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Mahavar N, Asghari M, Mofatteh M, Jaberi S, Erfanian N, Chahkandi M, Fereidouni M. Evaluation of the local and systemic pattern of sensitization to allergens in patients with adenotonsillar hypertrophy. Eur Arch Otorhinolaryngol 2024; 281:4231-4239. [PMID: 38546851 DOI: 10.1007/s00405-024-08550-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/12/2024] [Indexed: 07/24/2024]
Abstract
PURPOSE Adenotonsillar hypertrophy (ATH) is a medical condition characterized by the enlargement or swelling of the tonsils. The role of allergy in ATH has not been persuasively evidenced. Therefore, we investigated the state of humoral immunity and the presence of specific immunoglobulin E (sIgE) in tissues and sera in children suffering from TH. METHODS According to the skin prick test (SPT) result, 44 ATH children were divided into the atopic and non-atopic groups. The level of sIgE against 30 inhalants and food allergens in the sera and tissue homogenates was measured by a commercial allergy immunoblotting kit. In addition, we evaluated the following variables in both tonsillar tissue homogenates and serum: total IgE, IgA, IgM, IgG, and tissue eosinophil counts. RESULTS Our results showed that 21 (47.7%) of patients with ATH were sensitized to at least one allergen in the adenotonsillar sample and/or sera. Only two patients were negative for sIgE in the atopic group, but in the non-atopic group, only one had positive sIgE results. In the atopic group, 19 (86.4%) patients had positive sIgE in tonsillar tissues, and 18 (81.8%) had sensitized serum. There were no statistical differences in the case of other antibodies except IgE levels between the two groups. The average eosinophilic count was significantly higher in atopic patients than in the non-atopic group. CONCLUSION The results of this study support the role of allergy in the pathogenesis of ATH and confirmed local allergic inflammation in tonsillar tissue.
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Affiliation(s)
- Neda Mahavar
- Department of Immunology, Birjand University of Medical Sciences, Birjand, Iran
| | - Masoud Asghari
- Department of ENT, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Mohammadreza Mofatteh
- Department of ENT, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Sanaz Jaberi
- Department of Animal Science, Birjand University, Birjand, Iran
| | - Nafiseh Erfanian
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Mahboobeh Chahkandi
- Department of Pathology, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Mohammad Fereidouni
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran.
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Tu W, Nie D, Chen Y, Wen C, Zeng Z. Successful Treatment of SAPHO Syndrome Complicated with Ankylosing Spondylitis by Secukinumab: A Case Report. J Pers Med 2023; 13:516. [PMID: 36983699 PMCID: PMC10052174 DOI: 10.3390/jpm13030516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/10/2023] [Accepted: 03/12/2023] [Indexed: 03/15/2023] Open
Abstract
Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is characterized by a wide range of dermatological and musculoskeletal manifestations, and its outcome has recently been improved greatly by optimizing management. However, the treatment strategies are not standardized and require further refinement. Secukinumab, a fully human monoclonal antibody targeting IL-17A, is approved for the treatment of autoimmune psoriasis, psoriatic arthritis (PsA), and ankylosing spondylitis (AS). Here, a 53-year-old man was diagnosed with AS, and he presented scattered pustulosis in both hands and feet with a 5-year history of recurrent lumbosacral area pain and abnormal pain in the neck and front chest area. Secukinumab improved the patient's cutaneous lesion and prevented musculoskeletal pain by substituting adalimumab. Although only a few cases have been reported that secukinumab can effectively treat SAPHO syndrome complicated with AS, the efficacy remains controversial. Therefore, we hope to provide a novel valuable therapeutic strategy for SAPHO syndrome management, particularly in patients with skin lesions.
