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Andersen C, Greve T, Reinholdt KB, Kjaerulff AMG, Udholm N, Khalid V, Madzak A, Duez C, Münch H, Pauli S, Danstrup CS, Petersen NK, Klug TE. Bacterial findings in patients referred to hospital for the treatment of acute tonsillitis with or without peritonsillar phlegmon. BMC Infect Dis 2023; 23:439. [PMID: 37386401 DOI: 10.1186/s12879-023-08420-8] [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: 03/10/2023] [Accepted: 06/22/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND The vast majority of patients with acute tonsillitis (AT) are managed in general practice. However, occasionally patients are referred to hospital for specialized management because of aggravated symptoms and/or findings suggestive of peritonsillar involvement. No prospective studies have been conducted aiming to investigate the prevalent and significant microorganisms in this highly selected group of patients. We aimed to describe the microbiological findings of acute tonsillitis with or without peritonsillar phlegmon (PP) in patients referred for hospital treatment and to point out potential pathogens using the following principles to suggest pathogenic significance: (1) higher prevalence in patients compared to healthy controls, (2) higher abundance in patients compared to controls, and (3) higher prevalence at time of infection compared to time of follow up. METHODS Meticulous and comprehensive cultures were performed on tonsillar swabs from 64 patients with AT with (n = 25) or without (n = 39) PP and 55 healthy controls, who were prospectively enrolled at two Danish Ear-Nose-Throat Departments between June 2016 and December 2019. RESULTS Streptococcus pyogenes was significantly more prevalent in patients (27%) compared to controls (4%) (p < 0.001). Higher abundance was found in patients compared to controls for Fusobacterium necrophorum (mean 2.4 vs. 1.4, p = 0.017) and S. pyogenes (mean 3.1 vs. 2.0, p = 0.045) in semi-quantitative cultures. S. pyogenes, Streptococcus dysgalactiae, and Prevotella species were significantly more prevalent at time of infection compared to follow up (p = 0.016, p = 0.016, and p = 0.039, respectively). A number of species were detected significantly less frequently in patients compared to controls and the mean number of species was significantly lower in patients compared to controls (6.5 vs. 8.3, p < 0.001). CONCLUSIONS Disregarding Prevotella spp. because of the prevalence in healthy controls (100%), our findings suggest that S. pyogenes, F. necrophorum, and S. dysgalactiae are significant pathogens in severe AT with or without PP. In addition, infections were associated with reduced diversity (dysbacteriosis). TRIAL REGISTRATION The study is registered in the ClinicalTrials.gov protocol database (# 52,683). The study was approved by the Ethical Committee at Aarhus County (# 1-10-72-71-16) and by the Danish Data Protection Agency (# 1-16-02-65-16).
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Affiliation(s)
- Camilla Andersen
- Department of Clinical Microbiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99 Aarhus N, Aarhus, DK-8200, Denmark.
| | - Thomas Greve
- Department of Clinical Microbiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99 Aarhus N, Aarhus, DK-8200, Denmark
| | - Kasper Basse Reinholdt
- Department of Otorhinolaryngology, Head & Neck Surgery, Aarhus University Hospital, Aarhus, Denmark
| | | | - Nichlas Udholm
- Department of Otorhinolaryngology, Head & Neck Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Vesal Khalid
- Department of Otorhinolaryngology, Head & Neck Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Adnan Madzak
- Department of Otorhinolaryngology, Head & Neck Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Christophe Duez
- Department of Otorhinolaryngology, Head & Neck Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Münch
- Department of Otorhinolaryngology, Head & Neck Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Søren Pauli
- Department of Otorhinolaryngology, Head & Neck Surgery, Aarhus University Hospital, Aarhus, Denmark
- Department of Otorhinolaryngology, Head & Neck Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Christian Sander Danstrup
- Department of Otorhinolaryngology, Head & Neck Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Niels Krintel Petersen
- Department of Otorhinolaryngology, Head & Neck Surgery, Aarhus University Hospital, Aarhus, Denmark
- Department of Otorhinolaryngology, Head & Neck Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Tejs Ehlers Klug
- Department of Otorhinolaryngology, Head & Neck Surgery, Aarhus University Hospital, Aarhus, Denmark
- Aarhus University, Aarhus, Denmark
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Vilén ST, Ahde H, Puolakka T, Mäkitie A, Uittamo J, Snäll J. Differences in characteristics and infection severity between odontogenic and other bacterial oro-naso-pharyngeal infections. Head Face Med 2023; 19:10. [PMID: 36922880 PMCID: PMC10015701 DOI: 10.1186/s13005-023-00354-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/24/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND Different bacterial infections of the oro-naso-pharyngeal (ONP) region may progress and require hospital care. The present study clarified differences in infection characteristics between hospitalized patients with odontogenic infections (OIs) and other bacterial ONP infections. The specific aim was to evaluate clinical infection variables and infection severity according to infection aetiology, particularly regarding features of OIs compared with other ONPs. METHODS Records of patients aged ≥16 years requiring hospital care for an acute bacterial ONP infection in the emergency units of Otorhinolaryngology or Oral and Maxillofacial Surgery at the Helsinki University Hospital (Helsinki, Finland) during 2019 were evaluated retrospectively. The main outcome variables were need for intensive care unit (ICU) treatment and length of hospital stay. The primary predictor variable was infection category, defined as OI or other ONP. The secondary predictor variable was specific ONP infection group. Additional predictor variables were primary clinical infection signs, infection parameters at hospital admission, and delay from beginning of symptoms to