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PubMedDate not supplied

[Incidence of Streptococcus pyogenes pharyngitis in Bariloche, Argentina].

The incidence and seasonality of pharyngitis by S. pyogenes in Bariloche, a city where long periods of low temperatures result in extended indoor activities were studied. A total of 5276 throat swab specimens collected during 2000-2003 in the clinical microbiology laboratories of the three main medical institutions of the city, were analyzed. Samples were cultured on blood-agar media containing 5% defibrinated sheep blood, and incubated for 24-48 h at 35 degrees C. Strains were identified using standard procedures. Monthly means for throat swabs, S. pyogenes isolates, and percent of S. pyogenes pharyngitis, were estimated. The incidence of pharyngitis by this microorganism was greater than 24% for every month within the April-December period, reaching a maximum in November (33%). February was the month with the lowest incidence (13%). It was observed an increasing trend since March through November with a through in July, and a marked decrease that began in December, reaching its lowest rate in January and February, the warmest months. This seasonal pattern differs from those observed for temperate climates. The incidence of S. pyogenes pharyngitis in Bariloche was high through the greater part of the year, since about the middle of autumn to the beginning of summer.

Adult↗

PubMed2005

[To treat pharyngeal bursitis by microwave under nasal endoscope].

OBJECTIVE: Discussing the curative effect to treat pharyngeal bursitis by microwave under nasal endoscope, observing the wound change and writing down the time of white scar dropping after the operation. METHOD: Eleven cases of pharyngeal bursitis and 6 cases of nasopharyngeal cyst were treated by microwave under nasal endoscope, 0.9% sodium chloride solution were given for nasal irrigation two times daily,to observe the wound under nasal endoscope weekly up to the white scar dropping. RESULT: There are 14 cases cure and 3 cases in effect. The white scar dropped between 2 to 3 weeks and the patients symptom disappeared. CONCLUSION: Nasal endoscopy conduce to the diagnosis of pharyngeal bursitis. It is an effective method to treat pharyngeal bursitis by microwave under nasal endoscope and 0.9% sodium chloride solution were given for nasal irrigation after operation.

Adult↗

PubMed1992

Insensitivity of rapid antigen detection methods and single blood agar plate culture for diagnosing streptococcal pharyngitis.

OBJECTIVE: To compare the sensitivity of five group A streptococcal antigen detection systems and single blood agar plate culture with a two-plate culture method for diagnosis of streptococcal pharyngitis. DESIGN: Two simultaneous throat swabs were obtained from consecutive patients with suspected streptococcal pharyngitis. One swab was tested for streptococcal antigen by physicians' office nurses and the other was cultured on both aerobic blood agar and anaerobic trimethoprim-sulfamethoxazole blood agar plates. SETTING: Community office practice and community hospital laboratory. PARTICIPANTS: Consecutive outpatients seen by one of four pediatricians or a family practice physician. MAIN OUTCOME MEASURES: Results of rapid streptococcal antigen tests were compared with culture results either on a single aerobic blood agar plate or on the two-plate culture method. RESULTS: On throat swabs from 755 consecutive outpatients, the two-plate culture method detected 261 cases (defined as 100%) of group A streptococcal pharyngitis. The anaerobic trimethoprim-sulfamethoxazole plate alone, read at 1 and 2 days, detected 245 cases (94%). The blood agar plate used alone detected 189 cases (72%) at 2 days and 151 cases (58%) at 1 day. Antigen detection test results were positive for 106 throat specimens (41%), with individual kit sensitivity ranging from 31% to 50% compared with the two-plate culture method. Antigen detection test sensitivity decreased with decreasing colony counts. Antigen kit false-positivity rates varied from 0 to 28%. CONCLUSIONS: We conclude that the single blood agar plate culture and the antigen detection tests are insensitive, possibly leading the physician toward undertreatment and risking immunologic, local, or distant sequelae. The two-plate culture method should be the standard of practice to rule out streptococcal pharyngitis.

Antigens, Bacterial↗

PubMed1991

[Antibiotic treatment of pharyngitis].