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Affiliation(s)
- Wei Tu
- Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Daan Nie
- Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yuxue Chen
- Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Cheng Wen
- Department of Rheumatology and Immunology, Xiaogan First People’s Hospital, Xiaogan 432000, China
| | - Zhipeng Zeng
- Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Malmberg S, Petrén S, Gunnarsson R, Hedin K, Sundvall PD. Acute sore throat and Fusobacterium necrophorum in primary healthcare: a systematic review and meta-analysis. BMJ Open 2021; 11:e042816. [PMID: 34088705 PMCID: PMC8183226 DOI: 10.1136/bmjopen-2020-042816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE The main objective of this review was to describe and quantify the association between Fusobacterium necrophorum (FN) and acute sore throat in primary healthcare (PHC). METHODS In this systematic review and meta-analysis, we searched Scopus and PubMed for case-control studies reporting the prevalence of FN in patients attending primary care for an uncomplicated acute sore throat as well as in healthy controls. Only studies published in English were considered. Publications were not included if they were case studies, or if they included patients prescribed antibiotics before the throat swab, patients with a concurrent malignant disease, on immunosuppression, having an HIV infection, or patients having another acute infection in addition to a sore throat. Inclusion criteria and methods were specified in advance and published in PROSPERO. The primary outcome was positive etiologic predictive value (P-EPV), quantifying the probability for an association between acute sore throat and findings of FN in the pharynx. For comparison, our secondary outcome was the corresponding P-EPV for group A Streptococcus (GAS). RESULTS PubMed and Scopus yielded 258 and 232 studies, respectively. Removing duplicates and screening the abstracts resulted in 53 studies subsequently read in full text. For the four studies of medium to high quality included in the meta-analysis, the cumulative P-EPV regarding FN was 64% (95% CI 33% to 83%). GAS, based on data from the same publications and patients, yielded a positive EPV of 93% (95% CI 83% to 99%). CONCLUSIONS The results indicate that FN may play a role in PHC patients with an acute sore throat, but the association is much weaker compared with GAS.
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Affiliation(s)
- Stefan Malmberg
- General Practice / Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research, Education, Development & Innovation, Primary Health Care, Region Västra Götaland, Borås, Sweden
| | - Susanna Petrén
- General Practice / Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ronny Gunnarsson
- General Practice / Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research, Education, Development & Innovation, Primary Health Care, Region Västra Götaland, Borås, Sweden
- Centre for Antibiotic Resistance Research (CARe), University of Gothenburg, Gothenburg, Sweden
| | - Katarina Hedin
- Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
- Futurum Academy for Health and Care, Region Jönköpings County, Jönköping, Sweden
- Department of Clinical Sciences in Malmö, Family Medicine, Lund University, Malmö, Sweden
| | - Pär-Daniel Sundvall
- General Practice / Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research, Education, Development & Innovation, Primary Health Care, Region Västra Götaland, Borås, Sweden
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Xiang Y, Wang Y, Cao Y, Li Z, Xiong D, Wang L, Zhang W, Zeng X, Wang Y, Li C. Tonsillitis as a possible predisposition to synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome. Int J Rheum Dis 2021; 24:519-525. [PMID: 33502120 DOI: 10.1111/1756-185x.14064] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 10/10/2020] [Accepted: 11/04/2020] [Indexed: 11/29/2022]
Abstract
AIM To present the prevalence of tonsillitis in synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) patients, to compare the clinical characteristics and disease activities between SAPHO patients with and without tonsillitis and to preliminarily explore the efficacy of tonsillectomy in SAPHO syndrome. METHOD A total of 58 SAPHO patients were included. Clinical data were collected, including demographic characteristics and acute phase reactants (erythrocyte sedimentation rate, high-sensitivity C-reactive protein). The visual analog scale (VAS), Palmoplantar Pustule Psoriasis Area Severity Index (PPPASI) and Nail Psoriasis Severity Index (NAPSI) were used to measure the severity of bone pain, skin lesions and nail lesions, respectively. Patients were referred to the otolaryngology department for tonsil examinations, including tonsil hypertrophy (grade ≥ 2), chronic congestion, inflammatory secretion and tonsil stones. The patients who underwent tonsillectomy were followed up after the surgery. RESULTS A total of 67.2% of patients had tonsillitis. Patients with tonsillitis had markedly higher PPPASI (1.2 [0, 7.4] vs. 7.6 [1.75, 15.5], P = .018) and NAPSI (0 [0, 21] vs. 8 [3, 28], P = .032) scores. After tonsillectomy, the patients experienced significantly improved bone pain (VAS, 5 [4, 7] vs. 3 [1, 4], P = .034) and skin lesions (PPPASI, 16.2 [7.05, 18.35] vs 1.8 [0.7, 3.7], P = .028). CONCLUSION Approximately 2/3 of SAPHO patients had tonsillitis. Patients with tonsillitis had more severe skin and nail lesions. Tonsillectomy might be associated with improved bone and skin symptoms in SAPHO patients. Future prospective controlled studies are warranted.