hospitalization. Explanatory variables were sex, age, current smoking, heavy alcohol use or substance abuse, and immunosuppressive disease, immunosuppressive medication, or both. Comparison of study groups was performed using Fisher's exact test, student's t-test, and Mann-Whitney U. RESULTS A total of 415 patients with bacterial ONPs fulfilled the inclusion criteria. The most common infections were oropharyngeal (including peritonsillar, tonsillar, and parapharyngeal infections; 51%) followed by infections from the odontogenic origin (24%). Clinical features of OIs differed from other ONPs. Restricted mouth opening, skin redness, or facial or neck swelling (or both) were found significantly more often in OIs (p < 0.001). OIs required ICU care significantly more often than other ONPs (p < 0.001) and their hospital stay was longer (p = 0.017). CONCLUSIONS Infections originating from the tonsillary and dental origin had the greatest need for hospitalization. Clinical features of OIs differed; the need for ICU treatment was more common and hospital stay was longer compared with other ONPs. Preventive care should be emphasized regarding OIs, and typical infection characteristics of ONP infection subgroups should be highlighted to achieve early and prompt diagnosis and treatment and to reduce hospitalization time.
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Affiliation(s)
- Suvi-Tuuli Vilén
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Haartmaninkatu 1, PL 220, 00029, Helsinki, HUS, Finland.
| | - Hanna Ahde
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Haartmaninkatu 1, PL 220, 00029, Helsinki, HUS, Finland
| | - Tuukka Puolakka
- Department of Emergency Medicine & Services, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Antti Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery and Research Program in Systems Oncology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Johanna Uittamo
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Haartmaninkatu 1, PL 220, 00029, Helsinki, HUS, Finland
| | - Johanna Snäll
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Haartmaninkatu 1, PL 220, 00029, Helsinki, HUS, Finland.,Department of Oral and Maxillofacial Diseases, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Mettias B, Jenkins D, Rea P. Ten-year prevalence of acute hospital ENT infections and the impact of COVID: A large population study. Clin Otolaryngol 2022; 48:10-16. [PMID: 36068673 PMCID: PMC9538811 DOI: 10.1111/coa.13978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/07/2022] [Accepted: 08/19/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Acute ear, nose and throat (ENT) infections were the commonest referrals from accident and emergency to ENT services. The referral rate changed dramatically with season, year, national outbreaks and during the COVID pandemic. METHOD Retrospective longitudinal study of the epidemiology of seven acute ENT infections in secondary care over 10 years. A mixed city and rural population of over 650 000 in central England was studied. The risk factors for each wave of infection during the surge of infection were sought. A statistical analysis of their significance was undertaken. This included analysis and correlation of group A-beta haemolytic streptococcus (GABHS) in hospital and community. Seasonal variations, hospital admissions and the impact of the COVID were analysed. RESULTS There were 16 883 reported cases of the seven index ENT infections during the 10-year period. Great seasonal and year-to-year variations were recorded. There was an incremental rise in 2018. Spring had the highest season of acute ENT infections. An outbreak of GABHS was noted in the community in 2014. The mean duration of hospital admission was 1.5 days. There was no statistical ethnic or gender predominance. A dramatically lower number of acute ENT infections were recorded during the COVID-19 pandemic, and this continued after lifting of lockdown restrictions. CONCLUSION A resurgence in scarlet fever directly and indirectly contributed to an incremental rise in acute ENT infections in the following years. Both hospital and community B-haemolytic cultures have declined during the COVID-19 pandemic due to a reduction in infections as opposed to reduced case ascertainment.
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Affiliation(s)
| | | | - Peter Rea
- Leicester Royal InfirmaryLeicesterUK
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Fauck V, Schinz K, Alexiou C, Mantsopoulos K, Iro H, Mueller SK. [Abscesstonsillectomy: Uni- or bilateral?]. Laryngorhinootologie 2022; 101:896-901. [PMID: 35605964 DOI: 10.1055/a-1841-6419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE In addition to an empirical use of antibiotics for treatment of a peritonsillar abscess (PTA) there is a drainage of pus or the abscess tonsillectomy. Postoperative bleeding after abscesstonsillectomy (ABTE) is this surgery's most feared complication which can rarely lead to patients' deaths. The objective of this study was to compare bleeding complications of ABTE with and without contralateral tonsillectomy (TE) and to analyze the occurrence of a metachronous PTA at the contralateral side. METHODS Retrospective study of n= 655 patients undergoing ABTE with and without TE of the contralateral side from January 2004 to February 2019. Bleeding complications needing surgical hemostasis were analyzed regarding demographic and surgical parameters. In addition, occurrence of PTA and need for ABTE of the contralateral side after unilateral ABTE were evaluated. RESULTS Overall, 10/655 (1.5 %) patients presented with postoperative bleeding after ABTE. In 404/655 an ABTE with contralateral TE was performed. Here, 8/404 (1.98 %) patients showed contra- or bilateral bleeding. Only in 2/251 (0.7 %) patients occurred a bleeding complication after unilateral ABTE. Therefore, bleeding after unilateral ABTE was significantly lower than ABTE with contralateral TE (1.98 % vs. 0.7 %, p= 0.001). In 0.8 % of the patients a contralateral ABTE was necessary due to a metachronous PTA. CONCLUSION Overall, the rate of postoperative bleeding after ABTE (1.5 %) was low. Unilateral ABTE showed significantly lower postoperative bleeding rates compared to ABTE with contralateral TE. Consequently, the indication of a contralateral TE must be very strict.
