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BMJ Open 2019 Apr 3;9(4):e026251. Epub 2019 Apr 3.

Division of General Internal Medicine, Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan.

Objectives: To investigate oral antibiotic prescribing patterns and identify factors associated with antibiotic prescriptions, with the aim of guiding future interventions to reduce inappropriate prescribing.

Design: Retrospective cohort study.

Setting: Database of public health insurance claims in Kumamoto prefecture (Japan). Read More

Pediatr Dermatol 2019 Mar 31. Epub 2019 Mar 31.

Department of Dermatology, Children's National Medical Center, Washington, District of Columbia.

A 10-year-old girl, suspected 2 days prior to have streptococcal pharyngitis, presented with diffuse erythema, tense bullae, Nikolsky-positive desquamation, as well as ulcerations of her oral and genital mucosa. She denied recent travel, sick contacts, or preceding and concurrent use of medications, including over-the-counter and herbal supplements. A comprehensive viral polymerase chain reaction (PCR) panel, Mycoplasma pneumoniae PCR and IgM, streptococcal molecular antigen test, urine culture, blood culture, and rheumatologic serologies were negative. Read More

Pediatr Infect Dis J 2019 Mar 21. Epub 2019 Mar 21.

Department of Pediatrics, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.

Background: Saffold virus (SAFV) is a novel human cardiovirus that was identified in 2007. Recently, SAFV has been isolated from nasal and stool specimens of infants presenting with respiratory and gastrointestinal symptoms and from cerebrospinal fluid (CSF) specimens of children with central nervous system infection. However, little is known regarding clinical characteristics of SAFV in children. Read More

J Infect Chemother 2019 Feb 15. Epub 2019 Feb 15.

Department of General Medicine and Emergency Care, Toho University School of Medicine, Japan.

Introduction: Infectious mononucleosis (IM) is a common viral infection that typically causes fever, pharyngitis, and lymphadenopathy in young patients. The Epstein-Barr virus (EBV) is the most common cause of IM, followed by cytomegalovirus (CMV). Given that serological testing is associated with limitations regarding its accuracy, availability, and time to receive results, clinical differentiation based on symptoms, signs, and basic tests would be useful. Read More

Int J Emerg Med 2018 16;11:49. Epub 2018 Nov 16.

4Department of Pediatric Emergency, College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAUHS), Riyadh, Saudi Arabia.

Introduction: Pharyngitis is one of the major and commonly seen presentations in pediatric emergency departments. While it could be caused by both bacterial and viral pathogens, antibiotics are improperly prescribed regardless of the pathogen. Inappropriate usage of antibiotics has risen the concern of microbial resistance and the need for stricter guidelines. Read More

Eur Arch Otorhinolaryngol 2019 Mar 9;276(3):775-783. Epub 2019 Feb 9.

CRI-Clinical Research International Ltd., Cologne, Germany.

Purpose: Acute pharyngitis is an uncomfortable disorder mostly caused by viruses and for which antibiotics are unwarranted. This study compared lozenges containing ectoine, a natural extremolyte, with hyaluronic acid lozenges and hypertonic saline gargle for symptomatic treatment of acute viral pharyngitis.

Methods: This prospective, controlled clinical study, recruited 90 patients with moderate-to-severe pharyngitis symptoms who chose to use either ectoine (n = 35), hyaluronic acid (n = 35), or saline gargle (n = 20). Read More

Emerg Infect Dis 2019 02;25(2):245-248

Lassa virus is a rodentborne arenavirus responsible for human cases of Lassa fever, a viral hemorrhagic fever, in West Africa and in travelers arriving to non-Lassa-endemic countries from West Africa. We describe a retrospective review performed through literature search of clinical and epidemiologic characteristics of all imported Lassa fever cases worldwide during 1969-2016. Our findings demonstrate that approximately half of imported cases had distinctive clinical features (defined as fever and >1 of the following: pharyngitis, sore throat, tonsillitis, conjunctivitis, oropharyngeal ulcers, or proteinuria). Read More

BMC Infect Dis 2019 Jan 18;19(1):68. Epub 2019 Jan 18.

