Cases reported "Tonsillitis"

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1/27. Marginal zone B cell lymphomas of Waldeyer's ring--a report of two tonsillectomy cases resembling histomorphological features of inflammatory lesions.

    We identified two cases of lymphoma of the mucosa-associated lymphoid tissue (MALT) type in 11 tonsillectomy specimens of primary B cell lymphoma of Waldeyer's ring. Both patients were Japanese females presenting with bilateral enlargement of the palatine tonsils. One had a history of chronic otitis media. In that case, the lesion was characterized by an extrafollicular growth pattern with marginal zone-like arrangement. The tumor was mainly composed of medium-sized cells with round or indented nuclei with scant cytoplasm (centrocyte-like cells). In the other patient, most tumor cells were mature plasma cells, plasmacytoid cells, proplasmacytes, and immunoblasts with scattered centrocyte-like cells. tropism of tumor cells for the epithelium was noted in both lesions. Primary marginal zone B cell lymphoma of the MALT type arising from Waldeyer's ring has rarely been reported in the literature, causing certain diagnostic problems. Various florid reactive lymphoproliferative disorders, including chronic tonsillitis and infectious mononucleosis, should be differentiated from this type of primary Waldeyer's ring lymphoma.
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ranking = 1
keywords = infectious mononucleosis, mononucleosis
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2/27. Prospective identification and treatment of children with pediatric autoimmune neuropsychiatric disorder associated with group A streptococcal infection (PANDAS).

    BACKGROUND: The current diagnostic criteria for pediatric autoimmune neuropsychiatric disorder associated with group A streptococcal infection (PANDAS) are pediatric onset, neuropsychiatric disorder (obsessive-compulsive disorder [OCD]) and/or tic disorder; abrupt onset and/or episodic course of symptoms; association with group A beta-hemolytic streptococcal (GABHS) infection; and association with neurological abnormalities (motoric hyperactivity or adventitious movements, including choreiform movements or tics). OBJECTIVE: To assess new-onset PANDAS cases in relation to acute GABHS tonsillopharyngitis. DESIGN: Prospective PANDAS case identification and follow-up. RESULTS: Over a 3-year period (1998-2000), we identified 12 school-aged children with new-onset PANDAS. Each patient had the abrupt appearance of severe OCD behaviors, accompanied by mild symptoms and signs of acute GABHS tonsillopharyngitis. Throat swabs tested positive for GABHS by rapid antigen detection and/or were culture positive. The GABHS serologic tests, when performed (n = 3), showed very high antideoxyribonuclease antibody titers. Mean age at presentation was 7 years (age range, 5-11 years). In children treated with antibiotics effective in eradicating GABHS infection at the sentinel episode, OCD symptoms promptly disappeared. Follow-up throat cultures negative for GABHS were obtained prospectively after the first PANDAS episode. recurrence of OCD symptoms was seen in 6 patients; each recurrence was associated with evidence of acute GABHS infection and responded to antibiotic therapy, supporting the premise that these patients were not GABHS carriers. The OCD behaviors exhibited included hand washing and preoccupation with germs, but daytime urinary urgency and frequency without dysuria, fever, or incontinence were the most notable symptoms in our series (58% of patients). Symptoms disappeared at night, and urinalysis and urine cultures were negative. CONCLUSION: To our knowledge, this is the first prospective study to confirm that PANDAS is associated with acute GABHS tonsillopharyngitis and responds to appropriate antibiotic therapy at the sentinel episode.
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ranking = 0.0031596628242279
keywords = fever
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3/27. Utility of tonsillectomy in 2 patients with the syndrome of periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis.

    OBJECTIVES: To review the various causes of period fever in childhood, including the syndrome of periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA), and to examine the value of tonsillectomy in the treatment of PFAPA syndrome. DESIGN: Retrospective case series. SETTING: Urban and tertiary care referral children's hospital. patients: Two patients who underwent tonsillectomy for presumed recurrent adenotonsillitis were later diagnosed as having PFAPA syndrome.Intervention tonsillectomy. MAIN OUTCOME MEASURE: Frequency of PFAPA symptoms before and after tonsillectomy. RESULTS: No difference was found in the frequency of PFAPA symptoms after tonsillectomy. CONCLUSION: Although a larger series of patients is required, our initial experience suggests that tonsillectomy is not always beneficial for patients with PFAPA syndrome.
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ranking = 0.018957976945367
keywords = fever
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4/27. Hyperbaric oxygen (HBO2) in the treatment of lemierre syndrome.

