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At least 937 records · Page 52Linked to original sources
PubMed2000

[Isolated reversible unilateral paresis of hypoglossal nerve in tonsillitis--case report].

We report on a 30-year-old patient with isolated, left-sided hypoglossal nerve palsy after uncomplicated, presumably streptococci-induced tonsillitis. Needle electromyography (EMG) of the tongue showed denervation changes in the muscles supplied by the left hypoglossal nerve. Cranial CT and MRI, CSF examination, Doppler sonography, visual evoked potential (VEP), and auditory evoked potential (AEP) showed no abnormalities and, in particular, no signs of the carotid artery dissection or brainstem lesion. The symptoms and signs resolved within a few weeks after penicillin V treatment. We suppose that the hypoglossal affection of the uncomplicated tonsillitis in this case was due to an aberrant position of the nerve.

Adult↗
PubMed2005

Acute tonsillitis: an unusual presentation of Kawasaki syndrome: a case report and review of the literature.

Kawasaki syndrome is an acute, self-limiting vasculitis that occurs mainly in children. The disorder is difficult to diagnose, a problem compounded by the lack of a specific diagnostic test. If the condition is unrecognised or treated sub-optimally, there is a 25% risk of developing serious cardiovascular complications. We report the case of an 8-year-old boy presenting with a history of acute tonsillitis and cervical lymphadenopathy in which the diagnosis of Kawasaki syndrome became apparent 4 days after admission. The case emphasises the importance of having a high index of suspicion for Kawasaki syndrome in children presenting with tonsillitis and cervical lymphadenopathy who do not respond to antibiotics or who have atypical features at the time of or after admission. A literature review of previous cases reveals a higher than usual age of presentation for the disease that could result in a greater percentage of cardiac complications.

Acute Disease↗
PubMed2006

Benefit from tonsillectomy in adult patients with chronic tonsillitis.

The objective of this study was to determine the benefits of tonsillectomy in adult patients with chronic tonsillitis with special emphasis on the influence of age and gender. Cross-sectional survey analysis of patients at least 1 year after undergoing adult tonsillectomy at a university department. We used the Glasgow Benefit Inventory and a specifically constructed illness inventory (Specific Benefits from Tonsillectomy Inventory). One hundred and nine patients completed the survey. Significant improvements were demonstrated in three out of four GBI scores ['total score' (+16.9), 'general health' (+12.9), 'physical functioning' (+46.6), all P<0.0001] and in all SBTI scores ['symptom change' (+58.3), 'reduced use of resources' (+70.9), 'general benefit' (+52.1), all P<0.0001]. Gender did not play a significant role in benefit evaluation whereby younger patients evaluated the surgery as more beneficial than older patients. Adult patients with chronic tonsillitis definitely benefit significantly from tonsillectomy. Younger adult patients perceived greater surgical benefits than older adult patients. Patient gender did not significantly influence tonsillectomy benefit evaluation.

Adult↗
PubMed1997

M cells in the rabbit palatine tonsil: the distribution, spatial arrangement and membrane subdomains as defined by confocal lectin histochemistry.

The crypt epithelium of the palatine tonsil contains M cells that play an important role in the uptake of luminal antigens to initiate immune responses. To study the close interaction of M cells, squamous epithelial cells and lymphocytes we used confocal laser scanning microscopy and the lectin from Ulex europaeus (UEA-I), which selectively labels rabbit tonsillar M cells. Confocal serial sections and synthetic section planes showed that the M cells comprise up to 35% of the epithelial cells in the tonsil crypt and completely engulf clusters of two to eight lymphocytes with their apical cytoplasm. These lymphocytes lie in a pocket of the M cell's basolateral membrane that invaginates from one of the lateral aspects and forms a tunnel-like opening. Therefore, the tonsillar M cells closely resemble the M cells of the small and large intestines in their spatial structure, and likewise maintain an intraepithelial compartment for the interaction of lymphocytes, macrophages and antigens. The UEA-I bound intensely to the apical membrane of the M cells and to transcytotic vesicles in the apical cytoplasm. The pocket membrane bound the UEA-I more avidly than the remaining basolateral membrane, suggesting that the basolateral membrane of M cells is subdivided into membrane domains with different compositions of glycoconjugates.

Animals↗
PubMed1998

Syringomyelia associated with type I Chiari malformation. A 21-year retrospective study on 75 cases treated by foramen magnum decompression with a special emphasis on the value of tonsils resection.