Sri Jayawardanapura General Hospital, Thalapathpitiya, Nugegoda, Western province, Sri Lanka.

Background: Infectious mononucleosis is one of the main manifestations of Epstein - Barr virus, which is characterized by fever, tonsillar-pharyngitis, lymphadenopathy and atypical lymphocytes. Although 60% of patients with IMN develop cold type antibodies, clinically significant hemolytic anemia with a high ferritin level is very rare and validity of serum ferritin as an important biomarker has not been used frequently.

Case Presentation: 18-year-old girl presented with fever, malaise and sore throat with asymptomatic anemia, generalized lymphadenopathy, splenomegaly and mild hepatitis. Read More

BMC Infect Dis 2019 Jan 17;19(1):65. Epub 2019 Jan 17.

Division of Rheumatology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Hon-komagome, Tokyo, 1138677, Bunkyo-ku, Japan.

Background: Herpes simplex virus (HSV) has various presentations, depending on the patient's immune status, age, and the route of transmission. In adults, HSV type 1 is found predominantly in the oral area, and HSV type 2 (HSV-2) is commonly found in the genital area. HSV-2 infection without genital lesions is uncommon. Read More

JAMA Netw Open 2018 Jun 1;1(2):e180243. Epub 2018 Jun 1.

Centers for Disease Control and Prevention, Atlanta, Georgia.

Importance: Acute respiratory infections (ARIs) are the syndrome for which antibiotics are most commonly prescribed; viruses for which antibiotics are ineffective cause most ARIs.

Objectives: To characterize antibiotic prescribing among outpatients with ARI during influenza season and to identify targets for reducing inappropriate antibiotic prescribing for common ARI diagnoses, including among outpatients with laboratory-confirmed influenza.

Design, Setting, And Participants: Cohort study enrolling outpatients aged 6 months or older with ARI evaluated at outpatient clinics associated with 5 US Influenza Vaccine Effectiveness Network sites during the 2013-2014 and 2014-2015 influenza seasons. Read More

Int J Gen Med 2018 28;11:451-456. Epub 2018 Nov 28.

Reckitt Benckiser Healthcare International Ltd, Slough, Berkshire, UK,

Purpose: Pharyngitis is commonly caused by a self-limiting upper respiratory tract infection (URTI) and symptoms typically include sore throat. Antibiotics are often inappropriately used for the treatment of pharyngitis, which can contribute to antimicrobial resistance, therefore non-antibiotic treatments which have broad antiseptic effects may be more appropriate. Amylmetacresol (AMC) and 2,4-dichlorobenzyl alcohol (DCBA) are present in some antiseptic lozenges and have established benefits in providing symptomatic relief and some in vitro antiviral action. Read More

Med J Islam Repub Iran 2018 8;32:38. Epub 2018 May 8.

Department of Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Human parvovirus B19 was known as one of the possible cause of mild respiratory tract diseases in previous studies. However, there are some reports of acute obstructive respiratory disease and severe pneumonia. The purpose of current study was to assess the prevalence and clinical features of parvovirus B19 in respiratory infection. Read More

Int J Infect Dis 2018 Oct 23;75:89-91. Epub 2018 Aug 23.

Beijing Center for Disease Prevention and Control, No. 16 Hepingli Middle Road, Beijing 100013, People's Republic of China; Research Center for Preventive Medicine of Beijing, No. 16 Hepingli Middle Road, Beijing 100013, People's Republic of China. Electronic address:

Patients with swimming pool-acquired human adenovirus (HAdV) infections usually manifest characteristic clinical features that include fever, pharyngitis, and conjunctival inflammation, syndromically referred to as pharyngoconjunctival fever (PCF). HAdV types 3, 4, and 7 are most commonly associated with PCF. This article reports an outbreak of PCF that involved 55 students and staff at a university in Beijing, China. Read More

Ann Otol Rhinol Laryngol 2018 Oct 20;127(10):667-671. Epub 2018 Aug 20.

