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Antipharyngitis Effects of Syringa oblata L. Ethanolic Extract in Acute Pharyngitis Rat Model and Anti-Inflammatory Effect of Ir-Idoids in LPS-Induced RAW 264.7 Cells. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5111752. [PMID: 34925529 PMCID: PMC8683189 DOI: 10.1155/2021/5111752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/04/2021] [Accepted: 11/23/2021] [Indexed: 12/02/2022]
Abstract
Acute pharyngitis is an inflammation of the pharyngeal mucous membrane and submucous lymphoid tissues. Unsatisfactory treatment and repeated occurrences might cause chronic pharyngitis and other complications. Syringa oblata L. (S. oblata) is a traditional Chinese medicine that exhibited a significant therapeutic effect on various inflammatory diseases. Its commercial drug Yan Li Xiao (YLX) capsule is used as a cure for the treatment of inflammatory diseases, such as bacillary dysentery, tonsillitis, bronchitis, and acute gastroenteritis. However, studies about S. oblata relieving acute pharyngitis are rare. In this study, high-performance liquid chromatography (HPLC) was used to analyze the chemical profile of S. oblata, and the bioactive phytoconstituents were isolated and identified by nuclear magnetic resonance (NMR) and mass spectrometry. An ammonia-induced acute pharyngitis rat model was established to estimate the protective effect of S. oblata in vivo for the first time. The severity of pharyngitis was observed by appearance index and HE staining. The cytokines expression was performed by ELISA. Crucial proteins expression associated with TLR4/NF-κB/MAPK and NLRP3 inflammasome signaling pathways were analyzed by western blotting and immunohistochemistry. Furthermore, the anti-inflammatory effect of isolated compounds was evaluated by suppressing lipopolysaccharide- (LPS-) induced NO generation and regulating the cytokines levels in RAW 264.7 cells. The results showed that S. oblata exhibited a protective effect in the ammonia-induced acute pharyngitis rat model, and the compounds exert potential anti-inflammatory properties against LPS-activated RAW 254.7 cells.
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Abstract
Necrotizing soft tissue infections occur after traumatic injuries, minor skin lesions, nonpenetrating injuries, natural childbirth, and in postsurgical and immunocompromised patients. Infections can be severe, rapidly progressive, and life threatening. Survivors often endure multiple surgeries and prolonged hospitalization and rehabilitation. Despite subtle nuances that may distinguish one entity from another, clinical approaches to diagnosis and treatment are highly similar. This review describes the clinical and laboratory features of necrotizing soft tissue infections and addresses recommended diagnostic and treatment modalities. It discusses the impact of delays in surgical debridement, antibiotic use, and resuscitation on mortality, and summarizes key pathogenic mechanisms.
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Affiliation(s)
- Dennis L Stevens
- Infectious Diseases Center of Biomedical Research Excellence, Veterans Affairs Medical Center, 500 West Fort Street (Mail Stop 151), Boise, ID 83702, USA
| | - Amy E Bryant
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, Idaho State University, 1311 East Central Drive, Meridian, ID 83642, USA.
| | - Ellie Jc Goldstein
- David Geffen School of Medicine at UCLA, Los Angeles, CA 90074, USA; R M Alden Research Laboratory, 2021 Santa Monica Boulevard, Suite #740 East, Santa Monica, CA 90404, USA
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Vallée M, Gaborit B, Meyer J, Malard O, Boutoille D, Raffi F, Espitalier F, Asseray N. Ludwig’s angina: A diagnostic and surgical priority. Int J Infect Dis 2020; 93:160-162. [DOI: 10.1016/j.ijid.2020.01.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 10/25/2022] Open
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Nicollas R, Moreddu E, Le Treut-Gay C, Mancini J, Akkari M, Mondain M, Scavarda D, Hosanna G, Fayoux P, Pondaven-Letourmy S, Lescanne E, Triglia JM. Ibuprofen as risk-factor for complications of acute anterior sinusitis in children. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 137:99-103. [PMID: 31627971 DOI: 10.1016/j.anorl.2019.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