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Affiliation(s)
- Yirong Xiang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yutong Wang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yihan Cao
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Zhaohui Li
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Dingkun Xiong
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Lun Wang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Wen Zhang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaofeng Zeng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Yi Wang
- Department of Otolaryngology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Chen Li
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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Galli J, Calò L, Posteraro B, Rossi G, Sterbini FP, Paludetti G, Sanguinetti M. Pediatric oropharyngeal microbiome: Mapping in chronic tonsillitis and tonsillar hypertrophy. Int J Pediatr Otorhinolaryngol 2020; 139:110478. [PMID: 33160244 DOI: 10.1016/j.ijporl.2020.110478] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Aim of our study was to map the adenotonsillar lymphoid tissues' microbiome identifying its potential etiopathogenetic role in children affected by chronic tonsillitis or tonsillar hypertrophy with Obstructive Sleep Apnea Syndrome (OSAS). METHODS In our study, we examined tonsillar swabs from healthy children and children affected by chronic tonsillitis or by tonsillar hypertrophy with Obstructive Sleep Apnea Syndrome (OSAS). Microbiome's analysis was performed and bacterial 16Sr RNA gene was sequenced according to metagenomic principles. Variability was described according to the biodiversity concept, indicating species found in a certain environment and changes they undergo adapting to different environmental conditions. RESULTS The most significant differences concern variation of microbes in a single sample (alpha diversity) of some phyla in children affected by chronic tonsillitis compared with alpha diversity in healthy children and in children affected by OSAS with tonsillar hyperplasia. Proteobacteria are prevalent in chronic tonsillitis group, Fusobacteria and Spirochete in OSAS and Firmicutes, Actinobacteria, and Bacteroidetes were found in healthy children. Finally, comparison between the groups showed that children with OSAS with tonsillar hypertrophy had a higher presence of the Fusobacterium genus. CONCLUSION Recurrent upper airway inflammatory and/or infectious processes are polymicrobial; chronicity of such processes appear to be related to variations in microbiome's composition and interaction among various taxonomic units. Knowledge of the microbiomes' composition together with traditional clinical biomarkers can also determine relationships between oropharyngeal microbiome and systemic pathologies to determine preventive changes in lifestyle, eating habits, environmental exposure and use of probiotics.
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Affiliation(s)
- Jacopo Galli
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento-Neurologiche e della Testa e del Collo, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Lea Calò
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento-Neurologiche e della Testa e del Collo, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Brunella Posteraro
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Medicina Interna e Gastroenterologia Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Giorgia Rossi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento-Neurologiche e della Testa e del Collo, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Francesco Paroni Sterbini
- Fondazione Policlinico Universitario A. Gemelli IRCCS Istituto di Microbiologia Università Cattolica, Rome, Italy
| | - Gaetano Paludetti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento-Neurologiche e della Testa e del Collo, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Maurizio Sanguinetti
- Fondazione Policlinico Universitario A. Gemelli IRCCS Istituto di Microbiologia Università Cattolica, Rome, Italy.
