Pharyngitis (Pharyngitis, Tonsillitis, Tonsillopharyngitis, and Nasopharyngitis)

Cherry, James D.

doi:10.1016/b978-1-4160-4044-6.50015-7

Cited by 4 publications

(2 citation statements)

References 156 publications

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“…Most cases of pharyngitis were associated with exudate formation on the patient's tonsils, which is a typical symptom of streptococcal pharyngitis. 14 Therefore, PFAPA is often misdiagnosed as infectious pharyngitis 13 and treated with antibiotics. 1 When infectious pharyngitis can be ruled out, an exudate on the tonsils is an important characteristic of PFAPA.…”

Section: Discussionmentioning

confidence: 99%

“…showed that cervical lymphadenopathy was the most frequent symptom of PFAPA, 1 other studies have shown that pharyngitis/tonsillitis is the most frequent clinical manifestation, 3,5,13 which is in line with the results of our study. Most cases of pharyngitis were associated with exudate formation on the patient's tonsils, which is a typical symptom of streptococcal pharyngitis 14 . Therefore, PFAPA is often misdiagnosed as infectious pharyngitis 13 and treated with antibiotics 1 .…”

Section: Discussionmentioning

confidence: 99%

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Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome: Clinical characteristics and treatment outcomes – a single center study in Japan

Ohnishi

Sato

Uejima

et al. 2022

Pediatrics International

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Background Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is an autoinflammatory disease occurring in children. Although PFAPA is the most common periodic fever syndrome found in children, there are only a few studies defining the clinical characteristics and the efficacy of treatment strategies among Japanese children. This study aimed to clarify the demographic characteristics and clinical features of patients with PFAPA syndrome and to evaluate treatment efficacy. Methods We retrospectively reviewed the clinical features of children with PFAPA who visited Saitama Children's Medical Center between January and December 2019. We also evaluated treatment strategies and their efficacy; abortive treatment with corticosteroids, prophylaxis with cimetidine or colchicine, and surgical management with tonsillectomy. Results A total of 100 Japanese children (61% male) with PFAPA were included. Median age of onset was 3 years, median duration of fever episodes was 5 days, and median interval between episodes was 4 weeks. The symptoms (frequencies) were pharyngitis (89%), exudate on tonsils (71%), cervical adenitis (50%), and aphthous stomatitis (49%). Approximately 37% of patients took prednisolone for aborting fever attacks, showing a 100% response; 93% were treated with cimetidine, showing an 79.6% response, and 18% were treated with colchicine, showing a 66.7% response. Only one patient underwent tonsillectomy. Conclusions Among Japanese children with PFAPA, 28% of them were ≥5 years with a male predominance. Pharyngitis is the most frequent symptom associated with fever. Cimetidine is suitable for initial therapy because of its safety and efficacy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome: Clinical characteristics and treatment outcomes – a single center study in Japan

Ohnishi

Sato

Uejima

et al. 2022

Pediatrics International

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Evaluation of the Lyra Direct Strep Assay To Detect Group A Streptococcus and Group C and G Beta-Hemolytic Streptococcus from Pharyngeal Specimens

et al. 2016

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bThe Lyra Direct strep assay was compared to culture for its ability to detect Streptococcus group A and ␤-hemolytic groups C/G using rapid antigen-negative pharyngeal specimens (n ‫؍‬ 161). The Lyra assay correctly detected all ␤-hemolytic streptococci (group A, n ‫؍‬ 19; group C/G, n ‫؍‬ 5). In batch mode, the Lyra assay reduced intralaboratory turnaround time by 60% (18.1 h versus 45.0 h) but increased hands-on time by 96% (3 min 16 s versus 1 min 40 s per specimen). Various species of Streptococcus cause acute bacterial pharyngitis. Group A Streptococcus (GAS) (Streptococcus pyogenes) is the most common, but other ␤-hemolytic streptococci have also been implicated (1-3). These include S. equi, S. dysgalactiae, S. equisimilis, and S. zooepidemicus, and these in general are designated large-colony-forming or pyogenic Lancefield group C or G streptococci (4). The timely detection of these pathogens expedites appropriate antimicrobial therapy, thereby reducing illness duration and disease transmission, and in the case of GAS, nonsuppurative complications (i.e., rheumatic fever and glomerulonephritis). To improve turnaround time, rapid antigen tests (RATs) have largely augmented bacterial culture (the gold standard). However, the performance of commercially available RATs varies greatly depending upon the manufacturer, methodology used (i.e., optical immunoassay, immunochromatographic, or enzyme immunoassay), and the patient population (i.e., pediatric versus adult) being tested (5). Due to these limitations, nucleic acid amplification tests (NAATs) are being implemented in clinical laboratories. One such test, the Lyra Direct strep assay (Quidel, San Diego, CA), was recently approved (22 April 2014) by the U.S. Food and Drug Administration (FDA) for the qualitative detection and differentiation of GAS and pyogenic group C/G ␤-hemolytic streptococci from throat swab specimens obtained from patients with signs and symptoms of pharyngitis. However, the manufacturer's package insert (M112en v2014APR21) also states that all negative Lyra test results should be confirmed by bacterial culture and should not be used as the sole basis for treatment. To date, no peer-reviewed publications pertaining to the Lyra assay are available. As such, the goal of this study was to evaluate the performance and workflow characteristics of the Lyra assay as a replacement for the conventional "backup" culture in the setting of an initial negative rapid antigen test result. This study was approved by the Human Investigative Committee/Internal Review Board of Beaumont Health, MI (no. 2015-171).This evaluation included 161 unique and randomly selected outpatient subjects (pediatric [n ϭ 149; mean age, 6.3 years; age range, 0.5 to 17 years] and adult [n ϭ 12; mean age, 35.7 years; age range, 18 to 93 years]) with clinical findings supportive of acute bacterial pharyngitis. Specimens were collected with a flocked swab (ESwab) and placed into 1.0 ml of liquid Amies transport medium (Copan Diagnostics, Murrieta, CA). All specimens were negativ...

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The Factors Affecting the Use of Empirical Antibiotics in Febrile Infants from 1 Month to Less than 3 Months

Byun

Song

Kim

et al. 2018

Pediatr Infect Vaccine

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Pharyngitis (Pharyngitis, Tonsillitis, Tonsillopharyngitis, and Nasopharyngitis)

Cited by 4 publications

References 156 publications

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome: Clinical characteristics and treatment outcomes – a single center study in Japan

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome: Clinical characteristics and treatment outcomes – a single center study in Japan

Evaluation of the Lyra Direct Strep Assay To Detect Group A Streptococcus and Group C and G Beta-Hemolytic Streptococcus from Pharyngeal Specimens

The Factors Affecting the Use of Empirical Antibiotics in Febrile Infants from 1 Month to Less than 3 Months

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