a relationship between menstruation and other autoinflammatory syndromes such as familial Mediterranean fever (FMF), but not PFAPA specifically. CASE: This case describes a patient with a diagnosis of PFAPA who experienced complete resolution with tonsillectomy only to have recurrence of symptoms with onset of menstruation. She experienced symptom control with initiation of oral contraceptives. SUMMARY AND CONCLUSION: Prior to this case report, there had been no evidence in the literature suggesting a relationship between PFAPA and menstruation despite the observed association in other autoinflammatory syndromes. Onset of menses may be a trigger in PFAPA.


Assuntos
Febre/complicações , Linfadenite/complicações , Menstruação/fisiologia , Faringite/complicações , Estomatite Aftosa/complicações , Criança , Feminino , Febre/diagnóstico , Humanos , Linfadenite/diagnóstico , Masculino , Faringite/diagnóstico , Recidiva , Estomatite Aftosa/diagnóstico , Síndrome
20.
Int J Pediatr Otorhinolaryngol ; 133: 109980, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32197187

RESUMO

INTRODUCTION: The diagnosis of streptococcal pharyngitis is very important to prevent complications such as acute rheumatic fever. Throat culture is the gold standard method for the diagnosis of streptococcal pharyngitis, however, rapid antigen tests (RAT) have been developed for faster diagnosis. The purpose of this study is to evaluate the efficacy of the BD Veritor ™ System (USA) rapid antigen assay in detecting Group A Streptococcus (GAS) in throat swab samples. METHODS AND MATERIALS: A total of 12,391 throat swabs, taken with a double swab, were evaluated. The BD Veritor ™ System was used for the detection of GAS antigen. Simultaneous throat cultures were performed. RESULTS: Throat culture yielded positive for 18.5% (2291) while 19.1% (2369) were positive with RAT. The sensitivity of BD Veritor ™ System was determined as 94.1% and specificity as 97.9%, while positive predictive value, negative predictive value and accuracy were determined as 91.0%, 98.7%, 97%, respectively. When all age groups were included, the rate of GAS positivity was 18.5% and this ratio increased to 27.3% in the five-15 age group. CONCLUSION: Our study, conducted with quite a large number of patients, yielded high sensitivity for the BD Veritor System. When the RAT is negative, the necessity of culture for pediatric patients should not be forgotten.


Assuntos
Antígenos Virais/isolamento & purificação , Faringite/diagnóstico , Faringite/microbiologia , Infecções Estreptocócicas/diagnóstico , Streptococcus pyogenes/isolamento & purificação , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Imunoensaio , Masculino , Sensibilidade e Especificidade , Streptococcus pyogenes/imunologia
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