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Affiliation(s)
- Vanessa Fauck
- Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Katharina Schinz
- Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Christoph Alexiou
- Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Konstantinos Mantsopoulos
- Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Heinrich Iro
- Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sarina K Mueller
- Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Nielsen NØ, Nørlinger C, Greve T, Klug TE. Cervical suppurative lymphadenitis in children: microbiology, primary sites of infection, and evaluation of antibiotic treatment. Eur Arch Otorhinolaryngol 2021; 279:3053-3062. [PMID: 34623496 DOI: 10.1007/s00405-021-07115-7] [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: 09/13/2021] [Accepted: 09/29/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE The significant pathogens associated with paediatric cervical suppurative lymphadenitis (CSL) are unclarified, and there is a lack of clinical evaluations of antibiotic regimens in paediatric CSL. We aimed to (1) explore the bacterial findings and the associated primary sites of infection in paediatric cases of CSL and (2) evaluate the clinical outcomes in patients treated with different antibiotic regimens. METHODS All children (< 18 years) treated for non-mycobacterium CSL at the Department of Otorhinolaryngology, Aarhus University Hospital, from 2001 to 2018 were retrospectively evaluated. RESULTS Eighty-five patients were included in the study. The prevalent isolates were S. aureus (57%), S. pyogenes (17%), non-haemolytic streptococci (11%), and F. necrophorum (3%). The primary sites of infection were identified in 30 (35%) patients. The most common sites were the oropharynx (n = 15), the middle ear (n = 10), and the skin (n = 5). All patients were treated with surgical incision and antibiotics. No statistically significant differences were found between patients treated with antibiotics covering streptococci (n = 60) versus antibiotics covering streptococci and S. aureus (n = 25) in terms of duration of hospitalisation (median 4 vs 4 days, p = 0.26), altered antibiotic treatment because of insufficient clinical or biochemical progress (7% vs 12%, p = 0.41), and abscess recurrence (8% vs 12%, p = 0.69). CONCLUSION S. aureus was the predominant pathogen in paediatric CSL at all cervical levels, and even in cases with evidence of primary site infection not normally associated with S. aureus. We were unable to underscore the importance of antibiotic treatment covering S. aureus based on evaluation of the clinical outcomes.
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Affiliation(s)
- Nicolai Østergaard Nielsen
- Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, 8200, Aarhus N, Denmark.
| | - Christian Nørlinger
- Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, 8200, Aarhus N, Denmark
| | - Thomas Greve
- Department of Clinical Microbiology, Aarhus University Hospital, Aarhus N, Denmark
| | - Tejs Ehlers Klug
- Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, 8200, Aarhus N, Denmark
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Ameur E, Sarra M, Yosra D, Mariem K, Nabil A, Lynen F, Larbi KM. Chemical composition of essential oils of eight Tunisian Eucalyptus species and their antibacterial activity against strains responsible for otitis. BMC Complement Med Ther 2021; 21:209. [PMID: 34384412 PMCID: PMC8359536 DOI: 10.1186/s12906-021-03379-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 07/15/2021] [Indexed: 01/09/2023] Open
Abstract
Background The chemical composition and biological activity of Eucalyptus essential oils have been studied extensively (EOs). A few of them were tested for antibacterial effectiveness against otitis strains. The chemical composition and antibacterial activity of the EOs of eight Tunisian Eucalyptus species were assessed in the present study. Methods Hydrodistillation was used to extract EOs from the dried leaves of eight Eucalyptus species: Eucalyptus accedens, Eucalyptus punctata, Eucalyptus robusta, Eucalyptus bosistoana, Eucalyptus cladocalyx, Eucalyptus lesouefii, Eucalyptus melliodora and Eucalyptus wandoo. They are assessed by GC/MS and GC/FID and evaluated for antibacterial activity using agar diffusion and broth microdilution techniques against three bacterial isolates (Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiella pneumoniae) and three reference bacteria strains (Pseudomonas aeruginosa, ATTC 9027; Staphylococcus aureus, ATCC 6538; and Escherichia coli, ATCC 8739). Furthermore, the selected twenty-one major compounds and all values of the inhibition zone diameters were subjected to further statistical analysis using PCA and HCA. Results The EO yields of the studied Eucalyptus species range from 1.4 ± 0.4% to 5.2 ± 0.3%. Among all the species studied, E. lesouefii had the greatest mean percentage of EOs. The identification of 128 components by GC (RI) and GC/MS allowed for 93.6% – 97.7% of the total oil to be identified. 1,8-cineole was the most abundant component found, followed by α-pinene, p-cymene, and globulol. The chemical components of the eight EOs, extracted from the leaves of Eucalyptus species, were clustered into seven groups using PCA and HCA analyses, with each group forming a chemotype. The PCA and HCA analyses of antibacterial activity, on the other hand, identified five groups. Conclusion The oils of E. melliodora, E. bosistoana, and E. robusta show promise as antibiotic alternatives in the treatment of otitis media. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-021-03379-y.