The purpose of the present study is to evaluate retrospectively the effects of several intra-operative manipulations on the results of foramen magnum decompression (FMD) in patients having syringomyelia associated with type I Chiari malformation. Seventy-five patients having syringomyelia associated with Chiari I malformation were operated on between 1975 and 1996. This population was grouped into 4 subgroups according to the surgical protocol: group I = 42 patients with FMD alone; group II = 16 patients with FMD and third ventricle shunting; group III = 9 patients with FMD and syringosubarachnoid shunting (SSS); group IV = 8 patients with FMD and cerebellar tonsils resection. Pre- and postsurgical magnetic resonance imaging (MRI) studies were analyzed (and compared). Nine patients were lost to follow-up. The results were evaluated in the 66 remaining patients (mean follow-up: 52 months), using the Bidzinski's outcome scale (ref). Two patients (3%) died postoperatively, 31 (47%) had very good results (after additional surgery in 7), 16 (24.2%) had good results (after additional surgery in 7) and 17 (25.7%) had poor results despite further surgery in 9. A total of 27 reoperations were undertaken after primary FMD in 23 patients (35%). Thirty-nine patients (59%) had both pre- and postsurgical MRI evaluation. In 28 (72%) the syrinx had markedly decreased whereas it had remained stable in 11 (28%). Clinical results were not significantly different between the patients of groups I, II and III. Very good or good results were obtained in 24 patients (64.8%) of group I (after additional surgery in 10), in 8 (61.5%) of group II (after additional surgery in 1) and in 7 (87.5%) of group III (after additional surgery in 3). Results in group IV were as follows: 7 patients (87%) had very good results and one had a good result. With a mean follow-up of 28 months, no patient required additional surgery. Postsurgical MRI syrinx reduction was observed in all 8 patients either in the early postoperative course or on delayed followup. It is suggested that tonsils resection might enhance the results of FMD in individuals having Chiari I-related syringomyelia.

Adolescent↗
PubMed1992

Loracarbef versus penicillin VK in the treatment of streptococcal pharyngitis and tonsillitis in an adult population.

Loracarbef, a member of the carbacephem class of beta-lactam antibiotics, is a potent anti-bacterial agent. In a double-blind, randomized clinical trial to assess the efficacy and safety of loracarbef in the treatment of streptococcal pharyngitis and tonsillitis, 107 adult patients were treated with loracarbef (200 mg capsules twice a day or 15 mg/kg/day suspension) and 111 patients were treated with penicillin VK (250 mg capsules four times a day or 20 mg/kg/day suspension) for 10 days. In the loracarbef treatment group, 96.6% of the evaluable patients had a favorable clinical response 3-5 days after therapy, a result that compared favorably with the 93.9% response rate achieved in the penicillin group. The clinical failure/relapse rates were 3.4% for loracarbef-treated patients and 6.1% for patients receiving penicillin. Bacteriologic response data approximated the clinical results, with a successful response in 89.9% of the loracarbef-treated patients and 91.5% of the penicillin recipients. Two (1.9%) loracarbef-treated patients with rash and one (0.9%) penicillin-treated patient with diarrhea discontinued the study early because of these adverse events. The incidence of adverse events was comparable in the two treatment groups except for increased cough, which was reported by 3.7% of the loracarbef-treated patients and none of the penicillin recipients. These data support the conclusion that loracarbef is comparable to penicillin VK in the treatment of streptococcal pharyngitis and tonsillitis in adults.

Adult↗
PubMed1980

Tonsils and adenoids: why the dilemma?

Enlarged tonsils and adenoids have been implicated in dentofacial development and in the developing facial configuration. The growth pattern and the role of these lymphoid tissues are controversial, as are the benefits to be gained by their surgical removel. The diagnosis of enlarged tonsils and adenoids and of mouth breathing is not based on well-defined criteria.

Adenoidectomy↗
PubMed1989

Immunopathological and ultrastructural studies on the tonsil of gnotobiotic pigs infected with strain 67N of haemagglutinating encephalomyelitis virus.

The 67N strain of haemagglutinating encephalomyelitis virus (HEV) was inoculated orally or nasally into ten 3-day-old gnotobiotic piglets. Tonsillar changes characterized by epithelial degeneration and lymphatic cell infiltration occurred in the crypt from post-inoculation days (PID) 5 to 7, and HEV was isolated from the tonsil on PID 3 and 5. Ultrastructurally, many HEV particles were found in the cisternae, cytoplasmic vesicules and extracellular spaces of crypt epithelium. Immunohistologically, many HEV particles were observed in the crypt epithelial cells in the early stage of infection. Thereafter, a large number of immunoglobulin (IgG, IgM and IgA)-containing cells were observed in the tonsil. The appearance of IgM-containing cells was coincident with the detection of neutralizing antibody in the serum. These findings suggest that HEV replication in the crypt epithelium stimulates the proliferative response of immunoglobulin (IgG, IgM and IgA)-producing cells.