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Prates MCM, Tamashiro E, Proenca-Modena JL, Criado MF, Saturno TH, Oliveira AS, Buzatto GP, Jesus BLS, Jacob MG, Carenzi LR, Demarco RC, Massuda ET, Aragon D, Valera FCP, Arruda E, Anselmo-Lima WT. The Relationship between Colonization by Moraxella catarrhalis and Tonsillar Hypertrophy. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2018; 2018:5406467. [PMID: 30515253 PMCID: PMC6236706 DOI: 10.1155/2018/5406467] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 07/11/2018] [Indexed: 11/30/2022]
Abstract
We sought to investigate the prevalence of potentially pathogenic bacteria in secretions and tonsillar tissues of children with chronic adenotonsillitis hypertrophy compared to controls. Prospective case-control study comparing patients between 2 and 12 years old who underwent adenotonsillectomy due to chronic adenotonsillar hypertrophy to children without disease. We compared detection of Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Pseudomonas aeruginosa, and Moraxella catarrhalis by real-time PCR in palatine tonsils, adenoids, and nasopharyngeal washes obtained from 37 children with and 14 without adenotonsillar hypertrophy. We found high frequency (>50%) of Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, and Pseudomonas aeruginosa in both groups of patients. Although different sampling sites can be infected with more than one bacterium and some bacteria can be detected in different tissues in the same patient, adenoids, palatine tonsils, and nasopharyngeal washes were not uniformly infected by the same bacteria. Adenoids and palatine tonsils of patients with severe adenotonsillar hypertrophy had higher rates of bacterial coinfection. There was good correlation of detection of Moraxella catarrhalis in different sampling sites in patients with more severe tonsillar hypertrophy, suggesting that Moraxella catarrhalis may be associated with the development of more severe hypertrophy, that inflammatory conditions favor colonization by this agent. Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, and Moraxella catarrhalis are frequently detected in palatine tonsils, adenoids, and nasopharyngeal washes in children. Simultaneous detection of Moraxella catarrhalis in adenoids, palatine tonsils, and nasopharyngeal washes was correlated with more severe tonsillar hypertrophy.
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Affiliation(s)
- Mirela C. M. Prates
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP 14049-900, Brazil
| | - Edwin Tamashiro
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP 14049-900, Brazil
| | - José L. Proenca-Modena
- Department of Cell Biology, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP 14049-900, Brazil
- Virology Research Center, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP 14049-900, Brazil
- Department of Genetics, Evolution and Bioagents, Institute of Biology, University of Campinas, Campinas, SP 13083-970, Brazil
| | - Miriã F. Criado
- Department of Cell Biology, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP 14049-900, Brazil
| | - Tamara H. Saturno
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP 14049-900, Brazil
| | - Anibal S. Oliveira
- Department of Cell Biology, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP 14049-900, Brazil
| | - Guilherme P. Buzatto
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP 14049-900, Brazil
| | - Bruna L. S. Jesus
- Department of Cell Biology, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP 14049-900, Brazil
| | - Marcos G. Jacob
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP 14049-900, Brazil
| | - Lucas R. Carenzi
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP 14049-900, Brazil
| | - Ricardo C. Demarco
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP 14049-900, Brazil
| | - Eduardo T. Massuda
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP 14049-900, Brazil
| | - Davi Aragon
- Department of Pediatrics, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP 14049-900, Brazil
| | - Fabiana C. P. Valera
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP 14049-900, Brazil
| | - Eurico Arruda
- Department of Cell Biology, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP 14049-900, Brazil
- Virology Research Center, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP 14049-900, Brazil
| | - Wilma T. Anselmo-Lima
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirao Preto Medical School, University of São Paulo, Ribeirao Preto, SP 14049-900, Brazil
