1/17. Lingual tonsillectomy for refractory paroxysmal cough.Historically, the lingual tonsils are the most neglected members of Waldeyer's ring. They are often overlooked even in a thorough head and neck exam because of their anatomic location and the ambiguous constellation of symptoms which they produce when they are diseased or enlarged. The lingual tonsils have been reported to be associated with a variety of upper aerodigestive tract symptoms including odynophagia, dysphagia, otalgia, globus, halitosis, chronic cough, and dyspnea. Many patients with lingual tonsillar pathology may undergo extensive work-up for some of these non-specific upper airway complaints by their primary physician before referral to an otolaryngologist. Consequently, the diagnosis of lingual tonsillar disease requires a high index of suspicion and a thorough physical exam including evaluation of the tongue base and hypophaynx with indirect mirror or fiberoptic exam. In order to draw attention to this frequently unrecognized entity, we present a case report of a child with chronic cough resulting from lingual tonsillar hypertrophy.- - - - - - - - - - ranking = 1keywords = upper, tract (Clic here for more details about this article) |
2/17. coxiella burnetii: an unusual ENT pathogen.coxiella burnetii, the causative agent of q fever, is a prevalent zoonotic disease manifestating usually as atypical pneumonia or hepatitis. We describe 2 cases of serologically proven infection by coxiella burnetii whose primary manifestations arose from the upper respiratory tract and were initially referred to the ear, nose, and throat (ENT) department. This is the first related report in medical literature. A 20-year-old woman with fever, bilateral tonsillitis, lymphadenopathy, and mild aminotransferase elevation, and a 30-year old man with spiking fever and laryngitis are presented. Diagnosis in both cases was achieved through evolving serological response to coxiella burnetii. The importance of including the pathogen in the differential diagnosis of ENT patients, in assorted epidemiological settings, and the significance of the proper antibiotic selection are further discussed.- - - - - - - - - - ranking = 448.93381333811keywords = upper respiratory tract, respiratory tract, upper, tract (Clic here for more details about this article) |
3/17. Narcotic administration and stenosing lesions of the upper airway--a potentially lethal combination.Two cases are reported where significant narrowing of the upper airway in association with narcotic administration resulted in respiratory compromise and death. Case 1: A 29-year-old woman with upper airway narrowing due to tonsillar enlargement from an Epstein-Barr infection was admitted to hospital, administered morphine and left in a room on her own with the door closed. She was found dead several hours later. At autopsy there was significant narrowing of the upper airway due to tonsillomegaly with a blood morphine level of 0.16 mg/L. Case 2: A 48-year-old woman with severe narrowing of her glottic inlet from recurrent squamous cell carcinoma and an intravenous drug taking history was found dead at her home. At autopsy there was evidence of recent and remote intravenous drug administration with marked narrowing of the glottis due to a recurrent tumor with a blood morphine level of 0.48 mg/L. In both cases, death was due to the effects of severe upper airway narrowing in combination with the respiratory depressant actions of morphine. Additional exacerbating factors may have included muscle weakness, drowsiness and reduced clearance of airway secretions from the effects of morphine. Narcotic administration in individuals with compromised upper airways should be undertaken extremely circumspectly and hospital protocols should ensure constant surveillance if this has been undertaken. Individuals who self administer narcotics should also be made aware of the dangers if there is coincidental upper airway narrowing. Toxicological evaluation in fatal cases of upper airway narrowing/stenosis may be extremely useful in revealing compounding factors such as opiate administration.- - - - - - - - - - ranking = 4.3013743512715keywords = upper (Clic here for more details about this article) |
4/17. Grisel's syndrome: a case report and review of the literature.Grisel's syndrome is non-traumatic atlantoaxial subluxation (AAS) secondary to an inflammatory process in the upper neck. It is a rare condition that occurs almost exclusively in children and has been associated with upper cervical infections and otolaryngologic procedures. A case of AAS secondary to an upper cervical infection is presented. Potential sequelae can be severe; early diagnosis and treatment of Grisel's syndrome can prevent tragic outcome.- - - - - - - - - - ranking = 1.1731020958013keywords = upper (Clic here for more details about this article) |
