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At least 451 records · Page 25Linked to original sources
PubMed2001

Value of throat swab in diagnosis of melioidosis.

Throat swab (TS) cultures were performed for 1,011 patients with melioidosis and 3,524 healthy subjects or patients with other diseases. The specificity of TS culture for the diagnosis of melioidosis was 100%, and the overall sensitivity was 36% (24% for sputum-negative patients and 79% for sputum-positive patients). Direct plating of the TS specimen on Ashdown's medium was rapid (colonies were usually evident within 24 h) but only 63% sensitive compared to the results of primary culture in a selective broth. A throat swab should be cultured in all cases of suspected melioidosis.

Adolescent↗
PubMed1977

Selective and enhanced recovery of group A and B streptococci from throat cultures with sheep blood agar containing sulfamethoxazole and trimethoprim.

Sheep blood agar containing 23.75 microgram of sulfamethoxazole and 1.25 microgram of trimethoprim (SXT-BA) per ml was compared with conventional sheep blood agar (SBA) for isolating group A and B streptococci from throat cultures. This selective medium allowed much better recovery of group A and B streptococci and suppressed the growth of the normal flora, including "viridans" streptococci. In an initial study of 700 throat cultures, SXT-BA recovered 42% more group A and 49% more group B streptococci than did SBA. When SXT-BA was introduced into the routine microbiology laboratory and used by a number of medical technologists. SXT-BA recovered 28% more group A and 37% more group B streptococci than did SBA. In addition, the selective medium inhibited 83% of the non-group A and B streptococci that were recovered by SBA.

Agar↗
PubMed1978

Serological identification of group A streptococci from throat scrapings before culture.

The use of a microtechnique (modified nitrous acid extraction) to test samples from 150 school children and from patients with acute follicular tonsillitis has indicated that group A streptococci in the throat can be identified from tonsillar scrapings in 30 min. The results are comparable to the grouping results obtained by standard throat culture techniques and the Lancefield procedure for grouping. No cross-reaction with other bacteria or cellular material occurs. Study has also shown that the nitrous acid extraction yields three- to fourfold more polysaccharides than the Lancefield hot-HCl of Fuller formamide techniques. The use of the microtechnique leads to another 20-fold concentration of the antigen. Immune salting-out effect could be obtained with 1.00 M sodium acetate. Such molarity is too low to cause nonspecific slating out. It leads to a strong ampliciation of the precipitin reaction.

Child↗
PubMed1971

Sore throat in children: its causation and incidence.

Beta-haemolytic streptococci were isolated from 35% of 525 children who presented to their family doctors with sore throat. The first 306 were investigated bacteriologically and virologically and beta-haemolytic streptococci were isolated from 30% and viruses from 14.7%. The ages which had the highest incidence of sore throat, for both sexes, were 7, then 6, 8, and 5. Those with tonsils had a higher incidence of beta-haemolytic streptococci than those without, but the presence or absence of tonsils made no difference to the degree of growth of the streptococci.Viruses were isolated predominantly during the winter months, but streptococci, though mostly isolated in winter, were isolated throughout the rest of the year.

Adenoviridae↗
PubMed1988

Rational decisions in managing sore throat: evaluation of a rapid test.

Sixty nine general practitioners recorded what they had prescribed for a total of 1189 episodes of sore throat. Antibiotics were prescribed in 763 (64%) episodes and broad spectrum antibiotics in 161 (21%) of these. If there was dysphagia, hoarseness, cervical adenopathy, and inflamed or purulent tonsils a prescription was more likely to be written. An enzyme immunoassay rapid test was evaluated as a means of rationalizing prescribing. Among 23 general practitioners and 250 patients the sensitivity of the test was 63% and the specificity 91.7% compared with 74% and 58% for clinical assessment alone. Test results rarely caused previous prescribing decisions (34 [corrected] (13%) episodes) to be altered. We suggest that the time is not ripe for the use of the enzyme immunoassay rapid test on a wide scale in the routine assessment of sore throats.

Anti-Bacterial Agents↗
PubMed1989

Ear, nose, and throat symptoms in subacute Wegener's granulomatosis.

The standard description of Wegener's granulomatosis emphasises renal failure and thus a distorted impression may be given. Subacute and even chronic cases occur, and in these patients the presentation is varied and often insidious, leading to delay in diagnosis. Twenty two such patients (13 women and nine men) with a mean age of 44 years were seen in our connective tissue disease clinic. The mean duration of symptoms before diagnosis was 3.6 years and the mean duration of disease 5.9 years (19 years in one patient). All patients had malaise and ear, nose, and throat symptoms, and most had joint pains. Impaired renal function was seen in seven patients only. Tissue biopsy was diagnostic in half of the patients, and appreciably high titres of antineutrophil cytoplasmic antibodies were detected in only nine of 18 patients in whom these were measured. The most useful investigations were neutrophil counts, chest radiographs, and computed tomography of the sinuses and orbits. The most effective treatment was with intravenous pulses of cyclophosphamide. No deaths occurred. At the time of writing two patients were in remission and no longer being treated and 18 patients were in partial remission on continued treatment. Patients with subacute forms of Wegener's granulomatosis present with a variety of clinical features and the insidious presentation often leads to delay in diagnosis. A history of ear, nose, and throat symptoms was universal in our patients.