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Affiliation(s)
- Elaissi Ameur
- Chemical, Pharmacological and Gallenic Development Laboratory, University of Monastir, Faculty of Pharmacy, Avenue Avicennne, 5019, Monastir, Tunisia.
| | - Moumni Sarra
- Chemical, Pharmacological and Gallenic Development Laboratory, University of Monastir, Faculty of Pharmacy, Avenue Avicennne, 5019, Monastir, Tunisia
| | - Derbali Yosra
- Chemical, Pharmacological and Gallenic Development Laboratory, University of Monastir, Faculty of Pharmacy, Avenue Avicennne, 5019, Monastir, Tunisia
| | - Kouja Mariem
- University of Carthage, The National Research Institute of Rural Engineering, Water and Forestry, INRGREF, Laboratory of Management and Valorization of Forest Resources, BP 10, 2080, Ariana, Tunisia
| | - Abid Nabil
- Laboratory of Transmissible Diseases and Biological Active Substances LR99ES27, Faculty of Pharmacy, University of Monastir, Monastir, Tunisia.,High Institute of Biotechnology of Sidi Thabet, University of Manouba, Manouba, Tunisia
| | - Frederic Lynen
- Separation Science Group, Department of Organic and Macromolecular Chemistry, Faculty of Sciences, Ghent University, Krijgslaan 281-S4 Bis, B-9000, Ghent, Belgium
| | - Khouja Mohamed Larbi
- University of Carthage, The National Research Institute of Rural Engineering, Water and Forestry, INRGREF, Laboratory of Management and Valorization of Forest Resources, BP 10, 2080, Ariana, Tunisia
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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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Peritonsillar abscess may not always be a complication of acute tonsillitis: A prospective cohort study. PLoS One 2020; 15:e0228122. [PMID: 32243441 PMCID: PMC7122714 DOI: 10.1371/journal.pone.0228122] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/09/2020] [Indexed: 11/19/2022] Open
Abstract
The present study aimed to specify diagnostics for peritonsillar abscesses (PTAs) and to clarify the role of minor salivary glands. This prospective cohort study included 112 patients with acute tonsillitis (AT) and PTA recruited at a tertiary hospital emergency department between February and October 2017. All patients completed a questionnaire concerning their current disease. Serum amylase (S-Amyl) and C-reactive protein (S-CRP) levels, tonsillar findings, and pus aspirate samples and throat cultures were analyzed. Eight of 58 PTA patients (13.8%) had no signs of tonsillar infection. The absence of tonsillar erythema and exudate was associated with low S-CRP (p<0.001) and older age (p<0.001). We also observed an inverse correlation between S-Amyl and S-CRP levels (AT, r = -0.519; PTA, r = -0.353). Therefore, we observed a group of PTA patients without signs of tonsillar infection who had significantly lower S-CRP levels than other PTA patients. These findings support that PTA may be caused by an etiology other than AT. Variations in the S-Amyl levels and a negative correlation between S-Amyl and S-CRP levels may indicate that minor salivary glands are involved in PTA development.
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Olzowy B, Al-Nawas B, Havel M, Karbach J, Müller R. Calculated parenteral initial treatment of bacterial infections: Infections in the ear, nose, throat and mouth and jaw area. GMS INFECTIOUS DISEASES 2020; 8:Doc14. [PMID: 32373439 PMCID: PMC7186809 DOI: 10.3205/id000058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This is the sixth chapter of the guideline "Calculated initial parenteral treatment of bacterial infections in adults - update 2018" in the 2nd updated version. The German guideline by the Paul-Ehrlich-Gesellschaft für Chemotherapie e.V. (PEG) has been translated to address an international audience. The chapter deals with the antibacterial treatment of more severe infections of the ear, the nose, the throat and the maxillofacial region, including odontogenic and salivary gland infections.
