Acute tonsillitis and its complications: an overview

2015 ◽  
Vol 101 (1) ◽  
pp. 69-73 ◽  
Author(s):  
A Bartlett ◽  
S Bola ◽  
R Williams
Keyword(s):  
Hospital Admission ◽  
Antimicrobial Treatment ◽  
Basic Knowledge ◽  
Acute Tonsillitis ◽  
Parapharyngeal Abscess ◽  
Adequate Hydration ◽  
Life Threatening ◽  
Supportive Management ◽  
Nose And Throat ◽  
Formation Specific

AbstractAcute tonsillitis may be defined as inflammation of the tonsils, predominantly due to infection. It is part of the spectrum of pharyngitis, which ranges from localised tonsillar infection to generalised infection of the pharynx and commonly affects young healthy adults. Simple sore throats secondary to viral or bacterial pharyngitis are very common and generally do not require hospital admission or antimicrobial treatment. Supportive management in the form of analgesia and adequate hydration is often sufficient. However, there is potential for life-threatening complications to develop, highlighting the need for basic knowledge in the management of these conditions.This article aims to provide an overview of acute tonsillitis and its complications, including peritonsillar and parapharyngeal abscess formation. Specific attention will be given to the pathogenesis, diagnosis, investigation and management of each condition, in particular advising on emergency pre-shore treatment and indications for referral to an Ear, Nose and Throat Department. We will also summarise important guidelines and evidence from the literature to support these management decisions.

My patient is thrombocytopenic! Is (s)he? Why? And what shall I do?

2013 ◽  
Vol 33 (02) ◽  
pp. 83-94 ◽  
Author(s):  
L. Alberio
Keyword(s):  
Platelet Count ◽  
Basic Knowledge ◽  
Treatment Resistant ◽  
Antithrombotic Treatment ◽  
Life Threatening ◽  
Treatment Concepts ◽  
Low Platelet Count ◽  
Thrombocytopenic Patient ◽  
Taking Care

SummarySolving the riddle of a thrombocytopenic patient is a difficult and fascinating task. The spectrum of possible aetiologies is wide, ranging from an in vitro artefact to severe treatment-resistant thrombocytopenic bleeding conditions, or even life-threatening prothrombotic states. Moreover, thrombocytopenia by itself does not protect from thrombosis and sometimes a patient with a low platelet count requires concomitant antithrombotic treatment as well. In order to identify and treat the cause and the effects of the thrombocytopenia, you have to put together several pieces of information, solving a unique jig-jaw puzzle.The present work is not a textbook article about thrombocytopenia, rather a collection of differential diagnostic thoughts, treatment concepts, and some basic knowledge, that you can retrieve when facing your next thrombocytopenic patient. Enjoy reading it, but most importantly enjoy taking care of patients with a low platelet count. I bet the present work will assist you in this challenging and rewarding clinical task.

scholarly journals Incidence of ear, nose and throat disorders in children: a study in a teaching hospital in Telangana

2016 ◽  
Vol 2 (1) ◽  
pp. 26
Author(s):  
Harika Surapaneni ◽  
Shalini Singh Sisodia
Keyword(s):  
Otitis Media ◽  
Economic Status ◽  
Clinical History ◽  
Nasal Discharge ◽  
X Rays ◽  
Acute Tonsillitis ◽  
Suppurative Otitis Media ◽  
Socio Economic Status ◽  
Nasal Diseases ◽  
Nose And Throat

<p class="abstract"><strong>Background:</strong> ENT problems are very common among the children, especially diseases such as acute suppurative otitis media, acute tonsillitis, acute epiglottis, laryngotracheobronchitis, and rhinitis etc. Poor hygienic conditions, malnourishment, different socio-economic levels are also said to play a role in the prevalence of ENT disorders.</p><p class="abstract"><strong>Methods:</strong> 417 children between the ages of 0-15, attending the ENT department in our hospital were included in the study. General demographic details such as age, sex, socio-economic status, clinical history, and examination for common ENT complaints and disorders was taken for all patients. Otoscopy for ear examination for diseases such as otitis media, ear perforation and ear discharge anterior rhinoscopy for nasal discharge, airway obstruction and infection were performed Presence of any adenoid hypertrophy was looked for. Throat examination was performed for any sign of tonsillitis or pharyngitis. Appropriate investigations such as X-rays, culture and sensitivity, etc were performed where necessary.  </p><p class="abstract"><strong>Results:</strong> 258 (61.9%) patients were females while there were 159 (38.1%) males. More than 45% cases who had disorders were concentrated in the 6-15 years age group. Almost 75% of the children were from lower socio-economic status. Otitis media among the ear diseases, rhinitis in the nasal diseases and pharyngitis followed by tonsillitis in the diseases of the throat was found to be the most common.</p><strong>Conclusions:</strong> Our study provides basic information of the prevalent disorders in ENT in our area, based on which we can take the relevant step towards development of the medical setup and treatment.

