Differenzialdiagnostik der nekrotisierenden Tonsillitis

Gebhardt, B.; Herrmann, K.; Roessner, A; Vorwerk, Ulrich

doi:10.1055/s-0029-1243192

Cited by 11 publications

(6 citation statements)

References 3 publications

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“…A unilateral ulcer formation is reported in cases with a mixed infection with spirochaetes (Treponema vincentii and others) and fusobacteria (fusobacterium nucleatum and others). The findings in these cases of the so called Vincenti ´s angina include a painfree unilateral gray-greenish tonsillar exudation associated with a significant cloaca-like halitosis and potentially cervico-buccal abscess development [34]. An extremely rare infection is caused by Corynebacterium diphtheriae.…”

Section: Spectrum Of Pathogensmentioning

confidence: 99%

Clinical practice guideline: tonsillitis I. Diagnostics and nonsurgical management

Windfuhr

Toepfner

Steffen³

et al. 2016

Eur Arch Otorhinolaryngol

111

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More than 120,000 patients are treated annually in Germany to resolve repeated episodes of acute tonsillitis. Therapy is aiming at symptom regression, avoidance of complications, reduction in the number of disease-related absences in school or at work, increased cost-effectiveness and improved quality of life. The purpose of this part of the guideline is to provide clinicians in any setting with a clinically focused multi-disciplinary guidance through different conservative treatment options in order to reduce inappropriate variation in clinical care, improve clinical outcome and reduce harm. Surgical management in terms of intracapsular as well as extracapsular tonsillectomy (i.e. tonsillotomy) is the subject of part II of this guideline. To estimate the probability of tonsillitis caused by β-hemolytic streptococci, a diagnostic scoring system according to Centor or McIsaac is suggested. If therapy is considered, a positive score of ≥3 should lead to pharyngeal swab or rapid test or culture in order to identify β-hemolytic streptococci. Routinely performed blood tests for acute tonsillitis are not indicated. After acute streptococcal tonsillitis, there is no need to repeat a pharyngeal swab or any other routine blood tests, urine examinations or cardiological diagnostics such as ECG. The determination of the antistreptolysin O-titer (ASLO titer) and other antistreptococcal antibody titers do not have any value in relation to acute tonsillitis with or without pharyngitis and should not be performed. First-line therapy of β-hemolytic streptococci consists of oral penicillin. Instead of phenoxymethylpenicillin-potassium (penicillin V potassium), also phenoxymethlpenicillin-benzathine with a clearly longer half-life can be used. Oral intake for 7 days of one of both the drugs is recommended. Alternative treatment with oral cephalosporins (e.g. cefadroxil, cefalexin) is indicated only in cases of penicillin failure, frequent recurrences, and whenever a more reliable eradication of β-hemolytic streptococci is desirable. In cases of allergy or incompatibility of penicillin, cephalosporins or macrolides (e.g. Erythromycin-estolate) are valuable alternatives.

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Section: Spectrum Of Pathogensmentioning

confidence: 99%

Clinical practice guideline: tonsillitis I. Diagnostics and nonsurgical management

Windfuhr

Toepfner

Steffen³

et al. 2016

Eur Arch Otorhinolaryngol

111

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“…Prevotella disiens is a non-pigmented, saccharolytic and proteolytic strain, occasionally isolated from polymicrobial infections of the upper respiratory tract [ 6 ], central nervous system [ 7 ], urogenital [ 8 ] and oral [ 9 , 10 ] tract. To the best of our knowledge the present case is the first documented implant-related infection due to a Prevotella spp.…”

Section: Discussionmentioning

confidence: 99%

Sonication assisted microbiological diagnosis of implant-related infection caused by Prevotella disiens and Staphylococcus epidermidis in a patient with cranioplasty

et al. 2015

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BackgroundInfections present a major complication of cranioplasty procedures and in many cases removal of the implant material becomes a necessity. Sonication of the artificial implant material has been used during the last years, in order to facilitate better diagnosis of these infections, nevertheless its use in cranial implant infections is still limited.Case presentationA case of a 63-year-old Caucasian male patient who underwent a decompressive craniectomy, due to intracranial hemorrhage, and a consequent cranioplasty using an autogenic bone flap fixed by titanium clamps, is reported. After three unsuccessful cranioplasty efforts to repair a persistent skin defect, removing the bone flap and the titanium clamps was a necessity. Tissue and bone cultures were unable to reveal any microorganism whilst sonication of the removed titanium clamps and consequent culture of the resulting sonication liquid yielded Prevotella disiens and Staphylococcus epidermidis. The patient was treated with daptomycin and metronidazole until discharge and the skin defect was successfully repaired.ConclusionThe present case report indicates that the use of the sonication procedure assisted the microbiological diagnosis. This is the first known neurosurgical case of the implementation of the sonication procedure.

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“…Lues is among the most frequent causes of a unilateral necrotizing tonsillitis; the main differential diagnoses include carcinoma of the tonsil and angina Plaut–Vincent 2 …”

Section: Figurementioning

confidence: 99%