Antimicrobial therapy of pharyngitis focuses mainly on eradicating group A streptococci and treating recurrent pharyngitis. The French strategy rests on routine treatment of all cases of childhood pharyngitis; in the United-States, rapid tests are used to identify group A streptococci in the throat before treating. Antibiotics used against group A streptococci include beta-lactams and macrolides. Among beta-lactams, the reference drug is still penicillin, e.g., penicillin V for 10 days. However, numbers of carriers with positive throat cultures for Streptococcus pyogenes seem to be growing in the United States, with a 10-20% increase over the last twenty years. Duration of therapy could be reduced from 10 to 5 days with the new oral cephalosporins but these drugs are more expensive than penicillin. Recurrent pharyngitis is caused by a variety of organisms which are often penicillinase-producers. It follows that penicillin should not be used in these cases, which require oral cephalosporins or the amoxicillin-clavulanic acid combination. Maintenance antimicrobial therapy between acute episodes should be considered.

Anti-Bacterial Agents↗

PubMed1990

Causes, diagnosis, and treatment of pharyngitis.

Pharyngitis is a common disease of the respiratory tract that can be caused by several different viruses and bacterial organisms. Clinically speaking, the most important causative agent is group A streptococcus (Streptococcus pyogenes). Although rare, postpharyngitis complications arise as a result of disease caused almost exclusively by group A streptococcus. Because group A streptococcal pharyngitis usually responds well to antimicrobial treatment, it is important to diagnose it. Penicillin, erythromycin, and peroral first-generation cephalosporins have been documented to be effective. In addition to group A streptococcus, C. pneumoniae and M. pneumoniae have also been detected in patients with pharyngitis. The possibility of diagnosing these organisms is limited at the present. Clinical surveys are still needed, moreover, to evaluate the effect of antimicrobial treatment on the disease caused by these organisms. Although routine viral diagnostic methods do not help primary care physicians in treating patients with pharyngitis, information on bacteria and viruses in the immediate environment could prove to be of great help in daily clinical work.

Bacterial Infections↗

PubMed1977

Incongruous movements of the velum and lateral pharyngeal walls.

Five patients evaluated via multi-view videofluoroscopy were found to have incongruous movements between the velum and lateral aspects of the pharyngeal walls. All five patients had velopharyngeal insufficiency resulting from either absent lateral pharyngeal wall motion in the presence of velar mobility or absent velar mobility in the presence of lateral pharyngeal wall motion. The data indicates that these valving patterns are not rare phenomena of velopharyngeal valving. Treatment by pharyngeal flap or other methods for velopharyngeal insufficiency must be suited to these peculiar valving patterns based on adequate diagnostic information.

Adult↗

PubMed1989

Continuous electromyographic recordings of pharyngeal muscle activity in normal and previously denervated muscles in dogs.

Continuous electromyographic recordings of pharyngeal muscle activity were made in 5 clinically normal control dogs and in 7 dogs 3 years after partial denervation of the pharyngeal muscles. Electromyographic recordings were made of the sequence of actions of each muscle and of the combined muscle activity, at rest and during swallowing of food. During 30-second periods, the recordings were digitalized and stored on diskette for further analysis. All control dogs had a distinct pattern of muscle activity during swallowing, the onset being in a constant order (hyopharyngeal, thyropharyngeal, and cricopharyngeal) and bilaterally synchronous. While eating, each dog had about 5 to 12 short periods of synchronous activity in each muscle, between the swallowing actions. During the resting period, there were longer periods of activity, which were synchronous with respiration. In each denervated dog, there were normal and irregular swallowing actions. Swallowing activity was recognized, but the sequence of hyopharyngeal, thyropharyngeal, and cricopharyngeal muscle activity was irregular and different from that in control dogs. Partial denervation of the pharyngeal muscles does not seriously impair motor activity of the muscles, but does alter the sequence of activity in the pharyngeal muscles during swallowing.

Animals↗

PubMed1987

[Value of pharyngography in the diagnostic staging program of pharyngeal tumors].