IMPORTANCE Non-steroidal anti-inflammatory drugs (NSAIDs) are known to inhibit chemotaxis, oxidative burst and phagocytosis, bacterial killing in granulocytes as well as inhibiting neutrophil aggregation or degranulation, thereby interfering with the function of lymphocytes. On the other hand, ibuprofen is widely prescribed in pediatrics for its powerful analgesic and antipyretic effects. To our knowledge, no previous publication outlines the relationship between Ibuprofen therapy and an increased risk of intracranial and/or orbital complications of acute fronto-ethmoidal sinusitis in childhood. OBJECTIVE To look for a relationship between ibuprofen and occurrence of intra-cranial and/or orbital complications of acute fronto-ethmoidal sinusitis in pediatrics. SETTING AND METHODS The medical charts of patients younger than 18 years admitted into the E.N.T. departments of 4 academic care centers during 2 consecutive years for fronto ethmoidal sinusitis were reviewed retrospectively. The history of ibuprofen intake, the occurrence of complication (orbital or intracranial) as well as the usual demographic data were noted. A statistical analysis was performed in order to ascertain whether a relationship between taking NSAIDs and the onset of an intracranial and/or orbital complication exists. RESULTS Intake of ibuprofen appeared to be a risk-factor of intracranial complications or associated orbital and intracranial complications of acute fronto-ethmoidal sinusitis in children. Neither gender nor age nor initial pain intensity were statistically related to the onset of complications. CONCLUSION AND RELEVANCE This retrospective multicenter cohort study appears to suggest that ibuprofen increases the risk of orbital and/or intracranial complications of acute fronto-ethmoidal sinusitis in childhood. Therefore, we recommend not prescribing ibuprofen if one suspects an acute sinusitis in a child or adolescent.
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Affiliation(s)
- R Nicollas
- Aix-Marseille University, Department of Pediatric Otolaryngology Head and Neck Surgery, La Timone Children's Hospital, 264, rue St Pierre, 13385 Marseille cedex 5, France.
| | - E Moreddu
- Aix-Marseille University, Department of Pediatric Otolaryngology Head and Neck Surgery, La Timone Children's Hospital, 264, rue St Pierre, 13385 Marseille cedex 5, France
| | - C Le Treut-Gay
- Aix-Marseille University, Department of Pediatric Otolaryngology Head and Neck Surgery, La Timone Children's Hospital, 264, rue St Pierre, 13385 Marseille cedex 5, France
| | - J Mancini
- Aix-Marseille University Department of Biostatistics and Communication and Information Technologies, BiosTIC, La Timone Hospital, Inserm, IRD, UMR912 SESSTIMF, 264, rue Saint Pierre, 13385 Marseille cedex 5, France
| | - M Akkari
- Department of Otolaryngology Head and Neck Surgery, Gui de Chauliac Hospital, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
| | - M Mondain
- Department of Otolaryngology Head and Neck Surgery, Gui de Chauliac Hospital, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France
| | - D Scavarda
- Aix-Marseille University, Department of Pediatric Neurosurgery, La Timone Children's Hospital, 264, rue St Pierre, 13385 Marseille cedex 5, France
| | - G Hosanna
- Department of Otolaryngology Head and Neck Surgery, avenue Eugène-Avinée, 59037 Lille, France
| | - P Fayoux
- Department of Otolaryngology Head and Neck Surgery, avenue Eugène-Avinée, 59037 Lille, France
| | - S Pondaven-Letourmy
- Department of Otolaryngology Head and Neck Surgery, Gatien Clocheville Children's Hospital, 49, boulevard Béranger, 37000 Tours, France
| | - E Lescanne
- Department of Otolaryngology Head and Neck Surgery, Gatien Clocheville Children's Hospital, 49, boulevard Béranger, 37000 Tours, France
| | - J-M Triglia
- Aix-Marseille University, Department of Pediatric Otolaryngology Head and Neck Surgery, La Timone Children's Hospital, 264, rue St Pierre, 13385 Marseille cedex 5, France
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Piroulas C, Devillers L, Souty C, Sicsic J, Boisnault P, François M. Non-steroids anti-inflammatory drugs and risk of peritonsillar abscess in pharyngitis: a French longitudinal study in primary care†. Fam Pract 2019; 36:425-430. [PMID: 30423110 DOI: 10.1093/fampra/cmy111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The safety of non-steroids anti-inflammatory drugs (NSAIDs) in the context of pharyngitis is doubtful with contradictory results in the literature. OBJECTIVE To evaluate the risk of peritonsillar abscess (PTA) associated to NSAIDs consumption during a pharyngitis episode observed in primary care. METHOD A retrospective cohort study using Observatory of General Medicine Datalink from 1995 to 2010. All patients consulting a GP from the Datalink network for pharyngitis have been included. The occurrence of a PTA in the 15 days following the consultation for pharyngitis was matched. The association between PTA and prescriptions of NSAIDs was studied via an adjusted logistic regression model. RESULTS During the study period, 105 802 cases of pharyngitis and 48 cases of PTA following a pharyngitis were reported, concerning respectively 67 765 and 47 patients. In the multivariate analysis, the risk of PTA was associated positively with a NSAIDs prescription (OR = 2.9, 95% CI = 1.6-5.2). Other factors associated with PTA occurrence were the prescription of corticosteroids (OR = 3.1, 95% CI = 1.3-7.6) and an age between 20 and 40 years (OR = 5.7, 95% CI = 2.5-13.0). The prescription of antibiotics was not significantly associated with PTA (P = 0.7). CONCLUSION Prescription of NSAIDs in pharyngitis may increase the risk of PTA. This study encourages considering cautiously the balance between benefits and harms before prescription of NSAIDs for pharyngitis.