Ear Diseases↗
PubMed2003

Why do general practitioners prescribe antibiotics for sore throat? Grounded theory interview study.

OBJECTIVES: To understand why general practitioners prescribe antibiotics for some cases of sore throat and to explore the factors that influence their prescribing. DESIGN: Grounded theory interview study. SETTING: General practice. PARTICIPANTS: 40 general practitioners: 25 in the maximum variety sample and 15 in the theoretical sample. RESULTS: General practitioners are uncertain which patients will benefit from antibiotics but prescribe for sicker patients and for patients from socioeconomically deprived backgrounds because of concerns about complications. They are also more likely to prescribe in pressured clinical contexts. Doctors are mostly comfortable with their prescribing decisions and are not prescribing to maintain the doctor-patient relationship. CONCLUSIONS: General practitioners have reduced prescribing for sore throat in response to research and policy initiatives. Further interventions to reduce prescribing would need to improve identification of patients at risk of complications and be workable in busy clinical situations.

Anti-Bacterial Agents↗
PubMed1984

Plasmids in throat and genital isolates of meningococci.

Plasmids 1.6, 2.8, or greater than 40 megadaltons in size were found in one urethral and nine throat strains of meningococci. Throat meningococci are known to be heterogeneous in their aminopeptidase profiles. Their unexpected content of plasmids is further evidence of their difference from classic systemic strains. Although the 2.8 megadalton plasmid has some resemblance to the well known 2.6 megadalton gonococcal plasmid, restriction enzyme studies gave no evidence of identity. Possible sources of the plasmids are discussed.

Aminopeptidases↗
PubMedDate not supplied

Clinical pharmacology of the antimicrobial agents for infections in the ear, nose and throat.

Knowledge of which microorganisms cause infection in the ear, nose and throat must be coupled with an understanding of the susceptibility patterns of these bacteria as well as knowledge of the pharmacokinetic properties of antimicrobial agents. EVen though many of the bacteria which produce community-acquired infection are susceptible to the older agents, specific problems have developed with regard to species such as Hemophilus influenzae and to Staphylococcus aureus. Hospital-acquired infections due to Enterobacteriaceae may be resistant to the penicillin drugs and to some of the older cephalosporins and aminoglycosides. Use of the new agents often requires an understanding of how rapidly the compounds are cleared from the body or if they will accumulate to toxic levels in the elderly patient with decreased renal function. This article reviews the antimicrobial activity and clinical pharmacology of agents commonly used to treat infections of the ear, nose and throat.

Anti-Bacterial Agents↗
PubMed1984

Use of an anaerobic culture jar in processing pediatric throat cultures.

Two hundred consecutive throat cultures from a Pediatric Walk-in Clinic were processed, using both aerobic and anaerobic culture techniques. The 35 aerobic isolates of group A beta-hemolytic streptococci (BHS) were all confirmed anaerobically as well, and there were two additional isolates detected only by the anaerobic technique. Of these 37 bacitracin-sensitive isolates, only 24 (65%) could be identified at 24 hours using the aerobic technique, compared to 29 (78%) using the anaerobic technique. In contrast to this relatively small effect upon the isolation of group A BHS, the yield of BHS from groups B, C, F, and G was more than doubled by the anaerobic technique. The confusion engendered by the improved detection of these bacitracin-resistant BHS using the anaerobic technique offset the small advantage in thoroughness and speed of detection of group A organisms. On this account, until more is known about the possible significance of isolating nongroup A BHS in the pharynx, the advisability of using an anaerobic culture jar to process pediatric throat cultures remains uncertain.

Bacteria, Aerobic↗
PubMed1982

Treating sore throats in the emergency room. The importance of follow-up in decision making.

Evaluation and treatment of emergency room patients complaining of sore throats are complicated by an unknown probability of follow-up. Tompkins' analysis of cost-effective sore throat management strategies was modified by adding an expression for variable follow-up rate. The original analysis specified a culture range when the probability of streptococcal infection was between 0.05 and 0.20, while the expanded analysis demonstrates that this range decreases with decreasing follow-up. For follow-up rates of 0.70 or less, all patients would be in either the treatment or no treatment group. This analysis demonstrates the importance of follow-up in out-patient decision making, and illustrates the methodology for including follow-up (and similar factors) in our analyses.

