[Adenotonsillectomy in rheumatogenous streptococcal infections of children].
Explore the source record for details and available documents.
SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
A 6-year-old girl had a group A beta-haemolytic streptococcal (GABS) throat infection and Henoch-Schonlein purpura (HSP). The clinical course was complicated by nephrotic syndrome due to crescentic glomerulonephritis, transient neurological symptoms due to focal ischaemia of the brain, and congestive cardiac failure due to myocarditis. The clinical presentation highlights the diversity of systemic involvement in HSP, the transient nature of apparently serious central nervous system involvement, and a possible role of GABS in its aetiology.
Streptococci are amont the most common bacterial pathogens physicians encounter in practice. Infections with streptococci continue to occur with significant frequency despite the general sensitivity of these organisms to a variety of widely used antibiotics. In newborn infants and other special patient groups, streptococci may produce fulminant and fatal sepsis (Table 1). In normal children and adults, infections usually are short term and often mild or unrecognized but with the possibility of resulting, unpredictably, in nonsuppurative complications some weeks or months later. Although scarlet fever has become an unusual and clinically attenuated disease, its rashless analog, streptococcal pharyngitis, presents thorny problems in the differential diagnosis of symptomatic patients and in the detection of subclinical infections. Erysipelas now is a rare disease, but recent studies have confirmed that streptococci often are the primary etiologic agent in impetigo, another type of skin infection--with peculiar bacteriologic and epidemiologic features. Infections with group D streptococci have always been a special case because of their frequent resistance to penicillin, and group B streptococci (also somewhat resistant) present special problems in the perinatal period. Streptococci may appear in unexpected places or guises (see Table 1). Thus, the modern physician has little reason to relax in his vigilance for and knowledge of streptococcal infections.
In 1972 more than 20% of boys admitted to a closed community (Junior Detention Centre) developed acute tonsillitis and group-A streptococci were isolated from more than 40% of all boys at some time during their stay of two months. The most common serotype was M-type 5, which has frequently been associated with rheumatic fever in other epidemics; four cases of rheumatic fever occurred between 1972 and 1977. Various methods were tried to eliminate the infection, but only full penicillin prophylaxis (0.25 g oral penicillin 4 times a day for 10 days) to all boys on entry appeared to be effective. In a sample of cases of acute tonsillitis, group-A haemolytic streptococci were isolated from 31.7% by the use of dry swabs or unenriched transport medium, but with enrichment medium duplicate swabs, 77.6% yielded positive results. We question the current practice in some laboratories of reporting positive cultures only when more than ten colonies of beta-haemolytic streptococci are present. In this survey viruses did not appear to be an important cause of acute tonsillitis. High titres of streptococcal antibodies (antistreptolysin O, anti-desoxyribonuclease B and anti-M associated protein) were found, not only in cases and carriers, but in boys on entry to the centre. This supports epidemiological evidence that adolescent boys are particularly prone to streptococcal throat infections.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.