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Affiliation(s)
| | - Bilal Al-Nawas
- Klinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätsmedizin Mainz, Germany
| | - Miriam Havel
- Klinik und Poliklinik für HNO-Heilkunde, Klinikum der Universität München, Munich, Germany
| | - Julia Karbach
- Klinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätsmedizin Mainz, Germany
| | - Rainer Müller
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Carl Gustav Carus Dresden, Germany
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10
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Valentino WL, Lafferty D, Terk A. Acute Bilateral Peritonsillar Abscesses. EAR, NOSE & THROAT JOURNAL 2019; 99:NP129-NP130. [PMID: 31309845 DOI: 10.1177/0145561319858927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - David Lafferty
- Section of Pediatric Otolaryngology, The Department of Otolaryngology, 6556Philadelphia College of Osteopathic Medicine, St. Christopher's Hospital for Children, Philadelphia, PA, USA
| | - Alyssa Terk
- Section of Pediatric Otolaryngology, Otolaryngology and Pediatrics, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA, USA
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Whipps MD, Yoshikawa H, Demirci JR. Latent trajectories of infant breast milk consumption in the United States. MATERNAL & CHILD NUTRITION 2019; 15:e12655. [PMID: 30216665 PMCID: PMC7198923 DOI: 10.1111/mcn.12655] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 06/23/2018] [Accepted: 07/04/2018] [Indexed: 01/03/2023]
Abstract
Patterns of breastfeeding over time are not currently well understood. Limited qualitative and quantitative evidence suggests that there may be latent subgroups of mothers in the United States following very different trajectories of breast milk provision for their infants. This study used a quantitative modelling method (group-based trajectory modelling) to identify and describe these subgroups. Using data from the Infant Feeding Practices Study II (n = 3,023), the authors identified four distinct trajectories of breastfeeding intensity, each of which included a substantial subset of the total sample. A model with four groups fit the data well by objective and conceptual standards. Bivariate associations were analysed, and significant difference between trajectory group membership was found on an array of maternal and family determinants, including maternal demographics, hospital experience, and psychosocial resources, as well as on postweaning perceptions. These associations were used to create group profiles for each subgroup. Controlling for sociodemographic covariates, we also found that trajectory membership was significantly associated with several health outcomes for the target child 6 years later, including certain infections, picky eating, and health care utilization; trajectory group membership was also associated with maternal breastfeeding of subsequent children and maternal body mass index (BMI) at Year 6. Child BMI z-score and maternal breast cancer diagnosis were not significantly different across trajectory groups after accounting for confounding covariates, nor was time missed from school for the target child. Though exploratory, the initial identification and description of these four subgroups suggest future directions using breastfeeding trajectory methods, with potential implications for measurement, intervention development, and targeting.
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Affiliation(s)
- Mackenzie D.M. Whipps
- Department of Applied PsychologyNew York University Steinhardt School of Culture, Education, and Human DevelopmentNew YorkNew YorkUSA
| | - Hirokazu Yoshikawa
- Department of Applied PsychologyNew York University Steinhardt School of Culture, Education, and Human DevelopmentNew YorkNew YorkUSA
| | - Jill R. Demirci
- Department of Health Promotion and DevelopmentUniversity of Pittsburgh School of NursingPittsburghPennsylvaniaUSA
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Johnston J, Stretton M, Mahadevan M, Douglas R. Peritonsillar abscess: A retrospective case series of 1773 patients. Clin Otolaryngol 2018; 43:940-944. [DOI: 10.1111/coa.13070] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 11/30/2022]
Affiliation(s)
- J. Johnston
- Department of Surgery; University of Auckland; Auckland New Zealand
| | - M. Stretton
- Department of Surgery; University of Auckland; Auckland New Zealand
| | - M. Mahadevan
- Department of Surgery; University of Auckland; Auckland New Zealand
| | - R.G. Douglas
- Department of Surgery; University of Auckland; Auckland New Zealand
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Abstract
Most otolaryngology-related complaints are straightforward and easily recognized and treated. However, given the proximity of the ears, nose, and throat to numerous vital structures in the head and neck, the potential for serious consequences exists if disease processes go unrecognized and untreated. This article serves to familiarize the primary care provider with the clinical presentation of various complications associated with common otolaryngologic complaints. Clinicians who care for patients presenting with otolaryngologic complaints should keep these entities in mind and attempt to rule out any serious complication.
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14
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The role of Fusobacterium necrophorum in pharyngotonsillitis – A review. Anaerobe 2016; 42:89-97. [DOI: 10.1016/j.anaerobe.2016.09.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 09/26/2016] [Accepted: 09/26/2016] [Indexed: 11/23/2022]
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Klug TE, Rusan M, Fuursted K, Ovesen T. Peritonsillar Abscess: Complication of Acute Tonsillitis or Weber's Glands Infection? Otolaryngol Head Neck Surg 2016; 155:199-207. [PMID: 27026737 DOI: 10.1177/0194599816639551] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 02/26/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To review the literature concerning the 2 primary hypotheses put forth to explain the pathogenesis of peritonsillar abscess: "the acute tonsillitis hypothesis" (peritonsillar abscess is a complication of acute tonsillitis) and "the Weber gland hypothesis" (peritonsillar abscess is an infection of Weber's glands). DATA SOURCES PubMed, EMBASE. REVIEW METHODS Data supporting or negating one hypothesis or the other were elicited from the literature. CONCLUSIONS Several findings support the acute tonsillitis hypothesis. First, the 2 main pathogens in peritonsillar abscess have been recovered from pus aspirates and bilateral tonsillar tissues with high concordance rates, suggesting that both tonsils are infected in patients with peritonsillar abscess. Second, studies report signs of acute tonsillitis in the days prior to and at the time of peritonsillar abscess. Third, antibiotic treatment reduces the risk of abscess development in patients with acute tonsillitis. However, some findings suggest involvement of the Weber's glands in peritonsillar abscess pathogenesis. First, high amylase levels have been found in peritonsillar pus. Second, the majority of peritonsillar abscesses are located at the superior tonsillar pole in proximity of the Weber's glands. We propose a unified hypothesis whereby bacteria initially infect the tonsillar mucosa and spread via the salivary duct system to the peritonsillar space, where an abscess is formed. IMPLICATIONS FOR PRACTICE Our findings support the rationale for antibiotic treatment of patients with severe acute tonsillitis to reduce the risk of abscess development. Improved understanding of peritonsillar abscess pathogenesis is important for the development of efficient prevention strategies.