The role of barium pharyngograms in the pre- and post-therapeutic evaluation of pharyngeal tumors is described. The intralumenal part of the tumor is well shown by high spatial and contrast resolution of the pharyngeal mucosa. Barium pharyngogram is the only imaging method which can record the course of the swallowing act at the pharyngeal level. Post-operatively, barium pharyngography reliably demonstrates altered pharyngeal morphology; fibrotic stenoses may be distinguished from narrowing due to recurrence. The result of primary radiotherapy is easy to document.

Endoscopy↗

PubMed1983

Distribution of beta haemolytic streptococci in pharyngitis specimens obtained from children.

One hundred and nine isolates of beta haemolytic streptococci were recovered from 840 (13%) pharyngeal cultures obtained from children with acute pharyngitis. Seventy-four percent of these were group A, 4% were group B, 9% were group C, 1% were group D, 4.5% were group F, and 5.5% were group G. The significance of non-group A isolates in pharyngitis could not be evaluated in the absence of viral and serological studies. However, these findings demonstrate the predominance of group A beta haemolytic streptococci in acute pharyngitis in children, as compared to findings in adults.

Adolescent↗

PubMed1983

[Crohn disease of the oral and pharyngeal cavities].

Crohn's disease is very rarely found in the oral and pharyngeal cavity. The article reports on a female patient with Crohn's disease in the oral and pharyngeal cavity. The differences in the macroscopic findings due to the disease being localized in the oral and pharyngeal cavity are described. The clinical oral and pharyngeal lesions which suggest the presence of Crohn's disease.

Crohn Disease↗

PubMed1995

Secondary pharyngeal myotomy for tracheoesophageal speech.

Pharyngeal myotomy in the post-laryngectomy patient has been described to reduce pharyngoesophageal spasm and facilitate vocal rehabilitation and tracheoesophageal speech. This report describes the complications and speech outcomes in 22 consecutive patients who underwent a secondary pharyngeal myotomy. The patients were all drawn from a hospital clinic dedicated to voice rehabilitation after laryngectomies. Their ages ranged from 54 to 81-years-old with a mean of 64. Two patients suffered surgical complications--both had pharyngocutaneous fistulas which resolved with conservative management. One patient had an incomplete myotomy and was treated with injection of boulinum toxin in the pharyngeal plexus. This treatment resulted in good vocalization. Seventeen of 22 patients in the study were long-term TEP users, and all of these were judged to have good speech quality. Our experience with myotomy for TEP speech demonstrates that many patients with pharyngoesophageal spasm can benefit from the procedure and successfully phonate. There were several complications related to the procedure, but these were successfully managed conservatively and without long-term sequela. Pharyngeal myotomy as an adjunct to TEP is useful and effective in selected patients.

Aged↗

PubMed1995

[Pharyngeal metastasis and arteriovenous fistula of renal cell carcinoma--report of a case].

A 76-year-old Japanese male consulted our hospital complaining of dysphagia. He also complained of dyspnea, and a cardiovascular disorder was detected. Otolaryngological examination revealed dysphagia due to pharyngeal tumor. Further examination detected left renal cell carcinoma with multiple pulmonary metastasis, and selective angiography revealed arteriovenous fistula in the primary tumor. After resection of the pharyngeal tumor and left nephrectomy, pharyngeal tumor was pathologically confirmed as metastasis of renal cell carcinoma. Furthermore, after left nephrectomy, the cardiovascular disorder gradually improved. Thus, the cardiovascular disorder was considered to have developed based upon the arteriovenous fistulae. Pharyngeal metastasis of renal cell carcinoma is extremely rare, and the cardiovascular disorder in this case was also an extrarenal manifestation.

Aged↗

PubMed1994

[Bacterial epidemiology of pharyngitis in pediatric private practice].

