Tonsillitis In Children Research Articles

Rational antibiotic therapy in treatment of bacterial tonsillitis in children

On the part of tonsillitis every second child suffers, and chronization of the infectious process leads to a number of complications from the organs and systems. Peritonsillar abscesses, tonsillitis sepsis, arthritis, vasculitis, rheumatism and heart disease all of these are the consequence of defective tonsillitis. There fore, the approach to the treatment of inflammations of palatine tonsils should be comprehensive and based on the results of continuous monitoring of microbial flora with a clear definition of the spectrum of its sensitivity to antibacterial agents. Purpose — improvement of antibiotic therapy of acute bacterial tonsillitis in children, based on the results of antibioticograms. The bacteriological method was used for the study, the seeds were culled quantitatively on 5% blood meat peptone agar and dense Saburo agar. Determination of the sensitivity of isolated microorganisms' cultures to antibacterial preparations was carried out by disc diffusion method. The examined contingent was made up of 75 children aged 1 to 17 years old who were on treatment with a diagnosis of acute tonsillitis in VRCCIH. Gr. (+) bacterial microflora was represented by coca flora with a high density of colonization: S.pyogenes (in 100% of children) — (4.16±0.07) Ig CFU/ml, S.salivarius (at 24.0%) — (2.96±0.12) Ig CFU / ml, S.epidermidis (62.6%) — (2.27±0.09) Ig CFU / ml, S.aureus (91.0%) — (3.38±0.11) Ig CFU / ml and Enterococcus spp. (42.6%) — (4.17±0.32) Ig CFU / ml. Among the microbial flora of Gr. (–), K.pneumoniae (in 65.3% of patients) with colonization ability (4.61±0.43) Ig CFU /ml, P.aeruginosa (in 20.0%) — (5,53±0.13) Ig CFU/ml, Alcaligenes spp. (24.0%) — (4.71±0.25) Ig CFU/ml, E.coli (at 65.3%) — (5,13±0.22) Ig CFU/ml, E.coli (69.3%) — (4.35±0.15) Ig CFU/ml. The isolated microflora was characterized by a low spectrum of sensitivity to antibacterial agents. So, S.pyogenes and Enterococcus spp. were sensitive to ceftriaxone (83.5% and 89.9% respectively), and S.aureus to oxacillin (84.0%), whereas S.pyogenes was resistant to 92.3%. Resistant S.aureus and Enterococcus spp. to the reserve cefepime (96.2% and 58.6% respectively) to which P.aeruginosa and Alcaligenes spp. were sensitive (79.3% and 78.2% respectively). Resistant to the latter were up to azithromycin in 95.1% and 91.3% of cases. E.coli, E.coli and K.pneumoniae were almost equally resistant to clarithromycin, showing high susceptibility to reserve vancomycin. Thus, in a microbiological study all children in the smears showed β-hemolytic streptococcus represented by S.pyogenes with high colonization density (4.16±0.07) Ig CFC / ml and in 91.0% of children S.aureus was isolated from colonization capacity (3.38 ± 0.11) Ig CFU / ml. Bacteria of the genus Alkaligenes were sown in 18 diseased children (24.0%), and 15 children (20.0%) isolated Pseudomonas aeruginosa. Conditionally pathogenic E.coli, E.cloacae and K.pneumoniae cultivated in more than 60.0% of cases and were characterized by high pathogenic activity. According to the results of the antibioticograms S.pyogenes and Enterococcus spp. were sensitive to ceftriaxone and resistant to cefepime. Gr.( –) flora, on the contrary, reacted to the reserve cefepimum, while exhibiting high resistance to the macrolide.

Особливості метаболізму нейтрофілів і лімфоцитів крові при хронічному тонзиліті у дітей, хворих на цукровий діабет 1-го типу

Особливості метаболізму нейтрофілів і лімфоцитів крові при хронічному тонзиліті у дітей, хворих на цукровий діабет 1-го типу

Microbiological Profile of Chronic Tonsillitis in the Pediatric Age Group.