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Kalaiarasi R, Subramanian KS, Vijayakumar C, Venkataramanan R. Microbiological Profile of Chronic Tonsillitis in the Pediatric Age Group. Cureus 2018; 10:e3343. [PMID: 30473976 PMCID: PMC6248716 DOI: 10.7759/cureus.3343] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Tonsillitis is a very common disease in children. Understanding the microbiology and pathology of chronic tonsillitis is an important step in its management. The aim of the study was to describe the microbiological profile of core tonsillar tissue in chronic tonsillitis in children. Materials and methods Children under 16 years of age with chronic tonsillitis were recruited in the descriptive study. Children with recurrent tonsillitis and recurrent tonsillitis with obstructive symptoms were included. Children who underwent tonsillectomy for obstructive symptoms alone and those who received antibiotics for at least one month prior to surgery were excluded from the study. Dissection and the snare method of tonsillectomy were done on all children. The operated specimen was cut into two halves in a sterile container. The core of the tonsillar tissue was swabbed with two sterile cotton-tipped swabs and sent for the microbiological evaluation of aerobes and anaerobes. The tonsillar tissue was sent for a histopathological examination. Results A total of 106 children were operated for chronic tonsillitis in one year. The mean age of children included in this study was 9.4 years. The duration of symptoms due to tonsillar disease ranged from four weeks to 28 months. There were 48 males and 58 females. Recurrent tonsillitis was the most common indication for tonsillectomy in all children. A total of 301 aerobes and 171 anaerobic microorganisms were isolated from 106 children with chronic tonsillitis. The aerobic bacterial species most often isolated was Streptococcus viridans, which was present in 83 children followed by Group A, β-hemolytic Streptococci in 67 children. The anaerobic bacterial most often isolated was Peptococcus species in 49 children. Polymicrobial aerobic and anaerobic flora were present in all tonsillar specimens, yielding an average of 4.1 isolates per specimen. The histopathological examination revealed chronic tonsillitis with reactive follicular hyperplasia in all (100%) children. Actinomycosis was associated with non-specific reactive follicular hyperplasia in four specimens. Conclusion Polymicrobial aerobic and anaerobic flora are identified in deep tonsillar tissue in children with tonsillitis. The identification of bacterial isolates from the core tissue in recurrent tonsillitis could dictate the management of chronic tonsillitis. The histopathological examination of the core tissues of the tonsils helps in an accurate identification of organisms that are difficult to culture.
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Affiliation(s)
- Raja Kalaiarasi
- Otorhinolaryngology, Sri Lakshmi Narayana Institute of Medical Science, Puducherry, IND
| | | | - Chellappa Vijayakumar
- Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND
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8
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Diener VN, Gay A, Soyka MB, Attin T, Schmidlin PR, Sahrmann P. What is the influence of tonsillectomy on the level of periodontal pathogens on the tongue dorsum and in periodontal pockets. BMC Oral Health 2018; 18:62. [PMID: 29625605 PMCID: PMC5889595 DOI: 10.1186/s12903-018-0521-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 03/20/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND For periodontal treatment, the full mouth disinfection approach suggests disinfection of oral soft tissues, such as tongue and tonsils concomitant to scaling and root planning since patients might benefit from treatment of these oral niches either. Periodontopathogenes in tonsillar tissue support this hypothesis. This prospective controlled clinical study investigated the change in the oral flora of patients who underwent tonsillectomy. Pockets were tested for eleven bacterial species before and six weeks after the surgical intervention. METHODS Fifty generally healthy adults were included in this study. The test group consisted of 25 patients with tonsillectomy. The control group included 25 patients with otorhinolarynologic surgery without involvement of the oral cavity. Clinical parameters such as probing pocket depth, bleeding-on-probing index and plaque index were registered the evening before surgery. Also bacterial samples from the gingival sulcus and dorsum linguae were taken, and an additional sample from the removed tonsils in the test group. Six weeks after the intervention microbial samples of pockets and tongue were taken again. Data were tested for significant differences using Wilcoxon rank and Whitney-u-test. RESULTS No relevant intra- or intergroup differences were found for the change of the eleven investigated species. CONCLUSION Based on the results of the present study, tonsillectomy does not seem to have an immediate relevant effect on the bacterial flora of tongue or periodontium. This study design was approved by the ethical committee of Zurich (KEK-ZH-Nr.2013-0419). TRIAL REGISTRATION The trial was retrospectively registered in the German Clinical Trials Register ( DRK00014077 ) on February 20, 2018.