1 Department of Otolaryngology - Head and Neck Surgery, Washington University in St Louis, St Louis, Missouri, USA.

Introduction: Unilateral vocal fold paralysis (UVFP) without an identifiable cause is termed idiopathic unilateral vocal fold paralysis (IUVFP). Some authors have postulated that select cases of IUVFP have a viral etiology, but the causality has not been established. We set out to review institutional cases of IUVFP and determine if there is a correlation between upper respiratory infection symptoms and presentation of IUVFP. Read More

Korean J Fam Med 2018 Nov 4;39(6):375-378. Epub 2018 Jul 4.

Department of Pediatrics and Biomedical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Korea.

Benign acute childhood myositis (BACM) is a rare transient condition that occurs in children during the early convalescent phase of a viral upper respiratory infection. BACM is self-limiting and characterized by sudden-onset bilateral calf pain that leads to difficulty in walking. We report a case of a 5-year-old boy with BACM who presented with acute-onset bilateral calf pain after a resolved episode of viral pharyngitis and subsequently refused to walk. Read More

Pediatr Infect Dis J 2019 Mar;38(3):e39-e42

From the Parasitology-Mycology, EA 3593, Faculty of Medicine, French West Indies and French Guiana University, French Guiana.

Background: Amazonian toxoplasmosis is a recently described form of Toxoplasma gondii infection, characterized by severe clinical and biological features and involvement of atypical genetic strains circulating through a forest-based cycle. Though mostly reported in French Guiana since 1998, this disease is probably under-diagnosed in other areas of South America. Few data are available on its specific features in children. Read More

Pediatrics 2018 07 20;142(1). Epub 2018 Jun 20.

Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri.

Background And Objectives: Acute pharyngitis is a common diagnosis in ambulatory pediatrics. The Infectious Diseases Society of America (IDSA) clinical practice guideline for group A streptococcal (GAS) pharyngitis recommends strict criteria for GAS testing to avoid misdiagnosis and unnecessary treatment of children who are colonized with group A . We sought to improve adherence to the IDSA guideline for testing and treatment of GAS pharyngitis in a large community pediatrics practice. Read More

Georgian Med News 2018 May(278):132-138

Kharkiv National Medical University, Department of Children's Infectious Diseases; V.N. Karasin Kharkov National University, Department of Pediatrics №2; Department of Clinical Immunology and Allergy, Ukraine.

The article presents the results of our own studies to determine the criteria for the adverse variants of the course of infectious mononucleosis (IM) in children. The study was conducted in the regional children's infectious clinical hospital in Kharkov. 161 children aged three to fifteen years were under observation with diagnosis of infectious moninucleosis. Read More

Ann Clin Microbiol Antimicrob 2018 Jun 9;17(1):26. Epub 2018 Jun 9.

The Faculty of Medicine in the Galilee, Bar Ilan University, Zefat, Israel.

Background: Antibiotics are frequently prescribed at many of the visits to primary care clinics, often for conditions for which they provide no benefit, including viral respiratory tract infections.

Objectives: The aim was to evaluate primary care visits due to infectious diseases, and to estimate antibiotic prescribing and antibiotic dispensing by pharmacies.

Methods: Diagnosis of infectious disease, antibiotic prescribing and dispensing data at the individual patient level were extracted for 2015 from Clalit Health Services' electronic medical records and linked to determine the condition for which the antimicrobial was prescribed. Read More

Minerva Med 2018 Dec 31;109(6):498-500. Epub 2018 May 31.

Unit of Microbiology and Virology, Hospital of Padua, Padua, Italy.

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017 Jul;31(14):1082-1085

Department of Otolaryngology, Zhongnan Hospital of Wuhan University.

