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Mayer M, Esser J, Walker SV, Shabli S, Lechner A, Canis M, Klussmann JP, Nachtsheim L, Wolber P. Bi-institutional analysis of microbiological spectrum and therapeutic management of parotid abscesses. Head Face Med 2024; 20:38. [PMID: 38997761 PMCID: PMC11241904 DOI: 10.1186/s13005-024-00438-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 06/21/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND A parotid abscess (PA) is a complication of an acute bacterial parotitis with a potentially life-threatening course. To date, data on the diagnosis and therapy of PA is sparse and mostly consists of case reports or case series. Therefore, this study aimed at comprehensively analyzing the microbiological spectrum and the therapeutic management in a bi-institutional setting. METHODS A retrospective clinical chart review was performed to identify all patients surgically treated for PA at two tertiary care centers in Germany. Data on demographics, clinical management and microbiological data including species identification, pathogenicity, type of antibiotic therapy, adjustment of antibiotics, antibiotic sensitivity testing, and smear test results were extracted. Intervention-related variables and etiology were analyzed for their statistical association with outcome variables. RESULTS Overall, 85 patients were included. Most patients (92.9%) underwent surgical incision. Around half of the patients (45.9%) were treated under local anesthesia. No facial nerve palsy was observed. The most frequently detected pathogens were Streptococci (n = 23), followed by Staphylococcus aureus (n = 6) including one case of methicillin-resistant Staphylococcus aureus. Most patients (68.2%) received an aminopenicillin ± beta-lactamase inhibitor as empiric antibiotic therapy. In 6 cases the antibiotic therapy was modified after receiving the antibiogram. Four patients (5.2%) presented with recurrent PA. Etiology was idiopathic (42.4%), followed by tumorous (12.9%), obstructive, and immunosuppressive (each 11.8%). Patients with a dental focus (p = 0.007) had a longer duration of hospitalization. CONCLUSION The results show that the surgical therapy of PA under local anesthesia is safe. A dental examination should routinely be performed to rule out a dental focus. Obtaining a microbiological specimen in order to modify antibiotic therapy if necessary and a histopathological specimen to rule out a tumorous etiology is obligate.
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Affiliation(s)
- Marcel Mayer
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany.
| | - Julia Esser
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Sarah Victoria Walker
- Institute for Medical Microbiology, Immunology and Hygiene, Medical Faculty, University of Cologne, Cologne, Germany
- Institute for Clinical Microbiology and Hospital Hygiene, RKH Regionale Kliniken Holding Und Services GmbH, Ludwigsburg, Germany
| | - Sami Shabli
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Axel Lechner
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Munich, Munich, Germany
| | - Martin Canis
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Munich, Munich, Germany
| | - Jens Peter Klussmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Lisa Nachtsheim
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
| | - Philipp Wolber
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany
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2
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El Omri M, Jemli S, Belakhdher M, Kermani W. Neonatal Suppurative Parotitis: Case Report and Review of Literature. EAR, NOSE & THROAT JOURNAL 2024:1455613241234281. [PMID: 38476055 DOI: 10.1177/01455613241234281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024] Open
Abstract
Neonatal suppurative parotitis is a rare condition that is diagnosed primarily through clinical evaluation. The prognosis is generally good. In this report, we present the case of a 21-day-old female infant who was treated in our ENT department for neonatal suppurative parotitis. The patient presented with a feverish, hard, red, and tender swelling of the parotid loge which displaced the right earlobe outward. In addition, purulent exudate was observed from Stensen's duct. A computed tomography scan of the cervical and cerebral regions revealed a swollen right parotid gland with heterogeneous density and enhancement, but no detectable collection. The patient received intravenous antibiotics for 48 hours, resulting in a favorable outcome without the need for surgical treatment. The aim of this study is to emphasize the diagnostic and therapeutic aspects of this clinical condition. Suppurative parotitis should be suspected by the clinician in newborns who present with an inflammatory preauricular swelling, with or without contributing factors. The outcome is generally favorable, and complications are rare with timely and appropriate medical treatment.