Decision Making↗
PubMed1982

Two lozenges containing benzocaine assessed in the relief of sore throat.

A study has been conducted in general practice comparing two brands of lozenges, Merocaine (Merrell) and Tyrozets, (M.S.D.), in the management of acute sore throat and pharyngitis. Eighty-eight patients entered the between-patient study and each completed a diary card covering symptoms experienced and dosage used for each of the two drugs. The doctor reported upon the appearance of the throat and added antibiotics in cases of necessity, which was approximately for one-third of patients. Merocaine proved to be significantly superior to Tyrozets in producing rapid pain relief (within 15 minutes) and reduction of faucial and pharyngeal injection.

Adult↗
PubMed2003

Identifying barriers and tailoring interventions to improve the management of urinary tract infections and sore throat: a pragmatic study using qualitative methods.

BACKGROUND: Theories of behaviour change indicate that an analysis of factors that facilitate or impede change is helpful when trying to influence professional practice. The aim of this study was to identify barriers to implementing evidence-based guidelines for urinary tract infection and sore throat in general practice in Norway, and to tailor interventions to address these barriers. METHODS: We used a checklist to identify barriers and possible interventions to address these in an iterative process that included a review of the literature, brainstorming, focus groups, a pilot study, small group discussions and interviews. RESULTS: We identified at least one barrier for each category. Both guidelines recommended increased use of telephone consultations and reduced use of laboratory tests, and the barriers and the interventions were similar for the two guidelines. The complexity of changing routines involving patients, general practitioners and general practitioner assistants, loss of income with telephone consultations, fear of overlooking serious disease, perceived patient expectations and lack of knowledge about the evidence for the guidelines were the most prominent barriers. The interventions that were tailored to address these barriers included support for change processes in the practices, increasing the fee for telephone consultations, patient information leaflets and computer-based decision support and reminders. CONCLUSION: A systematic approach using qualitative methods helped identify barriers and generate ideas for tailoring interventions to support the implementation of guidelines for the management of urinary tract infections and sore throat. Lack of resources limited our ability to address all of the barriers adequately.

Adolescent↗
PubMed2003

Serious consequences of a sore throat.

Lemierre's syndrome, caused by Fusobacterium necrophorum, is a potentially fatal sequelae of a sore throat characterised by septicaemia, internal jugular vein thrombophlebitis and metastatic abscesses. The Chief Medical Officer reported in February 2001 that the incidence is increasing. Two cases seen in one year, with different presentations, are reported. The first patient presented with sepsis, jaundice, hepatic abscesses and portal vein/superior mesenteric vein thrombosis, whilst the second presented with sepsis, sore throat and internal jugular vein thrombophlebitis. Both patients were treated with antibiotics and anticoagulants with a favourable outcome.

Adult↗
PubMed2001

Salient beliefs and intentions to prescribe antibiotics for patients with a sore throat.

OBJECTIVES: General practitioners (GPs) in the UK continue to prescribe antibiotics for patients with sore throats despite evidence that they are ineffective and can contribute to the growth of antibiotic resistance in the population. This study uses the theory of planned behaviour (TPB) to investigate the strength of intention to prescribe antibiotics, and to identify the salient beliefs associated with this intention. DESIGN: Cross-sectional study testing hypotheses derived from the TPB. METHOD: A 66-item postal questionnaire was distributed to a random sample of GPs in one NHS region (N = 185). The questionnaire included measures of intention to prescribe antibiotics, attitude, behavioural beliefs and evaluations, normative beliefs and evaluations, perceived behavioural control, control beliefs, and past prescribing. RESULTS: Two-thirds of the GPs returned complete questionnaires (N = 126, 68%). The majority intended to prescribe antibiotics for less than half of their patients with sore throats (N = 69, 55%). The variables specified in TPB predicted 48% of the variance in intention, with past behaviour adding a further 15%. Seven salient beliefs distinguished between doctors who intend to prescribe antibiotics and those who do not. CONCLUSIONS: Attitudes towards antibiotics and control beliefs are important predictors of intention to prescribe, as predicted by TPB. Interventions could target salient beliefs associated with motivation to prescribe.

Journal Article↗
PubMed2000

beta-Lactamase activities and resistance to antibiotics of Haemophilus influenzae, H. parainfluenzae and H. aphrophilus strains identified in throat cultures from children.