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Affiliation(s)
- Cedric Piroulas
- Département de médecine générale, UFR des sciences de la santé Simone Veil, Université Versailles-Saint-Quentin-en-Yvelines, Montigny le Bretonneux, France
| | - Louise Devillers
- Département de médecine générale, UFR des sciences de la santé Simone Veil, Université Versailles-Saint-Quentin-en-Yvelines, Montigny le Bretonneux, France
| | - Cecile Souty
- Sorbonne Université, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMR-S1136), Paris, France
| | - Jonathan Sicsic
- Université Paris Saclay, INSERM, Centre de Recherche en Epidémiologie et Santé des Populations, Villejuif cedex, France
| | - Philippe Boisnault
- Société Française de Médecine Générale (SFMG), Issy les Moulineaux, France
| | - Mathilde François
- Département de médecine générale, UFR des sciences de la santé Simone Veil, Université Versailles-Saint-Quentin-en-Yvelines, Montigny le Bretonneux, France.,Université Paris Saclay, INSERM, Centre de Recherche en Epidémiologie et Santé des Populations, Villejuif cedex, France
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Comparison of needle aspiration versus incision and drainage under local anaesthesia for the initial treatment of peritonsillar abscess. Eur Arch Otorhinolaryngol 2019; 276:2595-2601. [DOI: 10.1007/s00405-019-05542-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 07/03/2019] [Indexed: 10/26/2022]
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Editorial: Pathogenesis and host response in the era of modern diagnostics: let's continue the basics. Curr Opin Infect Dis 2019; 32:187-190. [PMID: 30950856 DOI: 10.1097/qco.0000000000000551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Basille D, Plouvier N, Trouve C, Duhaut P, Andrejak C, Jounieaux V. Non-steroidal Anti-inflammatory Drugs may Worsen the Course of Community-Acquired Pneumonia: A Cohort Study. Lung 2016; 195:201-208. [PMID: 28005149 DOI: 10.1007/s00408-016-9973-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 12/16/2016] [Indexed: 12/15/2022]
Abstract
PURPOSE Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently prescribed or used as self-medication in cases of community-acquired pneumonia (CAP). Nevertheless, the consequences of such medication on the risk of pleuroparenchymal complications are not well known. The aim was to investigate whether exposure to NSAIDs prior to hospital admission among patients suffering from CAP is associated with the development of pleural complications or a lung abscess. METHODS All consecutive non-immunocompromised patients with CAP and admitted to a university hospital were prospectively included (2-year period). The risk of pleuropulmonary complications was analyzed according to previous exposure to NSAIDs. RESULTS Of the 221 included patients, 40 (18.1%) had developed a pleuropulmonary complication. NSAIDs intake prior to admission was reported for 24 patients (10.9%) who were younger (50.6 ± 18.5 vs. 66.5 ± 16.4 years; p = 0.001), had less comorbidities (60 vs. 25.1%; p = 0.001), had a longer duration between the first symptoms of CAP and the start of an antibiotic therapy (6.1 ± 7.6 vs. 2.8 ± 3.8 days; p = 0.001), and who had a higher incidence of pleuropulmonary complications (33.3 vs. 16.2%; p = 0.048). In multivariate analyses, two factors were independently associated with the development of pleuroparenchymal complications: NSAIDs intake [Odds Ratio (OR) = 2.57 [1.02-6.64]; p = 0.049] and alcohol abuse (OR = 2.68 [1.27-5.69]; p = 0.01). CONCLUSIONS Our findings suggest that NSAIDs, often taken by young and healthy patients, may worsen the course of CAP with delayed therapy and a higher rate of pleuropulmonary complications.
