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Data and Picture Interpretation Stations: Cases 1–45
Published in Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar, ENT OSCEs, 2023
Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar
The pharyngeal tonsils are part of Waldeyer's ring of tonsillar tissue which also includes the adenoid tissue, tubal tonsils and lingual tonsils. Tonsillitis can be viral or bacterial. Common pathogens include adenovirus, Epstein-Barr virus, enteroviruses, and Group A beta haemolytic streptococcus (GABHS). GABHS is best treated with penicillin, and amoxicillin should be avoided as it can cause a salmon-coloured maculopapular rash if the patient has EBV. Complications of tonsillitis include peritonsillar, parapharyngeal and retropharyngeal abscesses, and systemic complications include scarlet fever, rheumatic fever and post-streptococcal glomerulonephritis.
The Pharynx and Oral Cavity
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
Diagnosis of acute tonsillitis is largely clinical, and most children are managed in primary care settings rather than by ORL specialists. Acute tonsillitis can usually be managed with symptomatic treatment, i.e. analgesics (paracetamol), fluids and observation for signs of deterioration. Resolution is the norm with or without antibiotic treatment but, if antibiotics are deemed appropriate, penicillin is effective against most of the common causative organisms.
The Lymphatic/Immune System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Inflammation of the lymphatic tissue also occurs because of accumulation of white blood cells and other debris in lymph nodes. Tonsillitis (inflammation of the tonsils), for example, is common in pharyngeal infections. Splenitis is an inflammation of the spleen, usually caused by pyemia (a septicemia with numerous abscesses or foci of infection, creating an accumulation of pus in the spleen).
Sensory profiles, behavioral problems, and auditory findings in children with autism spectrum disorder
Published in International Journal of Developmental Disabilities, 2023
Ummugulsum Gundogdu, Ahmet Aksoy, Mehtap Eroglu
On physical examination performed by an otolaryngologist, none of the children had problems with the tympanic membrane, such as middle ear fluid, tympanic membrane perforation, tympanic membrane scarring, cholesteatoma, or other middle ear masses. No evidence of spontaneous nystagmus was found in any of the children. The parents of the children included in this study had no history of otosclerosis or hearing loss. Signs of tonsillitis were noted in 3 children. Fourteen children exhibited signs of nasal congestion. Examination findings of the ears, nose, and throat of 29 children were normal. When children with nasal congestion and tonsillitis symptoms in one group and children without symptoms in another group were examined, no difference was found in behavioral problems and sensory sensitivities. Pure-tone audiograms could be performed in only 3 of 46 children. Statistical analysis could not be performed because 3 children were in children with ASD who were performed pure-tone audiograms and 43 children were in the other group.
A study of guidelines for respiratory tract infections and their references from Swedish GPs: a qualitative analysis
Published in Scandinavian Journal of Primary Health Care, 2020
M. Tyrstrup, M. André, A. Brorsson, H. Gröndal, E.-L. Strandberg, K. Hedin
The implementation programme for guidelines less compatible with existing norms needs to be more thorough. GPs should be alerted to the evidence supporting the recommendations, but education and conventional knowledge translation may be insufficient. Facilitating reflective consideration, individually and collectively, of how to perform in particular cases and situations may influence personal practice through recognizing practical wisdom and case knowledge [33]. More attention should be given during the outreach visits by Strama GPs and pharmacists to discussing controversial recommendations in peer review groups [34]. Particularly, the guidelines for tonsillitis need attention as they have caused concern among hospital doctors about complications [35]. The exactness of the guidelines for tonsillitis and their interference with GPs’ ability to improvise might make other types of health care providers such as nurses more suitable for patients with tonsillitis. Or perhaps the guidelines need to be rewritten to address persistent ideas. Tailored implementation strategies based on the identified barriers [36] may also be important for a successful implementation [37].
The use of bacterial DNA from saliva for the detection of GAS pharyngitis
Published in Journal of Oral Microbiology, 2020
Saar Hashavya, Naama Pines, Ayelet Gayego, Avi Schechter, Itai Gross, Alon Moses
Acute tonsillitis is one of the most common medical conditions for which children and young adults seek medical advice. Although most episodes of tonsillitis are caused by viruses, Group A streptococcus (GAS) infection accounts for approximately 15% to 30% of all cases in children and 5% to 15% of all cases in adults [1,2]. The overlap in signs and symptoms of GAS and non-streptococcal tonsillitis makes accurate diagnosis based on clinical assessment alone very challenging even for the astute physician. Accurate diagnosis of streptococcal tonsillitis followed by appropriate antimicrobial therapy is crucial for the prevention of acute rheumatic fever as well as suppurative and other systemic complications [3]. A rapid and correct diagnosis is also important to avoid unnecessary antimicrobial therapy.