To investigate the seasonal disturbations and the rates of detection of EpsteinBarr virus (EBV), Human Bocavirus(HBoV), and polyomaviruses KI and WU (KIPyV and WUPyV) in adenoid and tonsil tissues during the absence of acute infection symptoms.DNA expressions of EBV, HBoV, polyomaviruses KIPyV and WUPyV were investigated in children with chronic tonsillar and adenoidal diseases using real time polymerase chain reaction. The patients were divided into three group: adenoid group, chronic tonsillit group and hypertrophic tonsillitis group. Read More

Am J Case Rep 2018 Apr 24;19:482-485. Epub 2018 Apr 24.

Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

BACKGROUND Extrapulmonary small cell carcinoma (SmCC) is a relatively rare clinical entity constituting only 2.5-5% of SmCCs. Recently, evidence has emerged that high-risk types of human papillomavirus (HPV) might play an etiologic role in oropharyngeal SmCC, similar to squamous cell carcinoma. Read More

PLoS Negl Trop Dis 2018 03 19;12(3):e0006335. Epub 2018 Mar 19.

University of Otago Wellington, Newtown, Wellington, New Zealand.

Objective: Antibiotic treatment of Group A Streptococcus (GAS) pharyngitis is important in acute rheumatic fever (ARF) prevention, however clinical guidelines for prescription vary. GAS carriers with acute viral infections may receive antibiotics unnecessarily. This review assessed the prevalence of GAS pharyngitis and carriage in different settings. Read More

J Emerg Med 2018 05 6;54(5):619-629. Epub 2018 Mar 6.

Department of Emergency Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas.

Background: Pharyngitis is a common disease in the emergency department (ED). Despite a relatively low incidence of complications, there are many dangerous conditions that can mimic this disease and are essential for the emergency physician to consider.

Objective: This article provides a review of the evaluation and management of group A β-hemolytic Streptococcal (GABHS) pharyngitis, as well as important medical conditions that can mimic this disease. Read More

Pediatr Emerg Care 2018 Feb 28. Epub 2018 Feb 28.

A spontaneous spinal epidural hematoma is a collection of blood in the spinal epidural space that occurs in the absence of trauma. They most commonly present in the fourth to fifth decade in life with acute onset neck or back pain with delayed neurologic deficit. However, this presentation is often complicated in children because of the limitations in the pediatric neurologic exam. Read More

BMC Pediatr 2018 02 9;18(1):43. Epub 2018 Feb 9.

Division of Infectious Diseases, Department of Medicine, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA.

Background: Group A streptococcus (GAS) is the most common bacterial etiology of pharyngitis but is difficult to distinguish clinically from viral pharyngitis. There are benefits to early antibacterial treatment of GAS pharyngitis, but administering antibiotics to children with viral pharyngitis is ineffective and costly. We evaluated adherence to guidelines that were developed to help clinicians distinguish between viral and GAS pharyngitis and guide management. Read More

Pediatr Infect Dis J 2018 09;37(9):861-867

From the Department of Pediatrics, University Hospital of Würzburg, Würzburg, Germany.

Background: Limited data on the influenza burden in pediatric outpatients are available, especially regarding direct comparison of the cocirculating (sub)types A(H1N1)pdm09, A(H3N2) and B.

Methods: Children 1-5 years of age, unvaccinated against influenza and presenting with febrile acute respiratory infections (ARIs), were enrolled in 33 pediatric practices in Germany from 2013 to 2015 (January-May). Influenza was confirmed by multiplex polymerase chain reaction from pharyngeal swabs and (sub)typed. Read More

Influenza Other Respir Viruses 2018 05 14;12(3):336-343. Epub 2018 Feb 14.

Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Background: Surveillance of influenza-like illness (ILI) in the United States is primarily conducted through medical settings despite a significant burden of non-medically attended ILI.

Objectives: To assess consistency between surveillance for respiratory viruses in outpatient and community settings using ILI surveillance from the Centers for Disease Control and Prevention Influenza Incidence Surveillance Project (IISP) and the Mobile Surveillance for Acute Respiratory Infections (ARI) and Influenza-Like Illness in the Community (MoSAIC) Study.