IntroductionTonsillitis is a very common disease in children. Understanding the microbiology and pathology of chronic tonsillitis is an important step in its management. The aim of the study was to describe the microbiological profile of core tonsillar tissue in chronic tonsillitis in children.Materials and methodsChildren under 16 years of age with chronic tonsillitis were recruited in the descriptive study. Children with recurrent tonsillitis and recurrent tonsillitis with obstructive symptoms were included. Children who underwent tonsillectomy for obstructive symptoms alone and those who received antibiotics for at least one month prior to surgery were excluded from the study. Dissection and the snare method of tonsillectomy were done on all children. The operated specimen was cut into two halves in a sterile container. The core of the tonsillar tissue was swabbed with two sterile cotton-tipped swabs and sent for the microbiological evaluation of aerobes and anaerobes. The tonsillar tissue was sent for a histopathological examination.ResultsA total of 106 children were operated for chronic tonsillitis in one year. The mean age of children included in this study was 9.4 years. The duration of symptoms due to tonsillar disease ranged from four weeks to 28 months. There were 48 males and 58 females. Recurrent tonsillitis was the most common indication for tonsillectomy in all children. A total of 301 aerobes and 171 anaerobic microorganisms were isolated from 106 children with chronic tonsillitis. The aerobic bacterial species most often isolated was Streptococcus viridans, which was present in 83 children followed by Group A, β-hemolytic Streptococci in 67 children. The anaerobic bacterial most often isolated was Peptococcus species in 49 children. Polymicrobial aerobic and anaerobic flora were present in all tonsillar specimens, yielding an average of 4.1 isolates per specimen. The histopathological examination revealed chronic tonsillitis with reactive follicular hyperplasia in all (100%) children. Actinomycosis was associated with non-specific reactive follicular hyperplasia in four specimens.ConclusionPolymicrobial aerobic and anaerobic flora are identified in deep tonsillar tissue in children with tonsillitis. The identification of bacterial isolates from the core tissue in recurrent tonsillitis could dictate the management of chronic tonsillitis. The histopathological examination of the core tissues of the tonsils helps in an accurate identification of organisms that are difficult to culture.

Сочетанное применение антибактериальных препаратов системного и местного действия как альтернативная стратегия лечения острого гнойного тонзиллита у детей и подростков

Сочетанное применение антибактериальных препаратов системного и местного действия как альтернативная стратегия лечения острого гнойного тонзиллита у детей и подростков

Characteristic Histological Findings of Asymptomatic EBV-associated Lymphoproliferative Disorders in Tonsils

Recently, an in situ hybridization (ISH) and immunohistochemical study demonstrated that Epstein-Barr virus (EBV) infection may be involved in tonsillar hypertrophy and recurrent tonsillitis in children and young adolescents. The present study was based on 630 consecutive specimens from tonsillectomies performed at the Dokkyo University School of Medicine between 2002 and May 2017. Clinical findings were obtained from hospital records. Histologically, a “pale clear zone” was characterized by hyperplastic germinal centers with ill-defined borders and interfollicular expansion. Immunohistologically, the majority of immunoblasts were CD20-positive, whereas medium to large lymphoid cells usually expressed CD3. Among 14 lesions, numerous EBV-encoded small RNA (EBER)-positive cells were detected in 10. In 7 of these 10 lesions, EBER-positive cells were detected in germinal centers as well as in the interfollicular area. Based on our results, the “pale clear zone” suggests asymptomatic EBV infection of the tonsil. The present study demonstrated that “pale clear zones” should be taken into consideration when diagnosing asymptomatic EBV-associated LPDs in the tonsils of children and young adolescents as well as in middle-aged patients.

The effect of tonsillotomy on chronic recurrent tonsillitis in children

Objectives: The objective of this study is to determine whether partial tonsillectomy (tonsillotomy) impacts the occurrence of acute or recurrent tonsillitis in children.Methods: One hundred and eighty patients (1–14 years) were retrospectively surveyed by a questionnaire or by data analysis of a regional database. Subjects who suffered from severe systemic diseases or immunodeficiency syndromes were excluded. Episodes of acute tonsillitis before and after surgery, rate of antibiotic treatment, postoperative hemorrhage, and re-operation were obtained.Results: Fifty-one patients suffered from preoperative tonsillitis. The rate of reinfection was 9.8%. The frequency of tonsillitis was significantly reduced in children after tonsillotomy (p < .001). Further, tonsillotomy led to a significant reduction of antibiotic treatment (p < .001). The rate of definitive tonsillectomy was 1.1% and thus effectiveness was very high. About 1.7% of all children suffered from postoperative bleeding, of which one (0.6%) required surgical revision. None of the bleedings was life threatening.Conclusions: Tonsillotomy is beneficial for patients with recurrent tonsillitis and carries less risk of postoperative complications than tonsillectomy.

