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BMJ Open 2020 Jun 1;10(6):e036703. Epub 2020 Jun 1.

Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.

Objectives: To assess variation in antibiotic prescribing practices among village doctors in a rural region of Shandong province, China.

Design, Setting And Participants: Almost all outpatient encounters at village clinics result in a prescription being issued. Prescriptions were collected over a 2. Read More

Aten Primaria 2020 May 29. Epub 2020 May 29.

Section of General Practice and Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; University Institute in Primary Care Research Jordi Gol, Via Roma Health Centre, Barcelona, Spain. Electronic address:

Objective: This study was aimed at evaluating the appropriateness of use and interpretation of rapid antigen detection testing (RADT) and antibiotic prescribing for acute pharyngitis six years after a multifaceted intervention.

Design: Before-and-after audit-based study.

Location: Primary care centres in eight autonomous Communities. Read More

Methods Mol Biol 2020 ;2136:303-308

Department of Molecular Medicine and Pathology, School of Medical Sciences and Maurice Wilkins Centre for Biomolecular Discovery, The University of Auckland, Auckland, New Zealand.

Group A Streptococcus (GAS) often exists as an asymptomatic colonizer of the upper respiratory tract in humans. Unsurprisingly, a high proportion of symptomatic infections caused by GAS include pharyngitis. While not usually life-threatening, these infections cause significant morbidity and economic burden/loss of productivity, and can have downstream life-threatening autoimmune consequences. Read More

Clin Infect Dis 2020 May 6. Epub 2020 May 6.

Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.

Background: Group A Streptococcus (GAS) is a leading cause of acute respiratory infections frequently resulting in antibiotic prescribing. Vaccines against GAS are currently in development.

Methods: We estimated the incidence of healthcare visits and antibiotic prescribing for pharyngitis, sinusitis, and acute otitis media (AOM) in the United States using nationally-representative surveys of outpatient care provision, supplemented by insurance claims data. Read More

Curr Med Chem 2020 May 4. Epub 2020 May 4.

Department of Plant Physiology, Institute for Biological Research "Siniša Stanković" - National Institute of Republic of Serbia, University of Belgrade, Bulevar Despota Stefana 142, 11000 Belgrade. Serbia.

Infections of the upper respiratory tract include inflammations of the nose, sinuses (sinusitis), pharynx (tonsillitis, pharyngitis) and larynx (laryngitis) with bacteria or viruses as the main cause of these conditions. Due to their repetitive nature, chronic respiratory infections represent a global problem which is often a result of an improper treatment. If not treated adequately, these conditions may have serious consequences. Read More

Scand J Prim Health Care 2020 May 2:1-12. Epub 2020 May 2.

Townsville Hospital, Queensland Health, Australia.

The pathogenicity of beta-hemolytic group C (GCS) in patients attending for an uncomplicated acute sore throat is unknown and it was the objective to clarify this. Systematic literature review with meta-analysis. Medline and Scopus were searched from inception to February 2019, with searches of reference lists, case-control studies stating prevalence of GCS in patients as well as healthy controls presented for children and adults separately. Read More

J Clin Microbiol 2020 Apr 22. Epub 2020 Apr 22.

Children's Mercy Hospital, Kansas City, Missouri, USA

Group A (GAS) causes bacterial pharyngitis in both adults and children. Early and accurate diagnosis of GAS is important for appropriate antibiotic therapy to prevent GAS sequalae. The Revogene Strep A molecular assay (Meridian Bioscience Canada Inc, Quebec City, QC) is an automated real time PCR assay for GAS detection from throat swab specimens within approximately 70 minutes. Read More

J Clin Microbiol 2020 May 26;58(6). Epub 2020 May 26.

Infectious Bacterial Diseases Research Unit, USDA/Agricultural Research Service/National Animal Disease Center, Ames, Iowa, USA.

causes pneumonia, pharyngitis, otitis, arthritis, mastitis, and reproductive disorders in cattle and bison. Two multilocus sequence typing (MLST) schemes have been developed for , with one serving as the PubMLST reference method, but no comparison of the schemes has been undertaken. Although the PubMLST scheme has proven to be highly discriminatory and informative, the recent discovery of isolates missing one of the typing loci, , raises concern about its suitability for continued use. Read More

Medicine (Madr) 2019 Nov 11;12(91):5339-5351. Epub 2019 Dec 11.

Servicio de Otorrinolaringología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.