Animals↗
PubMed1976

Keratonodular tonsillitis.

Reported is an unusual lesion on the right palatine tonsil in a man with latent primary syphilis. The lesion was white, nodular, firm, and asymptomatic, and histologically had a keratinized surface; it was not caused by primary syphilis or any other known or described entity. The term keratonodular tonsillitis has been coined to designate this lesion of unknown cause or significance.

Adult↗
PubMed1995

Changes in tonsils and adenoids in children with posttransplant lymphoproliferative disorder: report of three cases with early involvement of Waldeyer's ring.

Posttransplant lymphoproliferative disorder (PTLD) is an infrequent complication of transplantation in children, and this report emphasizes the value of tonsil and adenoid biopsy in the early management of this potentially life threatening condition. In all three cases biopsy specimens of tonsils and adenoids were diagnostic of polymorphic diffuse B-cell hyperplasia (PBCH). Immunophenotyping showed no immunoglobulin (Ig) light chain restriction, although immunoglobulin heavy chain (IgH) gene rearrangement was monoclonal in two cases. Despite an absence of serological evidence for acute Epstein-Barr virus (EBV) infection, EBV was detected in all cases by semiquantitative polymerase chain reaction (PCR) for EBV DNA, by in situ hybridization for EBV mRNA (EBER), and by immunoperoxidase for EBV latent membrane protein (LMP). All three patients were treated with reduced immunosuppression and acyclovir and are well (19, 28, and 28 months' follow-up) with no recurrence. Children without previous EBV exposure may develop PTLD localized to the tonsils/adenoids, and biopsy specimens of these tissues may permit early diagnosis and clinical intervention. Despite monoclonal gene rearrangement in two cases, overall features were not indicative of malignancy. Strong association with EBV is helpful in confirming the diagnosis of PTLD and is consistent with initial presentation in the tonsils/adenoids.

Adenoids↗
PubMed1992

Serum immunoglobulin E levels in children with chronic tonsillitis.

Serum immunoglobulin E (IgE) levels were estimated by ELISA in 50 children with chronic tonsillitis before and after tonsillectomy. When compared with the control group, mean serum IgE concentration was found to be significantly higher in children with chronic tonsillitis (P less than 0.001). After tonsillectomy the levels returned to normal.

Adolescent↗
PubMed1993

The membranous tonsillitis during infectious mononucleosis is nevertheless of bacterial origin.

Samples from the fur covering the palatine tonsils of 10 patients with infectious mononucleosis (IM) were subjected to fluorescence microscopy after staining with acridine orange. Standard aerobic cultures from swabs were set up simultaneously. The fur constituted a mass of variously sized cocci and rods intermingled with granulocytes and cellular detritus. Five patients had growth of beta-haemolytic Streptococci on the tonsils. Bacteria in abundance were found attached to the tonsillar epithelial cells. The B-lymphotrophic Epstein-Barr virus, responsible for the IM infection, causes an immense increase in the bacterial colonization of the tonsillar surfaces, probably due to an increased attachment of bacteria to the tonsillar epithelial cells.

Adolescent↗
PubMed1996

Early adenotonsillectomy for relief of acute upper airway obstruction due to acute tonsillitis in children.

Early adenotonsillectomy (TA) for acute upper airway obstruction precipitated by acute tonsillitis was performed in 17 children admitted to the Royal Childrens Hospital over a 15 year period. The age ranged from 13 to 83 months (mean 37 months) and surgery was performed from 1 to 11 days (mean 5.8 days) following admission. One child who underwent surgery within 24 h of admission had an intraoperative blood loss of 250 ml requiring transfusion, but there were no cases of post operative hemorrhage. Airway obstruction was relieved by surgery in all cases and patients were discharged 1 to 6 days (mean 2.4 days) later. Early TA should be considered for relief of upper airway obstruction due to acute tonsillitis after an initial 24 h of intravenous antibiotic therapy.

Acute Disease↗
PubMedDate not supplied

Medical treatment of non-streptococcal recurrent tonsillitis.

Forty patients with a history of recurrent non-beta-hemolytic streptococcal tonsillitis (RNST) participated in a prospective randomized study comparing penicillin and clindamycin in the treatment of acute non-group A streptococcal infection. The efficiency of each antibiotic was evaluated according to its ability to alleviate acute infection and prevent recurrence. Surface tonsillar cultures were obtained both before and ten days after the termination of therapy, and specimens were processed for aerobic and anaerobic bacteria. Beta-lactamase-producing bacteria (BLPB) were present in 36 (90%) tonsillar cultures. Thirty-one BLPB were isolated in 17 patients before penicillin therapy and 42 BLPB were recovered from 19 after such treatment. Thirty-three BLPB were recovered in 19 patients before clindamycin therapy, after which four BLPB were isolated in three patients (P less than .05). From the second day posttherapy onward, significantly fewer patients who received clindamycin had fever, pharyngeal injection, and sore throat. In a 1-year follow-up period, recurrent tonsillitis was noted in 13 of the patients who received penicillin and in two treated with clindamycin (P less than .001). The data clearly demonstrate the superiority of clindamycin therapy over penicillin in patients with RNST.