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Affiliation(s)
- Malika El Omri
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia
| | - Safaa Jemli
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia
- Ear Nose and Throat Department and Cervical Surgery, Farhat Hached Hospital, Medicine University, Sousse, Tunisia
| | - Mouna Belakhdher
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia
- Ear Nose and Throat Department and Cervical Surgery, Farhat Hached Hospital, Medicine University, Sousse, Tunisia
| | - Wassim Kermani
- Department of Ear, Nose, Throat and Head and Neck Surgery, Farhat Hached University Hospital, Sousse, Tunisia
- Ear Nose and Throat Department and Cervical Surgery, Farhat Hached Hospital, Medicine University, Sousse, Tunisia
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3
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Cochran J, Gottfried J, Chernichenko N, Walvekar RR, Butts SC. Traumatic Injuries of the Parotid Gland and Duct. Otolaryngol Clin North Am 2023; 56:1027-1038. [PMID: 37369609 DOI: 10.1016/j.otc.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
This review will focus on the key steps in the recognition of parotid gland and duct injuries focusing on the important steps needed at the initial assessment. Management planning is presented in the way that trauma surgeons interact with patients, highlighting the important parts of the informed consent conversation followed by the key information that must be communicated to the anesthesia and operating room teams, which ensures proper monitoring and equipment needs are in place. Short-term and long-term outcomes for patients with persistent sequelae of the trauma and their management are reviewed.
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Affiliation(s)
- James Cochran
- Department of Otolaryngology, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Box 126, Brooklyn, NY 11203, USA
| | - Jennifer Gottfried
- SUNY Downstate Health Sciences University-College of Medicine, 450 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - Natalya Chernichenko
- Department of Otolaryngology, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Box 126, Brooklyn, NY 11203, USA; Department of Otolaryngology-Kings County Hospital Center, 451 Clarkson Avenue, Brooklyn, NY 11203, USA
| | - Rohan R Walvekar
- Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, 533 Bolivar Street, Suite 566, New Orleans, LA 70112, USA
| | - Sydney C Butts
- Department of Otolaryngology, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Box 126, Brooklyn, NY 11203, USA; Department of Otolaryngology-Kings County Hospital Center, 451 Clarkson Avenue, Brooklyn, NY 11203, USA.
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4
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Easter QT, Matuck BF, Warner BM, Byrd KM. Biogeographical Impacts of Dental, Oral, and Craniofacial Microbial Reservoirs. J Dent Res 2023; 102:1303-1314. [PMID: 37731320 DOI: 10.1177/00220345231191115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
The human mouth, or oral cavity, is at the crossroads of our external and internal environments, and it is increasingly evident that local colonization of dental, oral, and craniofacial (DOC) tissues and cells by bacteria and viruses may also have systemic effects across myriad diseases and disorders. Better understanding of this phenomenon will require a holistic understanding of host-microbial interactions in both spatiotemporal and biogeographical contexts while also considering person-, organ-, tissue-, cell-, and molecular-level variation. After the acute phase interaction with microbes, the establishment of site-specific reservoirs constitutes an important relationship to understand within the human body; however, despite a preliminary understanding of how viral reservoirs originate and persist across the human body, the landscape of single-cell and spatial multiomic tools has challenged our current understanding of what cells and niches can support microbial reservoirs. The lack of complete understanding impacts research into these relevant topics and implementing precision care for microbial-induced or microbial-influenced diseases. Here, via the lens of acute and chronic microbial infections of the DOC tissues, the goal of this review is to highlight and link the emerging spatiotemporal biogeography of host-viral interactomics at 3 levels: (1) DOC cell types in distinct tissues, (2) DOC-associated microbes, and (3) niche-specific DOC pathologies. Further, we will focus on the impact of postacute infectious syndromes such as long COVID, neurodegenerative disorders, and other underappreciated postviral conditions. We will provide hypotheses about how DOC tissues may play roles systemically in these conditions. Throughout, we will underscore how COVID-19 has catalyzed a new understanding of these biological questions, discuss future directions to study these phenomena, and highlight the utility of noninvasive oral biofluids in screening, monitoring, and intervening to prevent and/or ameliorate human infectious diseases.
