The purpose of this investigation was to explore the epidemiology, clinical history and microbiology of peritonsillar abscess (PTA). A retrospective review of PTA cases treated at the Department of Otolaryngology, Regional Specialist Hospital in Radom, Poland between 1st October 2003 and 30th September 2013 was undertaken. A total of 111 PTA patients were admitted. The study population consisted of 57.7 % males and 42.3 % females, with an average age of 31.0 (range 5–78) years. Smokers comprised 22.0 % of the study group. The seasonal variation of PTA was statistically insignificant (p = 0.45). Recurrent tonsillitis occurred in 35.5 % of patients. In comparison with the rest of the study population, patients with a history of recurrent pharyngotonsillitis had higher incidence of previous PTA episodes [odds ratio (OR) 17.8, 95 % confidence interval (CI) 2.1–148.7, p = 0.001]. Also, they were more frequently treated with antibiotics prior to hospitalisation (OR 4.6, 95 % CI 2.0–10.9, p = 0.0005) and had significantly longer hospital stay (p = 0.03). Bacterial cultures of abscess aspirates were performed in 40.5 % of patients. Monomicrobial growth was detected in 77.8 % of aerobic cultures. Streptococcus pyogenes, growing most frequently in monoculture, was found in 28.9 % of aerobic cultures. PTA patients with and without recurrent pharyngotonsillitis differed with regard to clinical history and course of disease. The percentage of smokers among PTA patients was lower than that described in the literature. Monomicrobial growth predominated in PTA aspirate cultures. S. pyogenes proved to be the most frequent pathogen.

BackgroundDespite advances in the development of pneumococcal conjugate vaccines, acute otitis media (AOM) is a common childhood infection, caused mainly by Streptococcus pneumoniae. It has been suggested that persistence of pneumococcal nasopharyngeal carriage is a risk factor for subsequent recurrent infections.MethodsIn this study we evaluate the relationship between 55 pneumococcal strains obtained from nasopharynx/oropharynx (NP/OP) and middle ear fluid (MEF) of 62 children, aged between 1 and 16 years, during AOM (including recurrent/treatment failure AOM, and post-treatment visits), based on their phenotypic and genotypic characteristics performed by analyses of serotype, antibiotic susceptibility patterns and multilocus sequence typing.ResultsS.pneumoniae was isolated from 27.4% of MEF samples; it constituted 43.6% of all positive bacterial samples from MEF samples. There was statistically significant concordance between isolation from the MEF sample and NP/OP colonization by S. pneumoniae (p < 0.0001). During post-treatment visits S.pneumoniae was isolated from 20.8% of children; 91% of them were positive in pneumococcal NP/OP culture during AOM. The serotypes belonging to 10- and 13-valent pneumococcal conjugate vaccines constituted 84% and 92% of the strains, respectively. Multidrug resistance was found in 84% of the strains. According to multivariate analysis, pneumococcal colonization after antibiotic therapy was significantly associated with shorter length of therapy in children with bilateral AOM.ConclusionsHigh persistent prevalence of antibiotic-resistant S.pneumoniae strains in children with AOM after unsuccessful bacterial eradication may presumably be regarded as a predisposing factor of infection recurrence.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3398-9) contains supplementary material, which is available to authorized users.

The dynamic development of knowledge in the field of probiotics was commenced at the beginning of the 20th century. Since then, many ways of their possible usage in medicine have been established. In accordance with the WHO, probiotics are live microorganisms, which if applied in adequate amounts may benefit the host. Among probiotics, fungi and bacteria are distinguished, and mechanisms of action of these organisms in the oral cavity and gut are parallel. Application in dentistry, in prophylaxis and treatment of oral diseases is still not well known. Most commonly, Lactobacillus reuteri, Lactobacillus rhamnosus GG and Bifidobacterium are applied. The aim of the study was to collect and systematize the latest information about probiotics and their role in pathomechanisms of dental caries, gingivitis and periodontitis, candidiasis, and malodour. Based on the analyzed literature, it can be concluded that mechanisms of cariogenic pathogen inhibition using probiotics are still not well understood. The new research trend is based on application of probiotics which can naturally displace cariogenic bacteria in the oral cavity and influence oral health in adults and children. The results of studies also confirmed the beneficial role of probiotics in reduction of the bacterial population in periodontitis and halitosis. Long-term observation and a properly designed study protocol will allow us to answer many questions concerning substitution of one strain of bacteria by another.

Probiotics are a group of microorganisms able to have a positive influence on a host organism when applied in adequate amounts. They are grouped either as: bacteria (mainly Lactobacillus spp and Bifidobacterium) or fungi (Saccharomyces boulardii). Recent studies have revealed many opportunities for their use in several fields of medicine, such as in: reducing the level of cholesterol in the body, cancer therapy, human immune system regulation, skin regeneration, pancreas necrosis, cirrhosis of liver treatment, regulation of post- antibiotic bowel function, constipation and digestive disorders in infants. Probiotics efficacy has also been demonstrated in oral cavity malfunctions. With the use of modern scientific methods, probiotics have the potential to become an important part of the daily diet and a natural drug supplementation in severe diseases.

Background: Streptococcus pyogenes is responsible for 5-15% and 20-30% of acute pharyngitis/tonsillitis in adults and children, respectively. It not only causes acute illness but also can give rise to local suppurative complications such as peritonsillar abscess as well as trigger the postinfectious syndromes of glomerulonephritis, acute rheumatic fever and poststreptococcal reactive arthritis. Here, we report a case of a young healthy adult in whom both peritonsillar abscess and poststreptococcal reactive arthritis developed as a complication of acute streptococcal tonsillitis. To the best of our knowledge, such a coincidence of poststreptococcal sequelae has not been reported previously. Case presentation: A 32-year-old previously healthy woman was diagnosed with acute tonsillitis by her family doctor and treated empirically with amoxicillin/clavulanic acid (875/125 mg) twice daily for 5 days. Four days after completing antibiotic therapy, peritonsillar abscess of left tonsil developed. Needle aspiration followed by incision and drainage were performed by otolaryngologist at the Emergency Department. Next, the patient was discharged home on a 10-day course of cefuroxime and metronidazole. The symptoms of peritonsillar abscess were subsiding during treatment, however on the last day of antibiotic therapy, swelling and pain of the left ankle appeared. Five days later the patient was consulted by rheumatologist. Cultures of throat swabs and abscess aspirate collected 2 weeks before revealed the presence of Streptococcus pyogenes. Antistreptolysin O (ASO) titer was evaluated and proved to be 412 IU/ml (normal 0-200 IU/ml). The level of C-reactive protein was 13,0 mg/L (normal <5,0 mg/L). There was no known cardiac involvement. Poststreptococcal reactive arthritis was diagnosed. Left ankle arthralgia persisted for about 5-6 weeks. Six months after the presentation at the Emergency Department, the patient was well, with ASO titer reaching 262 IU/ml. Conclusions: Clinicians should be aware that appropriate choice of antibiotic, proper dose as well as duration of therapy of acute GAS pharyngitis/tonsillitis are crucial to prevent poststreptococcal sequelae.

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