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Affiliation(s)
- Tejs Ehlers Klug
- Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Maria Rusan
- Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Kurt Fuursted
- Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark
| | - Therese Ovesen
- Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark
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Souza DLS, Cabrera D, Gilani WI, Campbell RL, Carlson ML, Lohse CM, Bellolio MF. Comparison of medical versus surgical management of peritonsillar abscess: A retrospective observational study. Laryngoscope 2016; 126:1529-34. [DOI: 10.1002/lary.25960] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 01/27/2016] [Accepted: 02/11/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Dante L. S. Souza
- Department of Emergency Medicine; Mayo Clinic; Rochester Minnesota U.S.A
| | - Daniel Cabrera
- Department of Emergency Medicine; Mayo Clinic; Rochester Minnesota U.S.A
| | - Waqas I. Gilani
- Department of Emergency Medicine; Mayo Clinic; Rochester Minnesota U.S.A
| | - Ronna L. Campbell
- Department of Emergency Medicine; Mayo Clinic; Rochester Minnesota U.S.A
| | - Matthew L. Carlson
- Department of Otorhinolaryngology; Mayo Clinic; Rochester Minnesota U.S.A
| | - Christine M. Lohse
- Department of Biomedical Statistics and Informatics; Mayo Clinic; Rochester Minnesota U.S.A
| | - M. Fernanda Bellolio
- Department of Emergency Medicine; Mayo Clinic; Rochester Minnesota U.S.A
- Kern Center for the Science of the Healthcare Delivery; Mayo Clinic; Rochester Minnesota U.S.A
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Wikstén JE, Pitkäranta A, Blomgren K. Metronidazole in conjunction with penicillin neither prevents recurrence nor enhances recovery from peritonsillar abscess when compared with penicillin alone: a prospective, double-blind, randomized, placebo-controlled trial. J Antimicrob Chemother 2016; 71:1681-7. [PMID: 26968881 DOI: 10.1093/jac/dkw038] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 01/29/2016] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The objectives of this study were to evaluate the efficacy of metronidazole in conjunction with penicillin in preventing the recurrence of peritonsillar abscess (PTA) and to learn whether metronidazole enhances the recovery from PTA when compared with penicillin alone. METHODS In this prospective, double-blind, randomized, placebo-controlled trial, 200 adult outpatients with PTA at our ear, nose and throat emergency department received either penicillin (1 000 000IU) × 3 and metronidazole (400 mg) × 3 for 10 and 7 days orally (combination group, N = 100) or penicillin and placebo (penicillin group, N = 100) after incision and drainage of the PTA. Afterwards they received a symptom questionnaire via e-mail daily for 2 weeks, then weekly for 6 weeks. The primary outcome was efficacy of metronidazole in conjunction with penicillin in preventing PTA recurrence in 56 days; the secondary outcome was ability of metronidazole plus penicillin to enhance recovery from PTA in 28 days. All healthcare contacts were registered during follow-up. Registered on www.clinicaltrials.gov with the identifier NCT01255670. RESULTS Of the 200 patients, 20 returned to hospital with recurrent symptoms, 10 in each group (P = 1.00). In the combination group, the mean (SD) duration of throat-related symptoms was 5.6 (5.0) days and in the penicillin group it was 5.3 (2.7) days, values for fever were 1.5 (0.9) and 1.6 (1.0) days, respectively, and those for poor overall physical condition were 4.0 (3.9) and 4.5 (4.9) days; there were no significant differences between groups. The adverse effects nausea and diarrhoea lasted longer in the combination group (P = 0.01). CONCLUSIONS For healthy adult PTA patients treated with incision and drainage, metronidazole neither prevents recurrence nor enhances recovery when combined with penicillin compared with penicillin alone, but instead leads to increased adverse effects.