Infections are the most common cause of antibiotic prescription and one of the most frequent reasons for consultation in Primary Care. Among them, stand out acute media otitis and diffuse external otitis, acute pharyngitis and acute rhinosinusitis. Commonly they are viral and self-limited, so their complications are rare. Read More

Can Fam Physician 2020 Apr;66(4):251-257

Assistant Professor and Research Director in the Department of Otolaryngology at Queen's University and Adjunct Scientist with ICES Queen's.

Objective: To provide family physicians with an updated approach to diagnosis and treatment of pharyngitis, detailing key symptoms, methods of investigation, and a summary of common causes.

Sources Of Information: The approach described is based on the authors' clinical practice and peer-reviewed literature from 1989 to 2018.

Main Message: Sore throat caused by pharyngitis is commonly seen in family medicine clinics and is caused by inflammation of the pharynx and surrounding tissues. Read More

Vestn Otorinolaringol 2020 ;85(1):22-24

Pirogov Russian National Research Medical University of the Ministry of Health of Russia, Department of Otolaryngology of Pediatric Faculty, Moscow, Russia, 117997.

Group A β-hemolytic streptococcus (GABHS) is the most important bacterial agent in the genesis of acute inflammatory conditions of the pharynx due to the possible development of local and systemic complications. During the seasonal increase of incidence of respiratory viral infections, the possibility of viral-bacterial co-infection is often not taken into account.

Aim: Determine the incidence of GABHS in children with catarrhal symptoms (rhinorrhea, cough) and without them. Read More

Sci Rep 2020 Feb 24;10(1):3251. Epub 2020 Feb 24.

Division of Bacteriology, International Research Center for Infectious Diseases, Institute of Medical Science, The University of Tokyo, Tokyo, 108-8639, Japan.

Group A Streptococcus (GAS) secretes deoxyribonucleases and evades neutrophil extracellular killing by degrading neutrophil extracellular traps (NETs). However, limited information is currently available on the interaction between GAS and NETs in the pathogenicity of GAS pharyngitis. In this study, we modified a mouse model of GAS pharyngitis and revealed an essential role for DNase in this model. Read More

BMC Res Notes 2020 Feb 24;13(1):99. Epub 2020 Feb 24.

Reckitt Benckiser Healthcare International Ltd, 103-105 Bath Road, Slough, Berkshire, SL1 3UH, UK.

Objective: For the majority of people with acute sore throat, over-the-counter treatments represent the primary option for symptomatic relief. This study evaluated the in vitro bactericidal activity of lozenges containing the antiseptic hexylresorcinol against five bacteria associated with acute sore throat: Staphylococcus aureus, Streptococcus pyogenes, Moraxella catarrhalis, Haemophilus influenzae and Fusobacterium necrophorum.

Results: Hexylresorcinol 2. Read More

Arerugi 2020 ;69(1):53-58

Department of Molecular and Cellular Immunology, School of Medicine, Shinshu University.

We report an adult case of periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome, who had a tonsillectomy at 10 years old and relapsed later. An early 40's-year-old man had been suffering from recurrent fever attack once in 1-2 months during childhood. He was accompanied by fever which was persist for several days, aphthous stomatitis, tongued tonsillitis with moss, pharyngitis, and submandibular lymphadenitis with tenderness. Read More

Vestn Otorinolaringol 2019 ;84(6):112-117

I.M. Sechenov First Moscow State Medical University, Moscow 119991, Trubezkaya str. 8/2, Moscow, Russia.

The article discusses the main causative agents of acute inflammatory process of the pharynx, diagnostic features and treatment tactics. The question of the use of topical drugs in this pathology is covered. The data on the use of the drug Grammidin based on a local broad-spectrum antibiotic gramicidin C and antiseptic cetylpyridinium chloride, as well as data from clinical studies of the effectiveness of the drug in the treatment of acute tonsillopharyngitis in children and adults are presented. Read More

Vestn Otorinolaringol 2019 ;84(6):100-107

Russian Medical Academy of Post-Graduate Education, Moscow, Russia, 123242; Children's City Clinical Hospital Z.A. Bashlyaevoi, Moscow, Russia, 125373.

In recent years, OME in childhood tends to increase. The low efficiency of the currently used traditional methods of conservative therapy and the high rate of relapse of the disease make it necessary to develop new methods of treatment. It is important that there is a connection of development of OME and hypertrophy of the lymphoid tissue of the nasopharynx, which in childhood is considered as a response to the respiratory antigenic virus-bacterial load. Read More

J Med Microbiol 2020 Mar;69(3):443-450

Departments of Infectious Diseases, National Cancer Center Hospital, Tokyo, Japan.