scholarly journals Ear, Nose and Throat Emergencies and Anesthesia

2015 ◽  
Vol 7 (1) ◽  
pp. 28-34
Author(s):  
Tushar Bawankar
Keyword(s):  
Difficult Intubation ◽  
Foreign Bodies ◽  
Acute Onset ◽  
Team Work ◽  
Inhalational Induction ◽  
Emergency Procedures ◽  
Parapharyngeal Abscess ◽  
Emergency Tracheostomy ◽  
Deep Neck Space Infections ◽  
Nose And Throat

ABSTRACT Ear, nose and throat (ENT) emergency procedures demand significant anesthetic challenges. Variety of emergency conditions like deep neck space infections (Ludwig's angina, retropharyngeal, parapharyngeal abscess), acute onset of stridor, epiglottitis, laryngotracheobronchitis, inhaled foreign bodies, facial injuries, etc. are a challenge to both the surgeon and the anesthesiologist and communication and cooperation is vital. Priority in emergency is to clear and secure the airway and consider requirement of ‘shared airway’. Preferred anesthesia and airway technique include awake flexible fiberoptic (FOB) guided intubation in cooperative patients’ and an inhalational induction in uncooperative patient or tracheostomy. Anticipation, vigilance, readiness for difficult intubation, emergency tracheostomy and team work is essential while managing ENT emergency procedures. How to cite this article Harde M, Bawankar T, Bhadade R. Ear, Nose and Throat Emergencies and Anesthesia. Int J Otorhinolaryngol Clin 2015;7(1):28-34.

scholarly journals Survival from paraquat induced renal impairment in a 17 years old male

2021 ◽  
Vol 8 (2) ◽  
pp. 300
Author(s):  
Medo M. Kuotsu ◽  
N. Biplab Singh ◽  
Nyamnyei Konyak ◽  
Vikie-o Khruomo ◽  
Senjele Kath ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Treatment Options ◽  
Fatal Outcome ◽  
Radical Scavenging ◽  
Case Fatality ◽  
Kidney Injury ◽  
Organ Damage ◽  
Paraquat Poisoning ◽  
Adequate Hydration ◽  
Life Threatening

N, N’-dimethyl-4, 4’-bipyridinium dichloride (paraquat) is a herbicide commonly used in India that leads to fatal outcome on ingestion. Paraquat interferes in the intracellular electron transfer systems inhibiting the reduction of NADP to NADPH resulting in accumulation of superoxide radical causing lipid cell membranes destruction leading to various organ damage. Life threatening effects such as acute kidney injury as paraquat elimination is mainly by kidney, acute respiratory distress syndrome and multi-organ failure are the causes of mortality in paraquat poisoning. There is no specific antidotes for paraquat poisoning so prevention and aggressive decontamination remains the mainstay of management in case of exposure or ingestion. Paraquat poisoning presentation may vary in cases depending on the amount of paraquat consumed and thus the outcome. Here we report a case of a 17 years old male who presented with acute kidney injury following ingestion of paraquat in a suicidal attempt. In our case, induced vomiting of the stomach content readily after ingestion of the poison, early haemodialysis, use of immunosuppression such as methylprednisolone, cyclophosphamide and antioxidants such as acetylcysteine, Vitamin C and Vitamin E as free radical scavenging agent , supportive measures such as adequate hydration and antibiotics might have helped in the patient’s survival. The case fatality remains very high in paraquat poisoning till date owing to lack of effective treatment options.

Review on Mucormycosis

2021 ◽  
Vol 9 (07) ◽  
pp. 401-407
Author(s):  
Deepthi Somarouthu ◽  
Vasantha Thota ◽  
Kalyani Ampolu
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Bone Marrow ◽  
Species Level ◽  
Tissue Necrosis ◽  
Uncontrolled Diabetes ◽  
Life Threatening ◽  
Anti Fungal ◽  
Pcr Targeting ◽  
Nose And Throat

Mucormycosis is a opportunistic fungal infection that occurs in patients who are immunocompramised. The fungus causing mucormycosis belongs to the class of zygomycetes and the order of mucorales. It is highly life-threatening mycotic infection that is characterised by angioinvasion, infarction, and tissue necrosis. The risk factors include uncontrolled diabetes mellitus in ketoacidosis, various forms of metabolic acidosis, treatment with corticosteroids, organ or bone marrow transplantation etc. The diagnosis is challenging and treatment should start as early as possible to decrease mortality. Diagnosis is based on symptoms such as, in case of sinusitis, sinus biopsies are required. Ear, nose and throat endoscopy should be done. Molecular identification of mucormycosis can help in confirming diagnosis and identify the fungus from genus to species level. Different techniques are as follows: DNA probes targeting 18S subunit, ITS1 sequencing after PCR with pan-fungal primers, 18S-targeted semi-nested PCR and real time PCR targeting cytochrome b gene. The therapeutic approach should be multimodal including anti-fungal agents, surgical debridement, and correction of underlying symptoms predisposing the patient to disease.