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Affiliation(s)
- Damien Basille
- Respiratory and Intensive Care Unit, University Hospital Amiens, Amiens, 80054, France. .,Recif Unit, University Hospital Amiens, Amiens, France.
| | - Nathalie Plouvier
- Respiratory and Intensive Care Unit, University Hospital Amiens, Amiens, 80054, France
| | - Charlotte Trouve
- Respiratory and Intensive Care Unit, University Hospital Amiens, Amiens, 80054, France
| | - Pierre Duhaut
- Recif Unit, University Hospital Amiens, Amiens, France.,Internal Medicine, University Hospital Amiens, Amiens, France
| | - Claire Andrejak
- Respiratory and Intensive Care Unit, University Hospital Amiens, Amiens, 80054, France.,Recif Unit, University Hospital Amiens, Amiens, France
| | - Vincent Jounieaux
- Respiratory and Intensive Care Unit, University Hospital Amiens, Amiens, 80054, France
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Feasson T, Debeaupte M, Bidet C, Ader F, Disant F, Ferry T, Chidiac C, Valour F. Impact of anti-inflammatory drug consumption in peritonsillar abscesses: a retrospective cohort study. BMC Infect Dis 2016; 16:432. [PMID: 27544213 PMCID: PMC4992556 DOI: 10.1186/s12879-016-1761-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 08/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The experience of clinicians in charge of the in-hospital management of peritonsillar abscesses supports the association between severe forms and anti-inflammatory drug (AID) consumption. However, this observation is based on a limited number of clinical studies. Our objective was to assess the prevalence and impact of AID consumption in patients with peritonsillar abscesses. METHODS All patients referred to the ear, nose and throat surgery department for a peritonsillar abscess were included in a retrospective cohort study (2012-2014). RESULTS Among the 216 included patients (male, 55 %; median age, 32 years [IQR, 26-40]), 127 had received AID (59 %), including corticosteroids (n = 67, 31 %) and/or non-steroidal AIDs (NSAIDs, n = 76, 35 %). 199 patients (92 %) benefit from a puncture and 5 (2 %) from a surgery under general anesthesia, associated with ceftriaxone/metronidazole (51 %) or amoxicillin/clavulanic acid (46 %). An iterative surgical procedure was required in 93 cases (43 %), including 19 % under general anesthesia. Bacteriological analysis (79 %) mainly disclosed streptococci (66 %) of A (18 %) and/or milleri (33 %) groups. The prevalence of anaerobes was higher in patients using AIDs (46 % versus 29 %, p = 0.034), regardless of prior antibiotic therapy. 65 patients benefited from a CT-scan; AID consumption was associated with larger abscesses (6.8 [IQR, 3.7-12.7] versus 2.9 [IQR, 0.9-7.8] cm(3); p = 0.005). AID consumption was not a risk factor of iterative surgical procedure. CONCLUSIONS In comparison to the prescribing habits in uncomplicated upper respiratory tract infection, the high prevalence of AID consumption in patients with peritonsillar suppuration suggests a role of AIDs in promoting these complications.
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Affiliation(s)
- Thomas Feasson
- General Medicine Department, Claude Bernard Lyon 1 University, Lyon, France.,Infectious Disease Department, Groupement Hospitalier Nord, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Mathilde Debeaupte
- ENT Surgery Department, Groupement Hospitalier Est, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Clément Bidet
- Department of Radiology, Centre Hospitalier de Valence, Valence, France
| | - Florence Ader
- Infectious Disease Department, Groupement Hospitalier Nord, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Claude Bernard Lyon 1 University, Lyon, France.,INSERM U1111, International Center for Research in Infectiology (CIRI), Claude Bernard Lyon 1 University, Lyon, France
| | - François Disant
- ENT Surgery Department, Groupement Hospitalier Est, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Claude Bernard Lyon 1 University, Lyon, France
| | - Tristan Ferry
- Infectious Disease Department, Groupement Hospitalier Nord, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Claude Bernard Lyon 1 University, Lyon, France.,INSERM U1111, International Center for Research in Infectiology (CIRI), Claude Bernard Lyon 1 University, Lyon, France
| | - Christian Chidiac
- Infectious Disease Department, Groupement Hospitalier Nord, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.,Claude Bernard Lyon 1 University, Lyon, France.,INSERM U1111, International Center for Research in Infectiology (CIRI), Claude Bernard Lyon 1 University, Lyon, France
| | - Florent Valour
- Infectious Disease Department, Groupement Hospitalier Nord, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France. .,Claude Bernard Lyon 1 University, Lyon, France. .,INSERM U1111, International Center for Research in Infectiology (CIRI), Claude Bernard Lyon 1 University, Lyon, France.