Haemophilus bacteria are normally present in the upper respiratory tract of healthy individuals. However, these bacteria could be opportunistic pathogens especially in children. The present study was conducted to determine beta-lactamase activity of Haemophilus from the throat cultures of children with upper respiratory tract infections. 154 Haemophilus strains were isolated from throat swabs of 208 children whom had upper respiratory tract infections. Among the 154 Haemophilus strains isolated, 117 H. influenzae (76%), 35 H. parainfluenzae (22.7%), and two H. aphrophilus (13%) were identified by API NH. beta-Lactamase activity was positive in 42 isolates of 117 H. influenzae isolates, while it was negative in 75 isolates. beta-Lactamase activity was positive in 20 H. parainfluenzae isolates, and negative in 15. All the H. aphrophilus isolates were beta-lactamase negative. It is known that beta-lactamase positive Haemophilus bacteria are resistant to some antibiotics. Therefore, the antibiotic resistance of Haemophilus was further investigated in relation to beta-lactamase activity. The in vitro antibacterial susceptibilities of Haemophilus strains for ampicillin, sulbactam-ampicillin, trimethoprim-sulfamethoxazole, gentamicin, chloramphenicol and ciprofloxacin were tested by disk diffusion method on chocolate agar. In 42 beta-lactamase-positive H. influenzae isolates, 32 isolates were resistant against ampicillin. In 20 beta-lactamase-positive H. parainfluenzae isolates, 16 were resistant against ampicillin. The two beta-lactamase negative H. aphrophilus were sensitive to ampicillin. Biotypes and serotypes were also investigated. Biotypes of H. influenzae strains were as follows: 40 strains biotype II, 25 strains biotype I, 14 strains biotype III, and 38 strains biotypes VII, VIII, V, and IV. Biotypes of 35 H. parainfluenzae strains were: 6 strains biotype III, 5 strains biotype I, 5 strains biotype IV. Biotypes of remaining 19 isolates were II, VIII, VI and VII. The serotypes of H. influenzae strains were determined by specific antiserums. Serotypes of 117 H. influenzae found were type a, b, c, d, and f.

Adolescent↗
PubMed1990

The sore throat. When to investigate and when to prescribe.

Sore throats are most commonly due to infections, many of which are viral and do not require specific treatment. Symptoms and signs of the common cold, influenza or croup, the occurrence of conjunctivitis in some adenoviral infections, generalised lymphadenopathy and splenomegaly in glandular fever or the presence of vesicles characteristic of herpangina (Coxsackie A virus) or of herpes simplex infection, occasionally enable a clinical diagnosis and avoid the need for antibiotic therapy. In the case of treatable conditions a typical membrane may suggest diphtheria, a scarlatiniform rash infection due to Streptococcus pyogenes or to Corynebacterium haemolyticum, and a cherry-red epiglottis Haemophilus influenzae type b. Associated atypical pneumonia suggests infection with Mycoplasma pneumoniae or Chlamydia pneumoniae. Pharyngitis due to Neisseria gonorrhoeae may be accompanied by infection at other sites or by other sexually transmitted diseases. Candidal infection, in the appropriate clinical circumstance, should suggest HIV infection. Surgical drainage is required in the case of peritonsillar or retropharyngeal abscess. Noninfectious cases of sore throat, e.g. thyroiditis, are relatively uncommon considerations in the differential diagnosis of acute febrile pharyngitis. The most common problem is to recognise streptococcal pharyngitis, which requires antibiotic treatment for 10 days to avoid the risk of rheumatic fever.

Humans↗
PubMed2005

Ear, nose, and throat manifestations of Sjögren's syndrome: retrospective review of a multidisciplinary clinic.

OBJECTIVE: To assess the otolaryngologic manifestations of Sögren's syndrome (SS). DESIGN: A retrospective case study. SETTING: The Toronto Hospital. METHOD: Case note review of 196 patients evaluated in a multidisciplinary clinic for this disease. Patients were retrospectively classified according to the revised international classification. MAIN OUTCOME MEASURES: The prevalence of subjective and objective audiologic and otorhinolaryngologic abnormalities. RESULTS: One hundred eleven patients were diagnosed with primary and 26 with secondary SS, leaving 60 with unclassified sicca syndrome. There was minimal otologic pathology. There was a mildly increased prevalence of sensorineural deafness in secondary SS (41-60 years, 36%; 61-80 years, 70%). Approximately 50% of patients in each group complained of nasal symptoms, but only 20% had abnormal findings on rhinoscopy. Similarly, 60 to 70% in each group complained of throat symptoms, but only 20% had abnormal findings on indirect laryngoscopy. Thirty-eight percent of primary patients had parotid gland symptoms, and 25% had abnormally swollen glands, with eight subsequently diagnosed with lymphoma. No patients in the other two groups had abnormal parotid glands. CONCLUSIONS: SS does not appear to be associated with increased otologic or audiologic disease, except perhaps in conjunction with systemic autoimmunity. Nose and throat symptoms are common in SS, but the complications of mucosal dryness on examination are unusual (approximately 20%). Primary SS can cause serious parotid morbidity secondary to inflammation and infection. There is also a significant risk of lymphomas that often present as parotid masses, necessitating long-term follow-up.

Aged↗