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Affiliation(s)
- Q T Easter
- Lab of Oral & Craniofacial Innovation (LOCI), Department of Innovation & Technology Research, ADA Science & Research Institute, Gaithersburg, MD, USA
| | - B Fernandes Matuck
- Lab of Oral & Craniofacial Innovation (LOCI), Department of Innovation & Technology Research, ADA Science & Research Institute, Gaithersburg, MD, USA
| | - B M Warner
- Salivary Disorders Unit, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - K M Byrd
- Lab of Oral & Craniofacial Innovation (LOCI), Department of Innovation & Technology Research, ADA Science & Research Institute, Gaithersburg, MD, USA
- Salivary Disorders Unit, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
- Division of Oral & Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, NC, USA
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5
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Liljekvist MS, Foghsgaard J, Howitz MF. Sialendoscopy for pediatric salivary gland disorders: a study of safety and effect. Eur Arch Otorhinolaryngol 2023; 280:1927-1937. [PMID: 36478117 DOI: 10.1007/s00405-022-07747-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 11/07/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE Sialendoscopy has become the preferred modality for managing pediatric salivary gland disorders (PSGD) including juvenile recurrent parotitis (JRP) and sialolithiasis. The literature remains sparse, but several case series have reported good outcomes and few complications. The aim of this study was to investigate the safety and efficacy of sialendoscopy for PSGD in a Danish setting. METHODS From a national sialendoscopy database, we included records of children who had undergone sialendoscopy for PSGD at our clinic over a 6-year period. Clinical and intraoperative data, follow-up and e-mail surveys after 1, 3 and 5 years were retrieved for analysis. RESULTS We included 52 procedures on 50 glands (32 parotid, 18 submandibular) in 49 children. Of eligible patients, 90% attended clinical follow-up, 80% answered the survey after 1 year, 80% after 3 years and 60% after 5 years. JRP was diagnosed in 33 cases, obstructive causes in 18 cases. Complications noted were ductal perforation (2%), transient lingual nerve affection (4%) and infection (2%). For JRP patients, overall symptoms had improved for 96% after 3 months, 81% after 1 year and 83% after 3 years. For patients suffering from obstruction, overall symptoms were improved for 93% after 3 months and for 100% after 1 year. CONCLUSION Sialendoscopy is a safe procedure for PSGD, and effective for sialolithiasis and symptom reduction in JRP.
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Affiliation(s)
- Mads S Liljekvist
- Department of Ear, Nose, and Throat, Nordsjællands Hospital, Hillerød, Denmark.
| | - Jakob Foghsgaard
- Department of Ear, Nose, and Throat, Nordsjællands Hospital, Hillerød, Denmark
| | - Michael F Howitz
- Department of Ear, Nose, and Throat, Nordsjællands Hospital, Hillerød, Denmark
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6
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Kim D, Jeong YJ, Lee Y, Choi J, Park YM, Kwon OC, Ji YW, Ahn SJ, Lee HK, Park MC, Lim JY. Correlation Between Salivary Microbiome of Parotid Glands and Clinical Features in Primary Sjögren's Syndrome and Non-Sjögren's Sicca Subjects. Front Immunol 2022; 13:874285. [PMID: 35603219 PMCID: PMC9114876 DOI: 10.3389/fimmu.2022.874285] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
Recent studies have demonstrated that the oral microbiome in patients with Sjögren’s syndrome (SS) is significantly different from that in healthy individuals. However, the potential role of the oral microbiome in SS pathogenesis has not been determined. In this study, stimulated intraductal saliva samples were collected from the parotid glands (PGs) of 23 SS and nine non-SS subjects through PG lavage and subjected to 16S ribosomal RNA amplicon sequencing. The correlation between the oral microbiome and clinical features, such as biological markers, clinical manifestations, and functional and radiological characteristics was investigated. The salivary microbial composition was examined using bioinformatic analysis to identify potential diagnostic biomarkers for SS. Oral microbial composition was significantly different between the anti-SSA-positive and SSA-negative groups. The microbial diversity in SS subjects was lower than that in non-SS sicca subjects. Furthermore, SS subjects with sialectasis exhibited decreased microbial diversity and Firmicutes abundance. The abundance of Bacteroidetes was positively correlated with the salivary flow rate. Bioinformatics analysis revealed several potential microbial biomarkers for SS at the genus level, such as decreased Lactobacillus abundance or increased Streptococcus abundance. These results suggest that microbiota composition is correlated with the clinical features of SS, especially the ductal structures and salivary flow, and that the oral microbiome is a potential diagnostic biomarker for SS.