Management of recurrent tonsillitis in children

ObjectiveTo compare azithromycin (AZT) and benzathine penicillin (BP) in the treatment of recurrent tonsillitis in children. MethodsThe study comprised of 350 children with recurrent streptococcal tonsillitis, 284 of whom completed the study and 162 children received conventional surgical treatment. The rest of the children, 122, were divided randomly into two equal main groups. Group A children received a single intramuscular BP (600,000IU for children≤27kg and 1,200,000IU for ≥27kg) every two weeks for six months. Group B children received single oral AZT (250mg for children≤25kg and 500mg for ≥25kg) once weekly for six months. ResultsBoth groups showed marked significant reduction in recurrent tonsillitis that is comparable to results of tonsillectomy. There were no statistical differences between group A and B regarding the recurrence of infections and drug safety after six-month follow-up. Group B showed better compliance. ConclusionAZT proved to be good alternative to BP in the management of recurrent tonsillitis with results similar to those obtained after tonsillectomy.

The role of environmental tobacco exposure and Helicobacter pylori infection in the risk of chronic tonsillitis in children.

Helicobacter pylori (H. pylori) is a chronic infectious pathogen with high prevalence. This study investigated the interaction between environmental tobacco exposure and H. pylori infection on the incidence of chronic tonsillitis in Chinese children. Cross-sectional study performed in an outpatient clinic in China. Pediatric patients with chronic tonsillitis were enrolled. H. pylori infection was determined according to the presence of H. pylori CagA IgG antibodies. Serum cotinine levels and environmental tobacco smoke (ETS) exposure were determined for all participants. There was no significant difference in H. pylori infection between the children with chronic tonsillitis and children free of disease, but there was a significant difference in ETS between the two groups (P = 0.011). We next studied the association between ETS and chronic tonsillitis based on H. pylori infection status. In the patients with H. pylori infection, there was a significant difference in ETS distribution between the chronic tonsillitis and control groups (P = 0.022). Taking the participants without ETS as the reference, multivariate logistic regression analysis showed that those with high ETS had higher susceptibility to chronic tonsillitis (adjusted OR = 2.33; 95% CI: 1.67-3.25; adjusted P < 0.001). However, among those without H. pylori infection, ETS did not predispose towards chronic tonsillitis. Our findings suggest that tobacco exposure should be a putative mediator risk factor to chronic tonsillitis among children with H. pylori infection.

Bacteriological study of Haemophilus influenzae isolated from chronic tonsillitis in children under six year in Kirkuk city .

Bacteriological study of Haemophilus influenzae isolated from chronic tonsillitis in children under six year in Kirkuk city .

Asymptomatic Group A Streptococcus carriage in children with recurrent tonsillitis and tonsillar hypertrophy

BackgroundGroup A Streptococcus (GAS) is the most important bacterial cause of acute tonsillitis in children. Some children are chronic GAS carriers, and this carriage is poorly understood. We determined the frequency of GAS detection using a rapid antigen detection test in pediatric patients with indications for tonsillectomy due to adenotonsillar hypertrophy or recurrent GAS infections. MethodsSeventy-two patients underwent a tonsil swab for a rapid antigen detection test. ResultsThe GAS rapid antigen detection test was positive in 18.1% of children. GAS was not associated with sex, age or previous history of recurrent tonsillitis. Also, the prevalence of GAS was similar between patients with either recurrent tonsillitis or tonsil hypertrophy. ConclusionIn our study, the GAS carriage rate was similar to other reports, and GAS carrier state was not correlated with recurrent tonsillitis.

DEFB1 polymorphisms and susceptibility to recurrent tonsillitis in Italian children

IntroductionThe tonsils are secondary lymphoid organs fundamental for immune system response against pathogens within the oral cavity. Tonsillitis refers to inflammation of the pharyngeal tonsils that may include the adenoids and the lingual tonsils and that can be acute, recurrent, and chronic. Viral or bacterial infections, as well as immunologic factors are the main trigger to tonsillitis and disease's chronicity: the host immune responses, especially the innate one, could play an important role in susceptibility to the disease. ObjectivesThe current study aims at investigating the role of functional polymorphisms in the 5′UTR (c.-52G>A, c.-44G>C and c.-20G>A) of DEFB1 gene, encoding for the antimicrobial peptide human beta-defensin 1, in the predisposition to recurrent tonsillitis in children from North Eastern Italy. ResultsNo significant correlation was found between DEFB1 allele, genotype and haplotype frequencies and recurrent tonsillitis susceptibility with the exception of an increased risk to disease development in patients carrying DEFB1 rare haplotypes. ConclusionOur results may suggest that DEFB1 polymorphisms alone may not influence pathology susceptibility, however they could possibly concur, together with other factors involved in the genetic control of innate immune system, in the predisposition towards recurrent tonsillitis.