Pharyngotonsillitis caused by (group A streptococci, or GAS) is among the most common infections treated with antibiotics in pediatric patients. This study aimed to analyse changes in molecular epidemiology and antibiotic susceptibility among GAS isolates in three study periods spanning 10 years.. Read More

J Nippon Med Sch 2020 Jan 31. Epub 2020 Jan 31.

Health Sciences Research Institute East Japan.

Streptococcus pyogenes, or Group A Streptococcus (GAS), is one of the most common pathogens of bacterial infection in children. GAS can cause such non-serious and non-invasive diseases as pharyngitis and skin infections, as well as serious and invasive diseases like streptococcal toxic shock syndrome. One of the factors that make GAS pathogenic is the type-specific M protein found on the cell surface. Read More

BJGP Open 2020 Jan 21. Epub 2020 Jan 21.

Professor of Primary Care Research, School of Medicine Neuadd Meirionnydd, University Hospital of Wales, Cardiff, UK.

Background: Most people with sore throat do not benefit from antibiotic treatment, but nearly three-quarters of those presenting in primary care are prescribed antibiotics. A test that is predictive of bacterial infection could help guide antibiotic prescribing. Calprotectin is a biomarker of neutrophilic inflammation, and may be a useful marker of bacterial throat infections. Read More

Cureus 2019 Dec 8;11(12):e6327. Epub 2019 Dec 8.

Neurosurgery, Neurological Institute, Cleveland Clinic - Taussig Cancer Center, Cleveland, USA.

The typical presentation of infectious mononucleosis (IM) is characterized by a triad of fever, pharyngitis, and lymphadenopathy. Epstein-Barr virus (EBV) is the most common etiologic agent for IM. Humans are the reservoir for EBV, and it is transmitted via intimate contact between individuals. Read More

Photodiagnosis Photodyn Ther 2020 Mar 7;29:101652. Epub 2020 Jan 7.

São Carlos Institute of Physics, University of São Paulo, Box 369, 13566-970, São Carlos, SP, Brazil.

Introduction: A mixture of curcuminoids: curcumin, desmethoxycurcumin (DMC), and bisdemethoxycurcumin (BDMC) are named natural curcumin. It is a lipophilic photosensitizer (PS) highly soluble in an organic solvent such as dimethyl sulfoxide (DMSO). Curcumin is a PS used for microbial inactivation using photodynamic action. Read More

Orv Hetil 2020 Jan;161(2):50-55

Klinikai Mikrobiológiai Diagnosztikai Intézet, Szegedi Tudományegyetem, Szent-Györgyi Albert Klinikai Központ Szeged, Semmelweis u. 6., 6725.

Exudative tonsillitis is a common clinical picture during childhood. The majority of these cases are caused by viruses (Epstein-Barr virus [EBV], cytomegalovirus [CMV], influenza virus, parainfluenza virus, and adenovirus), and only some infections are caused by bacteria, mainly group A streptococci (GAS). On the basis of international guidelines, routine use of early antibiotic treatment is not recommended in these cases, because it seems not to prevent GAS-associated complications. Read More

Ann Ist Super Sanita 2019 Oct-Dec;55(4):380-385

Organismo Notificato 0373, Unità Operativa Dispositivi Medici, Istituto Superiore di Sanità, Rome, Italy.

Probiotics, defined as "living microorganisms that, whether ingested in useful amount, may have beneficial effects on human body", are widely used in various products for human use, such as dietary supplements, medical devices and pharmaceutical products. The European Directive on medical devices (MDs) (DDM 93/42), also includes those MDs containing live microorganisms, particularly probiotics, that may have various destinations of use, including that of assisting the therapy of several human pathologies. In this brief note we analyzed the use of probiotics in MDs and how probiotics administration could represent one of the new frontiers of scientific research on the prevention and treatment of various diseases. Read More

Vaccine 2020 Feb 13;38(6):1384-1392. Epub 2019 Dec 13.

Division of Infectious Diseases, Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.

Background: Streptococcus pyogenes (group A Streptococcus, Strep A) is a widespread pathogen that continues to pose a significant threat to human health. The development of a Strep A vaccine remains an unmet global health need. One of the major vaccine strategies is the use of M protein, which is a primary virulence determinant and protective antigen. Read More

Asian Cardiovasc Thorac Ann 2020 Jan 15;28(1):29-32. Epub 2019 Dec 15.

Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.

BMC Oral Health 2019 12 5;19(1):275. Epub 2019 Dec 5.

Centre for Gut Microbiota Research, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.

Background: Microbial culture-based investigations of inflamed tonsil tissues have previously indicated enrichment of several microorganisms such as Streptococcus, Staphylococcus and Prevotella. These taxa were also largely reflected in DNA sequencing studies performed using tissue material. In comparison, less is known about the response of the overall oral cavity microbiota to acute tonsillitis despite their role in human health and evidence showing that their compositions are correlated with diseases such as oral cancers. Read More

Drug Des Devel Ther 2019 16;13:3551-3558. Epub 2019 Oct 16.

Department of Innovation & Development, Established Pharmaceuticals Division, Abbott Healthcare Products B.V., Weesp 1381 CP, The Netherlands.

Introduction: Among the bacterial upper respiratory tract infections (UTRIs), the most medically significant is pharyngitis due to Group A beta-hemolytic (GABHS). A 2012 meta-review and a 2016 Cochrane systematic review reported favorably on the comparative efficacy and safety of clarithromycin in pediatric patients with URTIs and in adults with GABHS pharyngitis. In this paper, the evidence base for clarithromycin in patients with URTIs is augmented by a meta-analysis of comparative studies in GABHS pharyngitis. Read More

Microb Genom 2019 11;5(11)

Center for Antimicrobial Resistance and Microbial Genomics, University of Texas Health Sciences Center at Houston, Houston, TX, USA.

Despite universal susceptibility to β-lactams, resistance to second-line antimicrobials (e.g. erythromycin) is increasingly common among group A (GAS). Read More

Int J Infect Dis 2020 Feb 13;91:1-8. Epub 2019 Nov 13.

Division of General Internal Medicine, Jichi Medical University Hospital, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi 329-0498, Japan; Division of Infectious Diseases, Jichi Medical University Hospital, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi 329-0498, Japan. Electronic address:

Objectives: To evaluate condition-specific antibiotic prescription rates and the appropriateness of antibiotic use in outpatient settings in Japan.

Methods: Using Japan's national administrative claims database, all outpatient visits with infectious disease diagnoses were linked to reimbursed oral antibiotic prescriptions. Prescription rates stratified by age, sex, prefecture, and antibiotic category were determined for each infectious disease diagnosis. Read More

Rev Esp Salud Publica 2019 Nov 20;93. Epub 2019 Nov 20.

Hospital Católico Universitario Casa de Salud. Valencia. España.

Objective: There are two scales (Centor and McIsaac) that describe the frequent signs and symptoms in pharyngotonsillitis and determine the attitude to be followed for diagnosis and treatment; among them, the McIsaac criteria are one of the most widely used scales. The goal of the study was to determine the predictive value of the McIsaac criteria in the diagnosis of pharyngotonsillitis due to EbhGA in a Pediatric Emergency Service. The predictive value of these criteria is decisive in the adequate use of TDR test and antibiotics as a treatment. Read More

Medicine (Baltimore) 2019 Nov;98(46):e17220

Department of Clinical Pharmacology, Institute of Physiology and Pharmacology, Lithuanian University of Health Sciences.

The purpose of this study was to determine the trends in consumption of antibiotics and evaluate the antibiotic prescription rates in the pediatric population in Lithuania during 2003 to 2012.A cross-sectional study. Data of systemic antibiotic use in pediatric population for outpatient treatment was derived from National Health Insurance Fund database. Read More

FP Essent 2019 Nov;486:11-18

Hospital Medicine for Family Physicians Fellowship at Womack Army Medical Center, 2817 Reilly Road Fort Bragg, NC 28310-7301.

Upper respiratory tract infections (URTIs) include the common cold, rhinosinusitis, pharyngitis, and acute otitis media (AOM). URTIs account for billions of dollars in annual health care costs; acute respiratory tract infections are the most common reason for acute care appointments. Although URTIs typically are viral, these infections are the most common reason for prescription of antibiotics in adults. Read More

mSphere 2019 11 6;4(6). Epub 2019 Nov 6.