Methods: The Influenza Incidence Surveillance Project conducts ILI surveillance in 3 primary care clinics in New York City, and MoSAIC conducts community-based ILI/ARI surveillance through text messaging among a cohort of New York City residents. Read More

Minerva Pediatr 2018 Jun 11;70(3):240-245. Epub 2018 Jan 11.

Department of Biophysical, Medical, and Odontostomatological Sciences and Technologies, University of Genoa, Genoa, Italy.

Background: Previous trials, performed in subjects affected by recurrent streptococcal pharyngo-tonsillar infection, have shown that the use for 90 days of Streptococcus salivarius K12 (K12), an oral colonizing probiotic producing lantibiotic bacteriocins, reduces the occurrence of streptococcal and viral pharyngitis and acute otitis media (AOM). The aim was to evaluate the role of K12 in reducing the incidence of streptococcal and viral pharyngo-tonsillitis and AOM when administered in two separate trimesters, from October to December and then from April to June, in pediatric subjects with non-recurrent streptococcal infection.

Methods: We retrospectively analyzed the incidence of pharyngo-tonsillitis and AOM in 133 children by comparing the number of episodes occurring between September 1st, 2014 and August 31st, 2015, when no treatment with K12 was given, with the period between September 1st, 2015 and August 31st, 2016, when K12 was administered. Read More

Pol J Microbiol 2017 Sep;66(3):309-319

Department of Epidemiology and Clinical Microbiology, The National Reference Centre for Susceptibility Testing, National Medicines Institute, Warsaw, Poland.

Antimicrobial resistance has been one of the biggest global current issues in medicine and public health. Overuse and imprudent use of antimicrobial agents are recognized as one of the leading causes of antibiotic resistance. The aim of this study was to analyze the attitudes of Polish physicians practicing at the community level towards antibiotics and antimicrobial resistance. Read More

BMC Infect Dis 2018 01 2;18(1). Epub 2018 Jan 2.

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

Background: Longtime follow-up studies on patients with pharyngotonsillitis are rare. We aimed to describe the patterns of new visits for a sore throat, complications and tonsillectomy during 2 years in a cohort of patients with pharyngotonsillitis and non-infected controls.

Methods: A retrospective chart review was performed on a cohort of patients with acute sore throat (n = 207), and non-infected controls (n = 108). Read More

Am J Ophthalmol Case Rep 2017 Sep 8;7:149-152. Epub 2017 Jul 8.

Department of Ophthalmology, Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI, United States.

Purpose: To present an unusual case of endogenous endophthalmitis secondary to Group A (GAS) that resulted in dislocation of the crystalline lens.

Observations: An immunocompetent 51-year-old man presented to the emergency room (ER) with upper respiratory infection (URI) symptoms and painful right eye. He was diagnosed with URI and viral conjunctivitis and discharged on oral azithromycin and polytrim eyedrops. Read More

Clin Infect Dis 2018 May;66(10):1540-1549

US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring.

Background: Many individuals with acute human immunodeficiency virus infection (AHI) experience acute retroviral syndrome (ARS), which is associated with adverse long-term clinical outcomes.

Methods: Participants presenting for voluntary human immunodeficiency virus (HIV) testing were enrolled during AHI in Bangkok, Thailand. ARS was defined by ≥3 qualifying signs/symptoms. Read More

Pediatr Emerg Med Pract 2017 Dec 1;14(12):1-20. Epub 2017 Dec 1.

Assistant Professor, Department of Pediatrics and Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY

Although group A Streptococcus (GAS) pharyngitis is the most common cause of bacterial pharyngitis in children and adolescents, many viral and bacterial infections mimic the symptoms of GAS pharyngitis. Emergency clinicians must recognize the symptomatology of GAS pharyngitis and use appropriate means of diagnosis and treatment to promote good antibiotic stewardship. This issue reviews the signs and symptoms of GAS pharyngitis, as well as associated complications, and provides recommendations for appropriate treatment that focuses on reducing the severity and duration of symptoms, reducing the incidence of nonsuppurative complications, and reducing transmission. Read More

Hawaii J Med Public Health 2017 11;76(11 Suppl 2):3-6

Tripler Army Medical Center, Honolulu, HI 96859.