OBJECTIVES: While viruses are usually the causal agents of common sore throat in children, bacterial infections cannot be distinguished solely on the basis of clinical presentation. Thus most physicians in France prefer to prescribe antibiotics in order to prevent rheumatismal complications of group A streptococcal infections. We updated current epidemiological data on bacterial pharyngitis in paediatric out-patient clinics. METHODS: A prospective study was conducted from March 1 to June 1, 1992 by 9 physicians. Throat swabs were obtained from 102 controls and from 307 patients with acute pharyngitis. Samples were transferred to the same bacteriology laboratory for examination. RESULTS: The mean age of the children was 6.1 years for patients and 7.2 years for controls. Throat swabs were inoculated for culture within a mean delay of 22.6 hours. Cultures were performed on Columbia blood medium with nalidixic acid and colistin then incubated in CO2 enriched atmosphere and on trypticase blood soy medium + 3.5% NaCl. Group A streptococcal strains were identified by search for beta-haemolysis and latex characterisation of group A polyosides. Group A streptococcal strains were found in 8.8% of the controls and 36.8% of the patients. Groups B, C or G streptococci were found in 10.8 et 11.4% of the controls and patients respectively (NS). Arcanobacterium haemolyticum was never isolated. Clinical association of sore throat, erythematous pharyngitis, fever > 38 degrees C and cervical lymph nodes was found in only 33.63% of the sore throat cases with group A streptococcal infection and in 7.73% of those without group A streptococcal infection (p < 0.0001, sensitivity 33%, specificity 92%). CONCLUSION: These results emphasize the necessity either to treat all pharyngitis or to do throat swabs or rapid group A streptococcal tests for diagnosis.

Age Factors↗

PubMedDate not supplied

Meta-analysis in the evaluation of treatment for streptococcal pharyngitis: a review.

Penicillin has been first-line therapy for the treatment of streptococcal pharyngitis for more than 40 years. Since the 1980s, there have been a number of reports suggesting that bacteriologic failure rates with penicillin may be rising. A number of alternative therapies have been proposed, including oral cephalosporins. To evaluate the efficacy of these agents, two meta-analyses have recently been performed. In the meta-analysis performed by Pichichero and Margolis, oral cephalosporins were reported to achieve a significantly greater bacteriologic cure rate than penicillin (92% with cephalosporins vs 84% with penicillin, P < 0.0001) when results from 19 studies were analyzed. A separate meta-analysis performed by Deeter et al reported that the oral cephalosporin cefadroxil monohydrate achieved significantly greater bacteriologic cure rates (94.8% cefadroxil vs 87.5% penicillin, P < 0.05) than oral penicillin when 9 trials in 1406 patients with streptococcal pharyngitis were analyzed. A review of 65 studies of the use of penicillin for the treatment of streptococcal pharyngitis has shown that bacteriologic failure rates in the period 1980 to 1993 were approximately 12% to 13%, slightly but not significantly greater than during the period 1953 through 1979. Oral cephalosporins such as cefadroxil monohydrate provide reasonable alternatives for the treatment of streptococcal pharyngitis.

Administration, Oral↗

PubMed1993

Serum micronutrients and the subsequent risk of oral and pharyngeal cancer.

To investigate the relationship between serum micronutrients and the subsequent risk of oral and pharyngeal cancer, a nested case-control study was conducted within a cohort of 25,802 adults in Washington County, MD, whose blood samples were collected in 1974 and stored at -70 degrees C for subsequent assays. The serum levels of nutrients in 28 individuals who developed oral and pharyngeal cancer during 1975 to 1990 were compared with levels in 112 matched controls. Serum levels of all individual carotenoids, particularly beta-carotene, were lower among subjects who developed oral and pharyngeal cancer. The risks of this malignancy decreased substantially with increasing serum level of each individual carotenoid. Persons in the highest tertile of total carotenoids had about one-third the cancer risk as those in the lowest tertile. High serum levels of alpha-tocopherol also were related to a low oral cancer risk in later years, but the risks were elevated significantly with increasing serum levels of gamma-tocopherol and selenium. The findings from this study are consistent with many previous epidemiological investigations of dietary factors for oral and pharyngeal cancer and provide further evidence for the potential role of carotenoids and alpha-tocopherol in the chemoprevention of these malignancies.

Carotenoids↗

PubMed1996

Evaluation of penicillins, cephalosporins, and macrolides for therapy of streptococcal pharyngitis.