    In 1936 Lemierre described an aggressive neck infection with a high mortality rate. In the original characterization, he describes a pharyngotonsillitis and/or peritonsillar infection followed by unilateral swelling and tenderness along the sternocleidomastoid muscle owing to septic thrombophlebitis of the internal jugular vein. Subsequent to invasion and thrombophlebitis of the internal jugular vein, fusobacterium necrophorum septicemia occurs, with rigors, high fever, and septic thromboembolism to peripheral sites, especially the lungs and bones. This entity became known as lemierre syndrome. Hyperbaric oxygen (HBO2) has been described as adjunctive treatment in two cases of postanginal septicemia. This case describes the combined approach to a case of lemierre syndrome in which HBO2 was added as an adjunct to the treatment, with a favorable and rapid improvement in the patient's condition.
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ranking = 0.0031596628242279
keywords = fever
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5/27. 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.
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ranking = 0.0094789884726836
keywords = fever
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6/27. Distinguishing PANDAS from Sydenham's chorea: case report and review of the literature.

    Children with Sydenham's chorea and PANDAS (Pediatric autoimmune neuropsychiatric disorders associated with streptococcal throat infections) share an array of neuropsychiatric symptoms and distinguishing one from the other, especially at onset can prove challenging. It is, however, important to distinguish between these two post-streptococcal disorders since their response to therapy differs. Children with Sydenham's chorea require long-term benzathine penicillin prophylaxis to reduce the risk of rheumatic heart disease. In contrast, the efficacy of penicillin prophylaxis in preventing tic or obsessive-compulsive symptom exacerbations in children with PANDAS remains doubtful. Immunomodulatory therapies such as plasma exchange and intravenous immunoglobulin have shown to reduce neuropsychiatric symptom severity in children with PANDAS. tonsillectomy may also represent an effective treatment option in children severely affected by PANDAS. We present this case to demonstrate the pitfalls in differentiating between these two closely associated conditions in a developing country where the prevalence of rheumatic fever is high.
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ranking = 0.0031596628242279
keywords = fever
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7/27. Spontaneous resolution of acquired tonsillar herniation caused by isolated cerebellar tonsil inflammation: case report.

    OBJECTIVE AND IMPORTANCE: Chiari I malformation is a well-known disease involving caudal descent of the cerebellar tonsils and is generally considered to be a congenital condition. Acquired Chiari I malformations as a result of various causes are well described. An unusual case is reported in which regression of an acquired Chiari I malformation caused by isolated cerebellar tonsil inflammation in a patient with infectious mononucleosis was observed after conservative treatment. This supports the view that the cause of tonsillar herniation should be considered as an important factor in patient selection for surgical decompression. CLINICAL PRESENTATION: A 6-year-old boy presented with a 1-week history of progressive occipital headache, neck pain, and dysequilibrium. A neurological examination revealed hyperreflexia in all extremities; he also had a fever, pharyngitis, and cervical adenopathy. A magnetic resonance imaging study demonstrated isolated right cerebellar tonsil enhancement and herniation into the foramen magnum. Further laboratory findings disclosed Epstein-Barr virus infection. INTERVENTION: The patient underwent conservative treatment for systemic illness, and he was asymptomatic after 3 weeks. A follow-up magnetic resonance imaging study obtained 2 months after discharge demonstrated resolution of the tonsillar herniation. CONCLUSION: Because the patient presented with infectious mononucleosis and cerebellar tonsillar herniation, direct treatment of decompression was considered unnecessary. Thus, caution in patient selection for surgical treatment is suggested in such unique cases.
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ranking = 2.0031596628242
keywords = infectious mononucleosis, mononucleosis, fever
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8/27. Severe acute tonsillitis caused by Rothia dentocariosa in a healthy child.

    A 4-year-old Japanese girl developed a sore throat and high fever. Her tonsils were enlarged, red and covered with a thick white membrane. There was marked leukocytosis (26,600 leukocytes per mm) and elevated c-reactive protein levels (23.3 mg/dL). Rothia dentocariosa was recovered from the throat swab; many gram-positive cocci were observed in the smear from the pseudomembrane covering the tonsil.
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ranking = 0.0031596628242279
keywords = fever
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9/27. Report of an atypical case of leishmaniasis presented as acute tonsillitis in an immunocompetent patient.

    Visceral leishmaniasis typically presents with symptoms such as fever, enlargement of the spleen and the liver, hypergammaglobulinaemia and infection of the bone marrow resulting in anaemia and leukopenia. The disease is sporadic in the countries of the Mediterranean basin. We report an unusual case of acute tonsillitis due to tonsillar leishmaniasis, in an immunocompetent 34-y-old male patient. diagnosis was confirmed by serological tests and histopathological examination following biopsy of the right tonsil. The patient was successfully treated with liposomal amphotericin-B.
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ranking = 0.0031596628242279
keywords = fever
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10/27. 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.
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ranking = 0.0063193256484557
keywords = fever
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