Adult-onset Still's Disease is a rare, idiopathic, inflammatory disorder characterized by arthralgia, evanescent, salmon-colored rash, and daily fevers as well as lymphadenopathy, pharyngitis, splenomegaly, myalgias, and serositis. The inciting etiology of this syndrome is unknown, though it has been hypothesized that infection triggers an autoimmune response. The Yamaguchi Criteria, the most sensitive and widely used diagnostic criteria, requires both a minimum set of criteria to be met as well other potential etiologies to be excluded. Read More

Ear Nose Throat J 2017 Oct-Nov;96(10-11):E54-E55

Department of Otolaryngology-Head and Neck Surgery, Taichung Armed Forces General Hospital, Taichung, Taiwan.

Rheumatology (Oxford) 2018 01;57(1):134-139

Rheumatology Department, National Center for Rare Systemic Autoimmune Diseases, Hôpitaux Universitaires de Strasbourg, Strasbourg.

Objective: The aim was to evaluate the incidence of serious infusion-related reactions (SIRRs) in RA treated by non-TNF-targeted biologics.

Methods: We analysed data from three independent prospective registers, namely autoimmunity and rituximab, Orencia (abatacept) and RA (ORA) and Registry RoAcTEmra (tocilizumab), promoted by the French Society of Rheumatology and including patients with RA. SIRRs were defined by an occurrence during or within 24 h of an infusion and requiring discontinuation of treatment. Read More

J Infect Chemother 2018 Feb 17;24(2):142-146. Epub 2017 Oct 17.

Department of Otolaryngology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan.

Human cytomegalovirus (CMV) is an infectious herpes virus present in approximately 50% of the world's population. Pharyngitis is an uncommon manifestation of CMV infection, and vocal cord immobility (VCI) following CMV pharyngitis is quite rare. An 83-year-old man with well-controlled diabetes mellitus and hypertension was admitted due to dyspnea, odynophagia, and dysphagia. Read More

Cochrane Database Syst Rev 2017 10 17;10:CD010089. Epub 2017 Oct 17.

Department of Family Medicine, Universiti Sains Malaysia, School of Medical Sciences, Health Campus, Kubang Kerian, Kelantan, Malaysia, 16150.

Background: Acute otitis media (AOM) is one of the most common infectious diseases in children. It has been reported that 64% of infants have an episode of AOM by the age of six months and 86% by one year. Although most cases of AOM are due to bacterial infection, it is commonly triggered by a viral infection. Read More

Vestn Otorinolaringol 2017;82(4):25-28

N.N. Blokhin Russian Oncological Research Centre, Moscow, Russia, 115478.

The high prevalence of chronic inflammatory oropharyngeal pathologies and a large variety of specific pathogenetic features of the persistent viral infections caused by the species of the families Herpesviridae and Papillomaviridae as etiological agents of the disease suggest the necessity of investigations with a view to evaluating the clinical significance of persistent viral infections with Herpesviridae and Papillomaviridae species in the patients presenting with chronic inflammatory oropharyngreal pathology. The objective of the present study was to elucidate the prevalence and clinical significance of viral infections caused by the pathogenic agents belonging to the families Herpesviridae and Papillomaviridae in the patients presenting with chronic inflammatory pathology of the oropharynx. We examined two groups of patients one of which was comprised of 174 subjects suffering from chronic inflammatory oropharyngeal pathologies while the other consisted of 31 healthy people. Read More

IDCases 2017 1;10:58-59. Epub 2017 Sep 1.

Infectious Disease Division, Winthrop-University Hospital, Mineola, New York, United States.