Infectious Diseases Section, Veteran Affairs Medical Center, Boise, Idaho, USA

The low frequency of circulating antigen-specific memory B cells is a considerable obstacle in the discovery and development of human monoclonal antibodies for therapeutic application. Here, we evaluate two solid-phase isolation methods to enrich the number of antigen-specific B cells from individuals naturally immunized against streptolysin O (SLO), a key virulence factor and known immunogen of group A streptococcus (GAS). Class-switched B cells obtained from individuals with a history of GAS infection were separated from peripheral blood mononuclear cells (PBMCs) by immunomagnetic methods. Read More

APMIS 2020 Mar 4;128(3):211-219. Epub 2019 Dec 4.

Department of Food Hygiene and Consumer Health Protection, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland.

The aim of this study was to analyze the prevalence of Staphylococcus aureus in the tonsils of children subjected tonsillectomy due to recurrent tonsilitis and to determine the spa types of the pathogens, carriage of virulence genes and antimicrobial resistance profiles. The study included 73 tonsillectomized children. Bacteria, including S. Read More

Presse Med 2019 Oct 29;48(10):1202-1204. Epub 2019 Oct 29.

Hôpital d'instruction des armées Laveran, 34, boulevard Lavéran, 13013 Marseille, France.

BMC Infect Dis 2019 Oct 22;19(1):871. Epub 2019 Oct 22.

Beijing Shunyi Center for Disease Control and Prevention, Beijing, China.

Background: On 7th June, 2018, a primary school in Beijing, China notified Shunyi CDC of an outbreak of acute respiratory disease characterized by fever and cough among students and resulting in nine hospitalization cases during the preceding 2 weeks. We started an investigation to identify the etiologic agent, find additional cases, develop and implement control measures.

Methods: We defined probable cases as students, teachers and other staffs in the school developed fever (T ≥ 37. Read More

Neurocirugia (Astur) 2019 Oct 13. Epub 2019 Oct 13.

Servicio de Neurocirugía, Hospital Universitario Donostia, San Sebastián, Guipúzcoa, España.

Grisel syndrome (GS) is a non-traumatic atlanto-axial subluxation produced after an inflammatory, infectious or postsurgical process of the upper neck region. It is a characteristic, although currently uncommon complication of acute bacterial pharyngitis in the pediatric age. Presentation in adults is even more infrequent and requires specific management. Read More

Am J Health Syst Pharm 2019 10;76(21):1753-1761

Clinical Services Group, HCA Healthcare Nashville, Nashville, TN.

Purpose: To assess antibiotic selection, administration, and prescribing practices in emergency departments across a large hospital system using evidence-based practices and susceptibility patterns.

Methods: This retrospective data review was conducted using health system-level electronic data compiled from 145 emergency departments (EDs) across the United States. Data were examined for national generalizability, most common diagnoses of infectious origin seen in nonadmitted patients in the ED, most commonly administered antibiotics in the ED, and geographically defined areas' unique patterns of antibiotic resistance and susceptibility. Read More

Clin Pediatr (Phila) 2020 Jan 14;59(1):21-30. Epub 2019 Oct 14.

John R. Oishei Children's Hospital, Buffalo, NY, USA.

Pediatric antibiotic prescriptions originate from an increasingly broad range of ambulatory settings. In this retrospective study, pharyngitis, otitis media, sinusitis, pneumonia, and upper respiratory infection cases, at 11 primary care offices, 2 independent urgent care centers (UCCs), and a pediatric emergency department in Western New York, were analyzed relative to medical society practice guidelines and antibiotic utilization. Of 2358 eligible visits across all sites, 25% were for study diagnoses, with 38% at UCC ( < . Read More

Dtsch Med Wochenschr 2019 10 8;144(20):1449-1454. Epub 2019 Oct 8.

Medizinische Klinik I, UKSH-Campus Lübeck, Lübeck, Deutschland.

History And Clinical Findings: We report the case of a 30 years old man presenting with cough and a sore throat. The physical examination showed a painful neck, a scleral icterus, inflammation of the posterior pharyngeal wall and tonsils.

Investigations: Initial laboratory studies revealed an increase in white blood cells, a pronounced reduction of platelets, an elevated CRP and renal failure. Read More

J Pediatr 2019 12 3;215:187-191. Epub 2019 Oct 3.

Department of Pediatrics, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.

Objective: To describe clinical presentation, electrocardiographic, and echocardiographic characteristics of carditis at the time of diagnosis of acute rheumatic fever (ARF) over a 13-year period.

Study Design: A single-center retrospective chart analysis was conducted involving all consecutive patients diagnosed with ARF between 2003 and 2015. Patient age, sex, clinical characteristics, recent medical history for group A streptococcal pharyngotonsillitis and antibiotic treatment, and laboratory, echocardiographic, and electrocardiographic findings were recorded. Read More

BMJ 2019 10 4;367:l5337. Epub 2019 Oct 4.