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Affiliation(s)
- Johanna E Wikstén
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital, PO Box 263, FI-00290, Helsinki, Finland Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anne Pitkäranta
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital, PO Box 263, FI-00290, Helsinki, Finland Faculty of Medicine, University of Helsinki, Helsinki, Finland Faculty of Medicine, University of Qatar, Doha, Qatar
| | - Karin Blomgren
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital, PO Box 263, FI-00290, Helsinki, Finland Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Microarray identification of bacterial species in peritonsillar abscesses. Eur J Clin Microbiol Infect Dis 2014; 34:905-11. [PMID: 25547532 DOI: 10.1007/s10096-014-2301-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 12/07/2014] [Indexed: 10/24/2022]
Abstract
Peritonsillar abscess (PTA) is the most common otorhinolaryngological infection, requiring management at the special healthcare level. The microbiological findings vary due to geographical, etiological, and methodological factors. This study aimed to identify the bacterial species of PTAs by using a novel polymerase chain reaction (PCR)- and microarray-based assay, and to find causative cofactors among patients with different pathogens. We determined the bacterial findings of aspirates of pus prospectively collected from 180 PTA patients. Samples were pretreated prior to nucleic acid extraction and analyzed with a PCR- and microarray-based assay or DNA sequencing. Both methods were based on the gyrB/parE topoisomerase genes. Patients answered symptom questionnaires at admission, and their medical records were reviewed later. Altogether, 160 (89 %) aspirates of pus tested positive for bacteria, and a bacterial species was identified in 149 (83 %) of the samples. A polybacterial species was detected in 20 (13 %) and anaerobic bacteria in 77 (52 %) of the 149 samples. Fusobacterium necrophorum patients were younger (p < 0 .001) and had more severe symptoms (p = 0.04) than patients with other pathogens. Gender, smoking, or preadmission antibiotics showed no correlation with any of the pathogens. Although requiring some optimization, this microarray assay seems feasible and fast for bacterial identification directly from pus samples, and confirms the diversity of PTA pathogens. Young patients with more severe symptoms may require special attention. Species-specific antibiotic treatment of PTA remains challenging due to bacterial variations; the present assay may aid in specifying PTA antibiotic treatment in the future.
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Wikstén J, Blomgren K, Eriksson T, Guldfred L, Bratt M, Pitkäranta A. Variations in treatment of peritonsillar abscess in four Nordic countries. Acta Otolaryngol 2014; 134:813-7. [PMID: 24930914 DOI: 10.3109/00016489.2014.905702] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
CONCLUSION In four Nordic countries, peritonsillar abscess (PTA) patients are treated rather differently. OBJECTIVES To study how such patients are treated in those countries. METHODS The 81 chief physicians of otorhinolaryngology departments of all central hospitals in Denmark (n = 15), Norway (n = 19), Sweden (n = 27), and Finland (n = 20) received a multiple-choice questionnaire. RESULTS A total of 73 physicians (90%) replied. The largest differences arose in treating patients with intravenous versus per oral antibiotics, and treating as inpatients versus outpatients. In Finland, 50% of PTA patients aged >16 years were treated as inpatients and 50% as outpatients, whereas the respective quotas in Sweden were 9 and 91%, Norway 19 and 81%, and Denmark 33 and 67%. Of Finnish physicians, 30% treated their patients primarily with oral antibiotics, 70% with intravenous antibiotics; in Sweden 91 vs 9%, Norway 53 vs 47%, and Denmark 18 vs 82%. In Denmark, almost all patients were operated on immediately, whereas in the other three countries, especially Sweden, operations more often were performed after a recovery period. Combining metronidazole with penicillin or cephalosporins was most common in Denmark: 58% reported usage, compared with 30% in Finland, 16% in Norway, and 4% in Sweden.
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Affiliation(s)
- Johanna Wikstén
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Central Hospital, Helsinki University, Faculty of Medicine , Helsinki , Finland
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Powell EL, Powell J, Samuel JR, Wilson JA. A review of the pathogenesis of adult peritonsillar abscess: time for a re-evaluation. J Antimicrob Chemother 2013; 68:1941-50. [PMID: 23612569 DOI: 10.1093/jac/dkt128] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To perform a multifactorial exploration of the aetiology of peritonsillar abscess (PTA) in adults, in order to develop greater clinical understanding of the condition and improve management. DESIGN A literature review exploring key pathogens, predisposing host factors and current pathogenic hypotheses. METHODS A PubMed search for articles published between January 1980 and January 2012 using the terms 'peritonsillar abscess AND microbiology', 'peritonsillar abscess AND pathophysiology' and 'peritonsillar abscess AND etiology'. RESULTS Major pathogens in PTA are opportunistic microflora. Group A streptococcal PTA infections present differently from polymicrobial PTA. A number of host factors influence the conditions required for the pathogenesis of PTA. CONCLUSIONS PTA is clinically distinct from acute tonsillitis and occurs in people with a chronic underlying susceptibility. Targeting host factors, including oral hygiene, antibiotic use and smoking, may prevent PTA. Re-education of clinicians concerning the aetiology of PTA is necessary for appropriate disease management.