In young adults with acute pharyngitis, the main differential diagnosis is between GAS pharyngitis, EBV infectious mononucleosis, or other causes of viral pharyngitis. A positive RST does not differentiate GAS colonization from infection as is well illustrated by this case. Laboratory test results must be interpreted in the appropriate clinical context to be diagnostically meaningful. Read More

Pediatr Dev Pathol 2018 Sep-Oct;21(5):497-501. Epub 2017 Sep 7.

2 Division of Pediatric Rheumatology, Department of Pediatrics, University of British Columbia and British Columbia Children's Hospital, Vancouver, British Columbia, Canada.

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is a common cause of periodic fever in children. The pathogenesis of PFAPA is unknown but likely involves immune system dysregulation and may be initiated by an environmental trigger. Tonsillectomy resolves or improves symptoms in some patients, but the reason for this is unknown; moreover, specific abnormalities in tonsillectomy specimens from PFAPA patients have not been described. Read More

J Clin Med 2017 Sep 4;6(9). Epub 2017 Sep 4.

Infectious Disease Division, Winthrop-University Hospital Mineola, NY 11501, USA.

Clinically, in young immunocompetent adults, Epstein-Barr virus (EBV) usually manifests as infectious mononucleosis (IM). Typical clinical findings of EBV IM include fever, profound fatigue, pharyngitis, bilateral posterior cervical adenopathy, and splenomegaly. Respiratory involvement with EBV IM may occur, but is distinctly rare. Read More

BMJ Case Rep 2017 Sep 1;2017. Epub 2017 Sep 1.

Department of Clinical Pharmacology and Therapeutics, Austin Health, Heidelberg, Victoria, Australia.

A 32-year-old man who was receiving adalimumab for seronegative rheumatoid arthritis presented with a 4-week history of fever, night sweats, fatigue, myalgias and diarrhoea. On examination, he had obvious splenomegaly but no lymphadenopathy or pharyngitis. Full blood count revealed mild neutropenia and significant lymphocytosis, with a blood film showing atypical lymphocytes. Read More

Cas Lek Cesk Summer 2017;156(4):203-204

The article deals with sore throat, gives definition of acute and chronic pain and describes their causes. Further describes possibilities of diagnosis with regard to differential diagnosis. Special attention is focused on differentiation between viral and streptococcal infection. Read More

Pediatr Infect Dis J 2018 03;37(3):218-223

Background: Most antibiotics in children are used to treat viral and self-limiting conditions. This study aims to compare physicians' adherence to guidelines on antibiotic prescribing in fever and in ear and respiratory infections to children in different age groups in the Netherlands.

Methods: Data were used from the NIVEL Primary Care Database. Read More

J Med Virol 2018 01 12;90(1):34-40. Epub 2017 Sep 12.

Department of Microbiology, Yamagata Prefectural Institute of Public Health, Yamagata, Japan.

Although Saffold virus (SAFV) was reported as a novel human cardiovirus in 2007, no causative association between SAFV and clinical disease has been proven and the longitudinal epidemiology of SAFVs is not available. To establish the relationship between SAFVs and acute respiratory infections (ARIs) and to clarify the longitudinal epidemiology of SAFVs, 7258 nasopharyngeal specimens were collected from children with ARIs in Yamagata, Japan between 2008 and 2015. The specimens were inoculated on a microplate including six cell lines as part of routine surveillance, and molecular screening was performed for SAFVs using a reverse transcription (RT)-PCR method. Read More

BMJ Case Rep 2017 Aug 7;2017. Epub 2017 Aug 7.

Imperial College Healthcare NHS Trust, London, UK.

A 67-year-old woman presented with a 1-week history of left otalgia and a 1-day history of odynophagia, pain extending into the face and neck, and a productive cough. Flexible nasendoscopy showed features of supraglottitis, with swollen arytenoids and pooling of saliva in the piriform fossae. Laboratory investigations revealed a mildly raised C reactive protein. Read More