Department of Clinical Sciences in Malmö, Family Medicine, Lund University, Malmö, Sweden.

Objective: To determine whether total exposure to penicillin V can be reduced while maintaining adequate clinical efficacy when treating pharyngotonsillitis caused by group A streptococci.

Design: Open label, randomised controlled non-inferiority study.

Setting: 17 primary healthcare centres in Sweden between September 2015 and February 2018. Read More

Biomedicines 2019 Sep 21;7(4). Epub 2019 Sep 21.

Department of Physical Sciences, Earth and Environment, University of Siena, 53100 Siena, Italy.

Bee propolis, especially Euro-Asian poplar propolis, is among the most well-known natural products traditionally used to treat pharyngitis and minor wounds. The aim of this research was to investigate the pharmacological properties responsible for poplar propolis effectiveness using, for the first time, different in vitro approaches applied to a chemically characterized sample. The anti-inflammatory activity was compared with flurbiprofen by determining pro-inflammatory cytokines released by lipopolysaccharide-stimulated human peripheral blood mononuclear cells (PBMC). Read More

Pediatr Ann 2019 Sep;48(9):e343-e348

For pediatric practitioners, acute otitis media (AOM) and group A streptococcal pharyngitis are two of the most common infections seen in ambulatory practices. The purpose of this article is to review these conditions with the focus of highlighting evidence-based guidelines. AOM in children is a visual diagnosis and not one that can be made on history alone. Read More

Theor Biol Med Model 2019 09 10;16(1):14. Epub 2019 Sep 10.

Department of Mathematics, Faculty of Science, Silpakorn University, Nakorn Pathom Province, 73000, Thailand.

Background: Group A streptococcus (GAS) is the most frequent cause of bacterial pharyngitis in school-aged children. The postinfection sequel as acute rheumatic fever (ARF) and rheumatic heart disease that cause morbidity and mortality among young people is public health concerns in several developing countries. Asymptomatic carriage state of GAS is not fully understood in terms of host and bacterial factors. Read More

Clin Med Insights Ear Nose Throat 2019 29;12:1179550619871274. Epub 2019 Aug 29.

Department of Otorhinolaryngology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Johannesburg, South Africa.

Deep neck spaces are regions of loose connective tissue filling areas between the 3 layers of deep cervical fascia, namely, superficial, middle, and deep layers. The superficial layer is the investing layer, The pretracheal layer is the intermediate layer and the prevertebral layer is the deepest layer. Deep neck space infection (DNI) is defined as an infection in the potential spaces and actual fascial planes of the neck. Read More

Dan Med J 2019 Sep;66(9)

Introduction: It remains unclarified if bacterial co-infection is common in patients with infectious mononucleosis (IM) and acute tonsillitis and/or peritonsillar abscess (PTA). Recent studies suggest that Fusobacterium necrophorum is a prevalent pathogen in acute tonsillitis and PTA. We hypothesised that this anaerobe may play a significant role for the aggravated infection and the development of PTA among teenagers and young adults with IM. Read More

BMJ Case Rep 2019 Sep 6;12(9). Epub 2019 Sep 6.

Department of Otorhinolaryngology, Head and Neck Surgery, Kantonsspital Graubunden, Chur, Switzerland.

Tularaemia is a rare infectious disease endemic in most European countries caused by the bacterium Patients often show acute non-specific symptoms, which causes a delay in diagnosis and proper treatment, potentially resulting in significant morbidities such as deep neck abscess, meningitis, endocarditis and septic shock. The authors present a case of a 5-year old boy with a 4-day history of fever, sore throat and painful cervical lymphadenopathy, whose clinical progression worsened despite being treated with recommended antibiotics as per WHO guidelines once the diagnosis of Tularaemia was confirmed by serologic tests. He developed a parapharyngeal abscess and a persistent left necrotic cervical lymph node, which both were surgically drained and excised, respectively, and an extended course of antibiotic was given. Read More

J Pediatr 2019 12 30;215:118-122. Epub 2019 Aug 30.

Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS.

Objectives: To describe the rate and risk factors of deep neck space involvement of Kawasaki disease.

Study Design: We performed a retrospective analysis using the Kids' Inpatient Database from 2006, 2009, 2012, and 2016. Kawasaki disease and deep neck space involvement cases were identified using International Classification of Diseases codes among children aged <12 years. Read More