Adolescent↗
PubMed1990

Immunolocalization of tyrosine hydroxylase and vasoactive intestinal polypeptide in nerve fibers innervating human palatine tonsil and paratonsillar glands.

The presence of tyrosine hydroxylase (TH) and vasoactive intestinal polypeptide (VIP) in the nerve fibers of the human palatine tonsil and paratonsillar secretory glands is reported. By immunohistochemistry TH-immunoreactive nerves and those immunoreactive to VIP were localized to the tonsil, in particular, the tonsillar vessel wall, extranodular lymphoid tissue and lymph nodule, and to the acinar basal surface of the paratonsillar glands. In the lymph nodule, immunoreactive varicose nerve profiles were observed inside the marginal zone. The germinal center was devoid of immunoreactive fibers.

Adolescent↗
PubMed1992

Sudden infant death syndrome and hypertrophy of the palatine tonsil: reports on two cases.

Two cases of sudden infant death syndrome (SIDS) with hypertrophy of the palatine tonsil were reported. The pathogenesis of the SIDS has been clarified (Guilleminault et al., Pediatrics, 68 (1981) 354-360). According to this theory, it is due to a central impairment of the breathing control during sleep, which is particularly pronounced in predisposed subjects. The present cases suggest that the hypertrophied palatine tonsil might contribute as a predisposing factor to the emergence of a SIDS by mechanical impediment to breathing by narrowing of the upper airway.

Airway Obstruction↗
PubMed1995

Memory B cells from human tonsils colonize mucosal epithelium and directly present antigen to T cells by rapid up-regulation of B7-1 and B7-2.

Human memory B cells that carry mutated IgV region genes were isolated from tonsils by negative selection of IgD+ naive B cells and CD38+ germinal center B cells and plasma cells. They were mainly found within the intraepithelial areas, but not in the B cell follicles of human tonsils. Memory B cells but not naive B cells have the capacity to present antigen directly to T cells, owing to the constitutive expression of the accessory molecules B7-1/CD80 and B7-2/CD86. Signals through antigen receptors and CD40 antigen result in these two molecules being further up-regulated more rapidly and strongly on memory B cells than on naive B cells. The unique anatomical localization of memory B cells beneath the surface of mucosa, together with their strong APC capacity, may explain the well-known prompt and robust secondary antibody responses.

Antigen-Presenting Cells↗
PubMed2005

Oxidant and antioxidant levels in children with acute otitis media and tonsillitis: a comparative study.

OBJECTIVE: Recurrent episodes of acute otitis media (AOM) and acute tonsillitis (AT) are a common problem in infectious disorders during childhood and are major cause of morbidity in children. The organism maintains defense systems including nonenzymatic antioxidants such as Vitamins A, E and C and reduced glutathione (GSH) against reactive oxygen species (ROS). In the present study, lipid peroxidation status and nonenzymatic antioxidant capacity were investigated in children with AOM and AT. Our aim was to compare the lipid peroxidation and responses of the body's antioxidant status in the closely associated infections such as AOM and acute tonsillitis. METHODS: The study included 23 (14 males, 9 females) children with AOM, 27 (14 males, 13 females) with AT and 29 (16 males, 13 females) healthy control subjects. The ages of the study and control subjects were between 2 and 7 years. Serum beta-carotene, retinol, Vitamin E, Vitamin C, and whole blood malondialdehyde (MDA) (as an indicator of lipid peroxidation) and GSH levels were studied in all subjects. RESULTS: There was a statistically significant difference between the groups for all parameters (P<0.05). All of the antioxidant vitamins such as beta-carotene, retinol, Vitamin E, and Vitamin C levels were observed to be significantly decreased in the both patient groups. Nevertheless, GSH levels were also decreased in the patient groups. MDA levels were found to be higher in children with AOM and AT than in the healthy control subjects. When compared the AOM and AT groups, there was statistically significant difference between the groups for whole blood MDA (P<0.05). CONCLUSION: Even though they seem to react in a similar way against ROS, in the cases of AOM and AT, it is possible to see the different approaches in these tissues for the oxidative stress.

Acute Disease↗