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Lepelletier D, Pinaud V, Le Conte P, Bourigault C, Asseray N, Ballereau F, Caillon J, Ferron C, Righini C, Batard E, Potel G. Peritonsillar abscess (PTA): clinical characteristics, microbiology, drug exposures and outcomes of a large multicenter cohort survey of 412 patients hospitalized in 13 French university hospitals. Eur J Clin Microbiol Infect Dis 2016; 35:867-73. [PMID: 26942743 DOI: 10.1007/s10096-016-2609-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 02/15/2016] [Indexed: 10/22/2022]
Abstract
The aim of this study was to describe the epidemiology of hospitalized patients with peritonsillar abscess (PTA). We conducted a multicenter survey in 13 French university hospitals in 2009-2012 describing 412 patients. Median age was 29 year (range, 2-84) and current smoking habit was reported by 177 (43 %) patients. Most of the patients (92 %) had consulted a physician for sore throat within 10 days before admission for PTA diagnosis. Additional symptoms such as visible tonsil abnormalities (83 %), tender cervical adenopathy (57 %) and fever ≥ 38.5 °C (53 %) were also reported. A total of 65 % patients (269/412) reported recent systemic anti-inflammatory agents (AIAs) exposure by medical prescription (70 %), self-medication (22 %), or both (8 %); 61 % and 27 % reported recent exposure to antibiotic and topical treatments for sore throat, respectively. Non-steroidal AIAs were used most often (45 %), particularly arylpropionic derivatives. A rapid diagnosis antigen test (RDT) for Streptococcus pyogenes was performed in 70 (17 %) patients and was positive in 17 (24 %), of whom 9 (53 %) were exposed to AIAs and 14 (82 %) to antibiotics. To treat PTA, antibiotic therapy was given to 392 (95 %) patients. Of 333 antibiotic prescriptions, amoxicillin-clavulanic acid and metronidazole were the most prescribed antibiotics (42 and 17 %, respectively). Surgical drainage of the abscess was performed in 119 (29 %) cases and tonsillectomy in 75 (18 %) cases. The clinical outcome was favorable during the hospital stay in 404 (98 %) patients. In conclusion, patients with sore throat are often exposed to AIAs before PTA diagnosis, and antibiotic prescription was not often based on the RDT positivity.
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Affiliation(s)
- D Lepelletier
- Bacteriology and Infection Control Department, Nantes University Hospital, 44093, Nantes, France. .,Medical School, EA 3826, University of Nantes, 44035, Nantes, France.
| | - V Pinaud
- Emergency Department, Nantes University Hospital, 44093, Nantes, France
| | - P Le Conte
- Emergency Department, Nantes University Hospital, 44093, Nantes, France
| | - C Bourigault
- Bacteriology and Infection Control Department, Nantes University Hospital, 44093, Nantes, France
| | - N Asseray
- Infectious Diseases Department, Nantes University Hospital, 44093, Nantes, France.,Medical School, EA 3826, University of Nantes, 44035, Nantes, France
| | - F Ballereau
- Medqual, Nantes University Hospital, 44093, Nantes, France.,Medical School, EA 3826, University of Nantes, 44035, Nantes, France
| | - J Caillon
- Bacteriology and Infection Control Department, Nantes University Hospital, 44093, Nantes, France.,Medical School, EA 3826, University of Nantes, 44035, Nantes, France
| | - C Ferron
- Otorhinolaryngology Department, Nantes University Hospital, 44093, Nantes, France
| | - C Righini
- Otorhinolaryngology Department, Michallon University Hospital, 38000, Grenoble, France
| | - E Batard
- Emergency Department, Nantes University Hospital, 44093, Nantes, France.,Medical School, EA 3826, University of Nantes, 44035, Nantes, France
| | - G Potel
- Emergency Department, Nantes University Hospital, 44093, Nantes, France.,Medical School, EA 3826, University of Nantes, 44035, Nantes, France
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