Tonsillitis in children: unnecessary laboratory studies and antibiotic use.

The Finnish Current Care Guidelines on diagnostics and treatment of sore throat recommend the treatment of only group A streptococcus (GAS) positive cases with penicillin. The aim of the study was to evaluate how these guidelines are followed in the pediatric emergency unit. We analyzed retrospectively the data on microbiological studies and blood tests done, and data on prescribing of antibiotics, of 200 children admitted for febrile exudative tonsillitis. After the clinical diagnosis of exudative tonsillitis, antigen test and/or culture for GAS identification was done in >95% of cases. All the 32 (16%) children with GAS infection, but also 52 (38%) of the 137 children without any evidence of bacterial infection received antibiotics. Additional laboratory studies were done in 96% of children. Serum C-reactive concentrations or white blood cell counts were not able to separate streptococcal from non-streptococcal tonsillitis. No serious bacterial infection was diagnosed. The Finnish Current Care Guidelines lead to over-treatment with antibiotics. None of the 200 children returned after discharge, suggesting that undertreatment did not happen.

ACUTE TONSILLITIS IN CHILDREN: A PEDIATRICIAN’S PERSPECTIVE

научный биометрический журнал, который знакомит читателя с клиническими рекомендациями и особенностями применения лекарственных и вакцинных средств у детей, предоставляет исчерпывающую информацию о воздействии лекарственных средств на плод, о проводимых в

Tonsillotomy: facts and fiction

In contrast to total or extracapsular tonsillectomy (TE), subtotal/intracapsular/partial tonsillectomy (SIPT) or tonsillotomy (TT) is associated with significant less postoperative morbidity. It has been stated that patients older than 8years of age or with a history of tonsillitis should be excluded from SIPT/TT. Some health insurance companies mandate utilization of particular surgical instruments. Finally, it has been stated that the remaining tonsillar tissue may become a subject of recurrent tonsillitis or tonsillar regrowth, in both cases requiring revision surgery in terms of TE. This literature review was undertaken to clarify what has been validated in the literature concerning indications, surgical techniques, complications and outcome of SIPT/TT as reported since 1960. A Medline review was undertaken and all papers included that were published in English or German language until September 30, 2013. Exclusion criteria were: publication date 1960 and earlier, other languages, no relation to tonsil surgery, papers not available to the authors, uncommon surgical techniques, national surveys or studies without patients. The quality of the papers was classified according to "The Oxford 2011 Levels of Evidence". The surgical techniques were classified according to Windfuhr and Werner and extended to interstitial tonsil therapy. Other issues were: study period, hemorrhage, dehydration, intake of analgesics, return to normal diet, surgical instruments, operation time, number of surgeons involved, number of patients, age, indications, follow-up, rate of tonsillar regrowth, tonsillitis and secondary TE. A total of 379 different publications were retrieved, but only 86 studies found eligible for further analysis. There were 10,499 patients in the study groups and 10,448 patients in the control groups. Utilization of the microdebrider largely prevailed, followed by Coblation, CO2-LASER, surgical scissor, Radiofrequency, Interstitial ThermoTherapy with various instruments, Diode-LASER, and other instruments. Instruments were not specified for 1,815 patients. Data for operation time, intraoperative bleeding, return to normal diet, analgesic intake were in favor for SIPT/TT and ablation procedures. Regrowth and tonsillitis occurred in rates of <6% on average. Secondary surgery became necessary in only every third patient of this subgroup. Studies of variable quality impede comparison of all aspects in the papers. At least every second study did not address issues like operation time, intraoperative bleeding, return to normal diet, analgesic intake, rates of tonsillar regrowth, postsurgical tonsillitis and secondary TE. There are insufficient data to show that a single surgical instrument is superior. A history of tonsillitis and an age >8years are definitely not commonly accepted as contraindication for SIPT, TT or ablation procedures. There is a strong evidence that pain is less after SIPT, TT and tonsil ablation resulting in an earlier return to normal diet and activity. Large, well-designed randomized controlled trials with an adequate follow-up are necessary to determine whether the procedure is capable to replace TE to resolve upper airway obstruction resulting from tonsillar hypertrophy as well as recurrent episodes of tonsillitis in children and adults.