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Affiliation(s)
- V N Diener
- Clinic for Preventive Dentistry, Periodontology and Cariologiy, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
| | - A Gay
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland
| | - M B Soyka
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland
| | - T Attin
- Clinic for Preventive Dentistry, Periodontology and Cariologiy, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - P R Schmidlin
- Clinic for Preventive Dentistry, Periodontology and Cariologiy, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - P Sahrmann
- Clinic for Preventive Dentistry, Periodontology and Cariologiy, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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9
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Bacteriology and antibiotic sensitivity of tonsillar diseases in Chinese children. Eur Arch Otorhinolaryngol 2017; 274:3153-3159. [DOI: 10.1007/s00405-017-4603-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 05/08/2017] [Indexed: 11/25/2022]
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10
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Katkowska M, Garbacz K, Stromkowski J. Staphylococcus aureusisolated from tonsillectomized adult patients with recurrent tonsillitis. APMIS 2016; 125:46-51. [DOI: 10.1111/apm.12628] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 09/01/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Marta Katkowska
- Department of Oral Microbiology; Medical University of Gdansk; Gdansk Poland
| | - Katarzyna Garbacz
- Department of Oral Microbiology; Medical University of Gdansk; Gdansk Poland
| | - Józef Stromkowski
- Department of Otolaryngology and Otolaryngological Oncology; Voivodeship Specialist Hospital; Olsztyn Poland
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Moran Losada P, Chouvarine P, Dorda M, Hedtfeld S, Mielke S, Schulz A, Wiehlmann L, Tümmler B. The cystic fibrosis lower airways microbial metagenome. ERJ Open Res 2016; 2:00096-2015. [PMID: 27730195 PMCID: PMC5005179 DOI: 10.1183/23120541.00096-2015] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/04/2016] [Indexed: 11/23/2022] Open
Abstract
Chronic airway infections determine most morbidity in people with cystic fibrosis (CF). Herein, we present unbiased quantitative data about the frequency and abundance of DNA viruses, archaea, bacteria, moulds and fungi in CF lower airways. Induced sputa were collected on several occasions from children, adolescents and adults with CF. Deep sputum metagenome sequencing identified, on average, approximately 10 DNA viruses or fungi and several hundred bacterial taxa. The metagenome of a CF patient was typically found to be made up of an individual signature of multiple, lowly abundant species superimposed by few disease-associated pathogens, such as Pseudomonas aeruginosa and Staphylococcus aureus, as major components. The host-associated signatures ranged from inconspicuous polymicrobial communities in healthy subjects to low-complexity microbiomes dominated by the typical CF pathogens in patients with advanced lung disease. The DNA virus community in CF lungs mainly consisted of phages and occasionally of human pathogens, such as adeno- and herpesviruses. The S. aureus and P. aeruginosa populations were composed of one major and numerous minor clone types. The rare clones constitute a low copy genetic resource that could rapidly expand as a response to habitat alterations, such as antimicrobial chemotherapy or invasion of novel microbes. The CF lung metagenome is composed of few viruses and fungi and hundreds of bacterial species, clones and subcloneshttp://ow.ly/ZiqUE
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Affiliation(s)
- Patricia Moran Losada
- Clinic for Paediatric Pneumology, Allergology and Neonatology, OE 6710, Hannover Medical School, Hannover, Germany
| | - Philippe Chouvarine
- Clinic for Paediatric Pneumology, Allergology and Neonatology, OE 6710, Hannover Medical School, Hannover, Germany
| | - Marie Dorda
- Clinic for Paediatric Pneumology, Allergology and Neonatology, OE 6710, Hannover Medical School, Hannover, Germany
| | - Silke Hedtfeld
- Clinic for Paediatric Pneumology, Allergology and Neonatology, OE 6710, Hannover Medical School, Hannover, Germany
| | - Samira Mielke
- Clinic for Paediatric Pneumology, Allergology and Neonatology, OE 6710, Hannover Medical School, Hannover, Germany
| | - Angela Schulz
- Clinic for Paediatric Pneumology, Allergology and Neonatology, OE 6710, Hannover Medical School, Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research, Hannover, Germany
| | - Lutz Wiehlmann
- Clinic for Paediatric Pneumology, Allergology and Neonatology, OE 6710, Hannover Medical School, Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research, Hannover, Germany
| | - Burkhard Tümmler
- Clinic for Paediatric Pneumology, Allergology and Neonatology, OE 6710, Hannover Medical School, Hannover, Germany; Biomedical Research in Endstage and Obstructive Lung Disease (BREATH), Member of the German Center for Lung Research, Hannover, Germany
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