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Affiliation(s)
- Emily L Powell
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
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Yarden-Bilavsky H, Raveh E, Livni G, Scheuerman O, Amir J, Bilavsky E. Fusobacterium necrophorum mastoiditis in children - emerging pathogen in an old disease. Int J Pediatr Otorhinolaryngol 2013; 77:92-6. [PMID: 23102657 DOI: 10.1016/j.ijporl.2012.10.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 10/03/2012] [Accepted: 10/06/2012] [Indexed: 12/16/2022]
Abstract
BACKGROUND Anaerobic bacteria are uncommon etiologic agents of acute mastoiditis in children. However, recent studies suggest an increase in the incidence of Fusobacterium necrophorum mastoid infections in the last two decades. METHODS A surveillance study performed over 3.5 years in a tertiary pediatric medical center identified 7 children with acute F. necrophorum mastoiditis. Clinical, laboratory, and treatment data were collected by file review. RESULTS Five of the 7 children presented in the last year of the study. All 7 children were less than 26 months old on admission, and none had a history of otogenic infections. All cases were characterized by significantly elevated levels of inflammatory markers. All were diagnosed as complicated mastoiditis with abscess formation. Four children had an epidural abscess, three children had evidence of osteomyelitis beyond the mastoid bone, and four children had imaging evidence of sinus vein thrombosis. All seven children required cortical mastoidectomy with ventilatory tubes insertion and two children required more than one surgical intervention. During follow-up, two children had recurrent episodes of mastoiditis due to other pathogens. CONCLUSION Our data support the literature suggesting that the occurrence of F. necrophorum mastoiditis among children is rising. Acute coalescent mastoiditis due to F. necrophorum is associated with a complicated course and warrants particular attention by pediatricians, infectious disease experts, and ear, nose and throat specialists.
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The role of viruses in the pathogenesis of peritonsillar abscess. Eur J Clin Microbiol Infect Dis 2012; 31:2335-43. [PMID: 22373896 DOI: 10.1007/s10096-012-1573-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Accepted: 01/26/2012] [Indexed: 10/28/2022]
Abstract
Peritonsillar abscess (PTA) is the most frequent complication of acute tonsillitis and a prevalent cause for acute admission to otorhinolaryngology departments. Our aim was to examine the role of viruses in the pathogenesis of PTA, as this has not previously been considered. We examined both palatine tonsils from 25 patients undergoing acute tonsillectomy for PTA, using PCR-based assays for herpes simplex virus-1 and -2 (HSV-1 and -2), adenovirus, Epstein-Barr virus (EBV), influenza A and B, and respiratory syncytial virus (RSV) A and B. We similarly examined tonsils from 55 patients undergoing elective tonsillectomy due to chronic tonsillar conditions. These patients served as a control group, as they did not have a clinically apparent infection at the time of surgery. Only HSV-1 (5/80, 6.3%), adenovirus (11/80, 13.8%), and EBV (71/80, 88.8%) were detected in our study population. There was no statistically significant difference in the frequency of these viruses across different diagnostic groups. Quantification of EBV load demonstrated no differences between the PTA and the elective tonsillectomy group, nor between the abscessed and non-abscessed tonsil of PTA patients. In summary, our data do not support a significant role for the examined viruses in the pathogenesis of PTA.
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Who ends up having tonsillectomy after peritonsillar infection? Eur Arch Otorhinolaryngol 2011; 269:1281-4. [DOI: 10.1007/s00405-011-1807-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Accepted: 10/07/2011] [Indexed: 10/15/2022]
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Foisy M, Martin B, Domino F, Becker LA. The Cochrane Library and the Treatment of Sore Throat in Children and Adolescents: An Overview of Reviews. ACTA ACUST UNITED AC 2011. [DOI: 10.1002/ebch.771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Fossland NPW, Bugten V, Nordgård S, Aasly K. [A young man with mononucleosis and swelling of the right eye]. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2011; 131:35-7. [PMID: 21233887 DOI: 10.4045/tidsskr.09.1455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Treatment of acute infections in the upper airways comprises a significant part of direct healthcare expenditure and is a challenge for healthcare professionals. In Norway, 11,495 hospitalized days were recorded for acute infections (influenza and pneumonia excluded) in the upper airways in 2008. Acute bacterial rhinosinusitis (ABRS) is defined as inflammation of the nose and the paranasal sinuses characterized by both 1): symptoms of nasal blockage/obstruction/congestion or nasal discharge, and/or facial pain/pressure and 2): endoscopic signs of mucopurulent discharge from middle meatus and/or CT changes within the osteomeatal complex/sinuses. After 12 weeks of symptoms the definition changes to chronic rhinosinusitis. With antibiotic treatment of complicated ABRS we see fewer severe complications, but they still occur. Due to anatomical proximity of the orbit and intracranial structures a localized spread of the infection is especially unfortunate and potentially dangerous. We present a case report (with pan sinusitis and grave local complications) from the ear, nose and throat department in St. Olav's University Hospital in Trondheim, Norway.
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Significant pathogens in peritonsillar abscesses. Eur J Clin Microbiol Infect Dis 2010; 30:619-27. [DOI: 10.1007/s10096-010-1130-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Accepted: 12/06/2010] [Indexed: 10/18/2022]
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