До питання етіологічної діагностики тонзилофарингітів у дітей

У статті проведений літературний аналіз сучасного стану проблеми ранньої діагностики тонзилофарингітів у дитячому віці, а саме своєчасної етіологічної діагностики захворювання. Висвітлені питання етіології, епідеміології, клініки, диференціальної діагностики, параклінічної діагностики, напрямки лікування тонзилофарингітів у дітей. Основна увага була приділена літературному огляду проблем і сучасним можливостям швидкої етіологічної діагностики тонзиліту в дітей, а також принципам раціональної антибактеріальної терапії та методам профілактики захворювання з позицій доказової медицини. У роботі наголошується на тому, що особливе значення має рання діагностика стрептококової етіології тонзилофарингіту, яка дозволяє на самому початку захворювання призначити обґрунтовану антибактеріальну терапію. Це призведе до скорочення тривалості хвороби, істотного зниження ризику ранніх ускладнень і значного скорочення періоду заразності пацієнта, що, у свою чергу, знижує ймовірність поширення стрептококової інфекції. Золотим стандартом виявлення β-гемолітичного стрептокока з метою призначення антибактеріальної терапії є стрептотест. Використання експрес-тестових систем у клініці дитячих інфекційних хвороб повинно покращити ранню етіологічну діагностику тонзилофарингітів у дітей і тим самим сприяти своєчасному адекватному призначенню лікування, що в кінцевому результаті має значно знизити ризик розвитку ускладнень та сприяти позитивному економічному ефекту.

Use of Streptococcus salivarius K12 in the prevention of streptococcal and viral pharyngotonsillitis in children

BackgroundStreptococcus salivarius K12 is an oral probiotic strain releasing two lantibiotics (salivaricin A2 and salivaricin B) that antagonize the growth of S. pyogenes, the most important bacterial cause of pharyngeal infections in humans also affected by episodes of acute otitis media. S. salivarius K12 successfully colonizes the oral cavity, and is endowed with an excellent safety profile. We tested its preventive role in reducing the incidence of both streptococcal and viral pharyngitis and/or tonsillitis in children.Materials and methodsWe enrolled 61 children with a diagnosis of recurrent oral streptococcal disorders. Thirty-one of them were enrolled to be treated daily for 90 days with a slow-release tablet for oral use, containing no less than 1 billion colony-forming units/tablet of S. salivarius K12 (Bactoblis®), and the remaining 30 served as the untreated control group. During treatment, they were all examined for streptococcal infection. Twenty children (ten per group) were also assessed in terms of viral infection. Secondary end points in both groups were the number of days under antibiotic and antipyretic therapy and the number of days off school (children) and off work (parents).ResultsThe 30 children who completed the 90-day trial with Bactoblis® showed a significant reduction in their episodes of streptococcal pharyngeal infection (>90%), as calculated by comparing the infection rates of the previous year. No difference was observed in the control group. The treated group showed a significant decrease in the incidence (80%) of oral viral infections. Again, there was no difference in the control group. With regard to secondary end points, the number of days under antibiotic treatment of the treated and control groups were 30 and 900 respectively, days under antipyretic treatment 16 and 228, days of absence from school 16 and 228, and days of absence from work 16 and 228. The product was well tolerated by the subjects, with no side effects, and only one individual reported bad product palatability and dropped out.ConclusionProphylactic administration of S. salivarius K12 to children with a history of recurrent oral streptococcal disease resulted in a considerable reduction of episodes of both streptococcal and viral infections and reduced the number of days under antibiotic and/or antipyretic therapy and days of absence from school or work.

Bacterial Causes Tonsillitis in Children, Study the Resistance to Antimicrobials and the Effect of Clove Extracts on Selected Isolated Bacteria.