Wounds, Fractures, Orthopaedics

2011 ◽  
Author(s):  
Pawan Gupta
Keyword(s):  
Physical Examination ◽  
Soft Tissue Injuries ◽  
Basic Knowledge ◽  
X Rays ◽  
Number Of Patients ◽  
Before And After ◽  
Life Threatening ◽  
Minor Injuries ◽  
High Degree ◽  
Type Of Injury

A significant number of patients attending the ED are those who are often referred to as ‘minors’, ‘streamers’, ‘walking wounded’, etc. These include patients with minor injuries, wounds, fractures or other soft tissue injuries. Therefore, a basic knowledge of anatomy and its application in various circumstances is mandatory. The injuries mentioned above are rarely life-threatening, but they may be limb-threatening and severely disabling. So it is extremely important to avoid errors in diagnosis and management, and to know when to ask for help at the appropriate time. By following the key principles listed below, you will be able to avoid many problems with such patients: • In the history, a detailed description of the mechanism of injury and the patient’s complaint will help in predicting the type of injury sustained. • A careful and thorough physical examination can point to the site and type of injury, on the basis of which appropriate radiological images can then be requested. • A neurovascular examination must be completed and documented in every limb injury, before and after any reductions, and before and after immobilization. • Appropriate radiological imaging, accompanied by a thorough physical examination, can pick up injuries with a high degree of accuracy. Inadequate radiographic films should not be accepted. • Immobilize the patient if a fracture is clinically suspected even if the X-rays are negative. • In cases of dislocations or subluxations, X-rays should be done before and after reductions, except when a delay could be potentially harmful to the patient (for example, when a severe traumatic deformity of a joint threatens to jeopardize the viability of the overlying skin). • The patient should be able to mobilize safely before being discharged from the ED. • Patients should be given proper aftercare instructions before leaving the ED, including how to look after themselves and to recognize limb-threatening features, the follow-up arrangement, and to return if things go wrong. • Ask for senior help if you are not sure about an injury or its management.

Otorrhoea

2020 ◽  
Vol 13 (5) ◽  
pp. 281-288
Author(s):  
Mark Newton ◽  
Paraskevi Tsirevelou
Keyword(s):  
Primary Care ◽  
Cerebrospinal Fluid ◽  
Physical Examination ◽  
Hospital Admission ◽  
Secondary Care ◽  
Common Causes ◽  
Management Guidance ◽  
Throat Symptom ◽  
The Common ◽  
Nose And Throat

The discharging ear, also known as otorrhoea, is a common ear, nose and throat symptom and defined as drainage or flow exiting the ear. The discharge can be wax, blood, pus, mucus, or cerebrospinal fluid. The underlying cause can usually be determined from the history and physical examination. Most patients with otorrhoea can be managed within primary care and do not require referral or hospital admission. This article considers the common causes of a discharging ear, appropriate management, guidance for referral of patients to secondary care and some key take home points.

Parapharyngeal abscess secondary to lymphovenous malformation

2019 ◽  
Vol 133 (03) ◽  
pp. 256-259
Author(s):  
S Khosla ◽  
N Caton ◽  
T-T Zhang ◽  
C R Davies-Husband
Keyword(s):  
Low Flow ◽  
Airway Compromise ◽  
Parapharyngeal Abscess ◽  
Emergency Presentation ◽  
Life Threatening

AbstractBackgroundDeep neck space abscesses are an uncommon but life-threatening emergency presentation to the ENT surgeon because of potential acute airway compromise.ObjectiveThis paper presents a novel case of a palatine tonsillar, low-flow, lymphovenous malformation pre-disposing to multifocal deep neck space collections and resultant acute airway compromise.

Life-threating complication of parapharyngeal abscess and mediastinitis in a 10-year-old otherwise healthy girl following elective tonsillectomy – first reported paediatric case

2019 ◽  
Vol 133 (2) ◽  
pp. 161-163 ◽  
Author(s):  
C C Holm-Hansen ◽  
E Thisted ◽  
M Kaltoft
Keyword(s):  
Paediatric Population ◽  
Neck Swelling ◽  
Resonance Imaging ◽  
Thoracic Pain ◽  
Intravenous Antibiotic ◽  
Parapharyngeal Abscess ◽  
First Case ◽  
Operative Complications ◽  
Paediatric Case ◽  
Life Threatening

AbstractBackgroundParapharyngeal abscess and mediastinitis are rare but very severe post-operative complications following an elective tonsillectomy. Parapharyngeal abscess as a complication to tonsilectomy is very seldom described in the literature and no cases in the paediatric population have been described.Case reportThis paper presents, to our knowledge, the first case of life-threatening parapharyngeal abscess and mediastinitis following elective adenotonsillectomy in an otherwise healthy, fully vaccinated 10-year-old girl.ConclusionDiagnosing parapharyngeal abscess and mediastinitis can be challenging, but should be suspected and ruled out in cases of post-operative odynophagia, fever, and/or neck swelling and thoracic pain. Diagnosis is made based on magnetic resonance imaging and computed tomography findings. Prompt broad-spectrum intravenous antibiotic treatment and surgical drainage should be initiated. Other severe complications such as meningitis should also be considered.

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