OBJECTIVE: To review recent clinical experience with treatment of acute streptococcal pharyngitis with penicillins, cephalosporins, and macrolide antibiotics. METHODS: Literature review and analysis. RESULTS AND CONCLUSIONS: Oral penicillin V administered two to three times daily for 10 days is the treatment of choice for acute streptococcal pharyngitis and is the oral standard against which other treatments should be measured. A single intramuscular dose of benzathine penicillin also remains highly effective. Recent studies evaluating alternative oral agents given for less than 10 days or in once-daily regimens have yielded promising results. Studies should make efforts to exclude chronic streptococcal carriers with intercurrent viral pharyngitis because their inclusion in treatment trials substantially confounds the data. As issues of health care costs assume increasing importance, the cost of newer antimicrobial agents will deter their usage for acute streptococcal pharyngitis.

Anti-Bacterial Agents↗

PubMed1996

[Variations of the constrictor pharyngeal muscles in humans].

Fifteen halves of ten nonrandomized human cadavers were dissected under a stereoscopic microscope in order to examine the existence of variations in the constrictor pharyngeal muscles. Obvious variations of the constrictor muscles were found in three cases. The results are summarized as follows: 1. In the first case of variations, the superior constrictors arose from the pterygomandibular raphe and merged into the outer surfaces of the middle and inferior constrictors. This muscle was supplied by the upper part of the pharyngeal branches of the vagus. 2. In the second case, the muscle bundle of inferior constrictors originated from the thyroid cartilage and passed upward, joining the muscular fibers of the outer surface of the superior constrictors arising from the pterygomandibular raphe. Some of these muscular fibers extended to the surface of the posterior part of the pharyngobasilar fascia. This muscle was innervated by the lower part of the pharyngeal branches of the vagus. 3. In the third case, the lower part of the superior constrictors passed laterally between the stylopharyngeus and the glossopharyngeal nerve, running between the external and internal carotids in the retrostyloid space and reaching the cervical fascia around the submandibular triangle. This anomalous muscular bundle of superior constrictors was innervated by the carotid branch of the glossopharyngeal nerve and the middle part of the pharyngeal branches of the vagus.

Glossopharyngeal Nerve↗

PubMed1998

Preventing and controlling oral and pharyngeal cancer. Recommendations from a National Strategic Planning Conference.

In August 1996, CDC convened a national conference to develop strategies for preventing and controlling oral and pharyngeal cancer in the United States. The conference, which was cosponsored by the National Institute of Dental Research of the National Institutes of Health and the American Dental Association, included 125 experts in oral and pharyngeal cancer prevention, treatment, and research; both the private and public sectors were represented. Participants at the conference developed recommendations concerning advocacy, collaboration, and coalition building; public health policy; public education; professional education and practice; and data collection, evaluation, and research. A follow-up meeting consisting of selected participants of the 1996 conference was held in September 1997. During this meeting, changes that had occurred in the political and scientific arenas since the 1996 conference were considered, and 10 recommended strategies from the conference were selected for priority implementation. These 10 strategies were to a) establish a mechanism to implement and monitor the recommended strategies developed during the conference; b) urge oral health professionals to become more actively involved in community health; c) require instruction in preventing and controlling tobacco and alcohol use at all levels of training in dental, medical, nursing, and other related health-care disciplines; d) encourage Medicaid, Medicare, traditional insurance plans, and managed-care entities to consider making oral cancer examinations an integral part of comprehensive physical and oral examinations; e) designate federal funding for a national program of oral cancer prevention, early detection, and control; f) after assessing local needs, develop, implement, and evaluate statewide models to educate all relevant groups; g) develop and conduct a national promotional campaign to raise public awareness of oral cancer and its link to tobacco use and heavy alcohol consumption; h) develop health-care curricula that require competency in prevention, diagnosis, and multidisciplinary management of oral and pharyngeal cancer; i) sponsor and promote continuing education for health-care professionals on the multidisciplinary management of all phases of oral cancer and its sequelae; and j) strengthen organizational approaches to reducing oral cancer by developing organized cooperative and collaborative arrangements, funding formal centers, and involving commercial firms. CDC will use these recommended strategies to develop programs to reduce the burden of oral and pharyngeal cancer in the United States. Through the Oral Cancer Roundtable, a group of conference and meeting participants, CDC will communicate to interested agencies, organizations, and state health departments ways in which they can implement elements of the national plan. The Roundtable will help CDC track the efforts and progress of these groups.

Congresses as Topic↗