In this study Isolated Pathogenic bacteria which causes Tonsillitis in Children with ages between 3-17 years. They are admitted to Central Children Hospital (Al-Karch) and Ebn-Albalady Hospital (Al-Rusafa). 200 cases were collected which include 120 Male and 80 Female. The result of the recent study shows that the isolation percentage was 40% from Male and 35% from Female. In this study Fifty six isolated were Identified, 20 were ?-hemolytic Streptococcus which was Streptococcus pyogenes, formed (36%) from all isolated.6 Pathogenic bacteria were ?- hemolytic Streptococcus which was Streptococcus pneumoniae formed (11%). The number of Moraxella catarrhalis bacteria was 12 formed (21%), the number of Haemophilus influenzae was 10 formed (18%).Whereas the number of Staphylococcus aureus was 8 formed (14%). The Antimicrobial Susceptility test to commonly used Antimicrobial shows that the most isolate Bacteria were sensitive to Antimicrobial ( AMC and CEP ) and Resistance to ( P and E ) with some exception. The Antimicrobial Susceptility test of Staphylococcus aureus to Oxacillin showed the predominant of Oxacillin-Sensitive S. aureus (OSSA) which form 88% whereas the percentage of Oxacillin -Resistant S. aureus (ORSA) was 12%. The effect of crude aqueous and solvent extracts of clove on selected isolated bacteria. Shows the efficiency of clove extracts which gives the biggest inhibition zones by all extracts with efficacy of methanol extract compared with the other solvents extracts. The inhibition zone was 25.2 mm fore Streptococcus pyogenes and the MIC wasMIC was 75?g/ml. 25.6 mm 75?g/ml. 24.8 mm for Streptococcus pneumoniae and For Staphylococcus aureus and MIC was 50?g/ml, whereas the inhibition zone was 22.2 mm and 22.1 mm for Moraxella catarrhalis and Haemophilus influenza respectively and the MIC was 100?g/ml.

Bacterial Causes Tonsillitis in Children, Study the Resistance to Antimicrobials and the Effect of Clove Extracts on Selected Isolated Bacteria.

In this study Isolated Pathogenic bacteria which causes Tonsillitis in Children with ages between 3-17 years. They are admitted to Central Children Hospital (Al-Karch) and Ebn-Albalady Hospital (Al-Rusafa). 200 cases were collected which include 120 Male and 80 Female. The result of the recent study shows that the isolation percentage was 40% from Male and 35% from Female. In this study Fifty six isolated were Identified, 20 were ?-hemolytic Streptococcus which was Streptococcus pyogenes, formed (36%) from all isolated.6 Pathogenic bacteria were ?- hemolytic Streptococcus which was Streptococcus pneumoniae formed (11%). The number of Moraxella catarrhalis bacteria was 12 formed (21%), the number of Haemophilus influenzae was 10 formed (18%).Whereas the number of Staphylococcus aureus was 8 formed (14%). The Antimicrobial Susceptility test to commonly used Antimicrobial shows that the most isolate Bacteria were sensitive to Antimicrobial ( AMC and CEP ) and Resistance to ( P and E ) with some exception. The Antimicrobial Susceptility test of Staphylococcus aureus to Oxacillin showed the predominant of Oxacillin-Sensitive S. aureus (OSSA) which form 88% whereas the percentage of Oxacillin -Resistant S. aureus (ORSA) was 12%. The effect of crude aqueous and solvent extracts of clove on selected isolated bacteria. Shows the efficiency of clove extracts which gives the biggest inhibition zones by all extracts with efficacy of methanol extract compared with the other solvents extracts. The inhibition zone was 25.2 mm fore Streptococcus pyogenes and the MIC wasMIC was 75?g/ml. 25.6 mm 75?g/ml. 24.8 mm for Streptococcus pneumoniae and For Staphylococcus aureus and MIC was 50?g/ml, whereas the inhibition zone was 22.2 mm and 22.1 mm for Moraxella catarrhalis and Haemophilus influenza respectively and the MIC was 100?g/ml.

Острый стрептококковый тонзиллит у ребенка. Вопросы, заданные жизнью (ответы науки на вопросы, заданные практикой)

Проблема острого тонзиллита сохраняет свою актуальность в клинической педиатрии. Особую роль при этом играет β-гемолитический стрептококк группы А (Streptococcus pyogenes), обнаруженный у каждого четвертого ребенка с острым бактериальным тонзиллитом. В статье на примере клинического случая описаны характеристика возбудителя, эпидемиология и прогноз заболевания. Авторами рассмотрены современные критерии диагностики и международные подходы к лечению. Обоснована необходимость применения цефуроксима аксетила при эрадикационной терапии Streptococcus pyogenes.

Cross-sectional survey: risk-averse French GPs use more rapid-antigen diagnostic tests in tonsillitis in children

ObjectivesWe tested the following hypotheses: (1) risk-averse general practitioners (GPs) might use more Rapid Antigen Diagnostic Tests (RADTs) in tonsillitis in children, probably to decrease their diagnostic uncertainty regarding the...