5/17. Lemierre's syndrome.Lemierre's syndrome is a rare, potentially severe disease consisting of septic emboli from an internal jugular vein thrombus after oropharyngeal infection. We report a 20-year-old man who had a tonsillitis with fever for 3 days. After a 2-day defervescence, fever relapsed as well as painful swelling over the left side of the neck. Computed tomography scan and sonography of the neck revealed thrombosis of left internal jugular vein and swelling of surrounding soft tissue. Chest radiograph demonstrated cavitary infiltrates over the left upper lobe. Septic thrombophlebitis of the internal jugular vein and metastatic pulmonary emboli was highly suspected. Intravenous ceftriaxone and metronidazole were given empirically. fusobacterium necrophorum was isolated from the blood culture with susceptibility to metronidazole. Complete defervescence and resolution of the neck swelling and pulmonary infiltrates occurred after antibiotic administration for 21 days. Lemierre's syndrome should be considered when encountering a febrile patient with painful neck swelling.- - - - - - - - - - ranking = 0.39103403193377keywords = upper (Clic here for more details about this article) |
6/17. infectious mononucleosis complicated by lingual tonsillitis.Although upper airway obstruction and superimposed infection are well-known complications of infectious mononucleosis, lingual tonsillitis in this context has not been mentioned in the literature. We describe a case of acute bacterial lingual tonsillitis with airway obstruction complicating infectious mononucleosis. The role of the base of tongue region in the pathophysiology of infectious mononucleosis is discussed.- - - - - - - - - - ranking = 0.39103403193377keywords = upper (Clic here for more details about this article) |
7/17. Rapid development of cor pulmonale following acute tonsillitis in adults.We describe two adult patients in whom acute tonsillitis resulted in the rapid development of cor pulmonale in the absence of clinically evident upper airway obstruction or diffuse obstructive airway disease. Both patients had developed symptoms of sleep apnea and all-night polysomnography confirmed the presence of severe obstructive sleep apnea. These cases emphasize the potentially severe cardiovascular consequences of acute tonsillar hypertrophy in the obese adult patient.- - - - - - - - - - ranking = 0.39103403193377keywords = upper (Clic here for more details about this article) |
8/17. Pseudo aneurysm of the external carotid artery: report of a case.The authors report a case of left otorrhagia in a 1-year-old male infant in the presence of a mass involving the parotideal and upper cervical regions, which had appeared after an infection of the upper airways. Non-invasive techniques, such as echography and CT scan, provided useful but contradicting information. Surgery allowed us to define the diagnosis of mycotic aneurysm of the external carotid artery. The authors, after pointing out the extreme rarity of such a pathology, discuss the ethiopathogenetic theories, the clinical features, the diagnosis and the surgical and medical treatment of the disease. Concerning surgery ligation of the external carotid artery is the treatment of choice, since distally the blood flow is provided by a conspicuous collateral circle and because a possible postoperative septic dissemination is avoided.- - - - - - - - - - ranking = 0.78206806386754keywords = upper (Clic here for more details about this article) |
9/17. A case of IgA nephropathy associated with marked hematuria after upper respiratory tract infections.IgA nephropathy is characterized by recurrent hematuria which is occasionally associated with upper respiratory infections. Since serial follow-up of IgA nephropathy has not been reported, a 43 year old patient who showed a typical course of this disease is described. hematuria was markedly increased each time after upper respiratory infections. Renal biopsy revealed typical features of IgA nephropathy by light and immunofluorescent microscopy. Marked hematuria subsided after administration of antibiotics. Upper respiratory tract infections might be a risk factor in some patients with IgA nephropathy. In some patients upper respiratory tract infections may exacerbate IgA nephropathy.- - - - - - - - - - ranking = 89550.401748423keywords = upper respiratory tract infection, respiratory tract infection, upper respiratory tract, respiratory tract, tract infection, upper, tract (Clic here for more details about this article) |
10/17. Complications of the 'treatment' of tonsillar infection by traditional healers in nigeria.Traditional healers in nigeria attempt to treat tonsillar infections either by performing uvulectomy with a sickle knife or by digital rupture of the tonsil. These procedures result in various complications, including haemorrhage, septicaemia, cellulitis of the neck, peritonsillar and parapharyngeal abscess, upper airway obstruction, and pharyngo-laryngocele with pneumothorax. These complications are illustrated with case reports. The danger of encouraging traditional healers to practise unsupervised and unscientific medicine is stressed.- - - - - - - - - - ranking = 0.39103403193377keywords = upper (Clic here for more details about this article) |
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