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Affiliation(s)
- Donghyun Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
| | - Ye Jin Jeong
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea
| | - Yerin Lee
- Yonsei University College of Medicine, Seoul, South Korea
| | - Jihoon Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea.,Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Min Park
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea.,Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Oh Chan Kwon
- Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.,Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Yong Woo Ji
- Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.,Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung Jun Ahn
- Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.,Department of Radiology, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyung Keun Lee
- Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.,Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, South Korea
| | - Min-Chan Park
- Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.,Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jae-Yol Lim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea.,Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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7
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Saibene AM, Allevi F, Ayad T, Lechien JR, Mayo-Yáñez M, Piersiala K, Chiesa-Estomba CM. Treatment for parotid abscess: a systematic review. ACTA OTORHINOLARYNGOLOGICA ITALICA 2022; 42:106-115. [PMID: 35612503 PMCID: PMC9132006 DOI: 10.14639/0392-100x-n1837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/30/2022] [Indexed: 12/02/2022]
Abstract
A parotid abscess is a dangerous complication of parotitis. In this study, we aimed to define current treatment concepts for parotid abscess, focusing on different management options. The authors performed a PRISMA-compliant systematic review across multiple databases including all original studies published until January 2021 focusing on treatment of parotid abscess. Studies specifying treatment modalities and treatment success rates were included based on abstract and full-text selection. The authors assessed study quality, demographics, success rates, management modalities and adverse events. Among 1,318 citations, 18 studies met our inclusion criteria. Twelve studies relied only on incision and drainage with antibiotic therapy; the remaining 6 compared different treatment modalities (incision and drainage versus exclusive medical therapy or ultrasound-guided drainage). Heterogeneity between studies precluded meta-analysis of data. The review showed that antibiotics remain the mainstay of treatment for parotid abscess. Conversely, the role of incision and drainage, and aspiration should be studied further. The higher rate of complications following incision and drainage suggests a more conservative approach is needed. Incision and drainage remain the main salvage option for conservative treatment failures.
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8
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Oral Lesions in Children and Adolescents. Pediatr Dent 2022. [DOI: 10.1007/978-3-030-78003-6_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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9
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Kim M, Lee SW, Kim J, Shin Y, Chang F, Kim JM, Cong X, Yu GY, Park K. LPS-induced epithelial barrier disruption via hyperactivation of CACC and ENaC. Am J Physiol Cell Physiol 2021; 320:C448-C461. [PMID: 33471620 DOI: 10.1152/ajpcell.00295.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Gram-negative bacterial lipopolysaccharide (LPS) increases the susceptibility of cells to pathogenic diseases, including inflammatory diseases and septic syndrome. In our experiments, we examined whether LPS induces epithelial barrier disruption in secretory epithelia and further investigated its underlying mechanism. The activities of Ca2+-activated Cl- channels (CACC) and epithelial Na+ channels (ENaC) were monitored with a short-circuit current using an Ussing chamber. Epithelial membrane integrity was estimated via transepithelial electrical resistance and paracellular permeability assays. We found that the apical application of LPS evoked short-circuit current (Isc) through the activation of CACC and ENaC. Although LPS disrupted epithelial barrier integrity, this was restored with the inhibition of CACC and ENaC, indicating the role of CACC and ENaC in the regulation of paracellular pathways. We confirmed that LPS, CACC, or ENaC activation evoked apical membrane depolarization. The exposure to a high-K+ buffer increased paracellular permeability. LPS induced the rapid redistribution of zonula occludens-1 (ZO-1) and reduced the expression levels of ZO-1 in tight junctions through apical membrane depolarization and tyrosine phosphorylation. However, the LPS-induced epithelial barrier disruption and degradation of ZO-1 were largely recovered by blocking CACC and ENaC. Furthermore, although LPS-impaired epithelial barrier became vulnerable to secondary bacterial infections, this vulnerability was prevented by inhibiting CACC and ENaC. We concluded that LPS induces the disruption of epithelial barrier integrity through the activation of CACC and ENaC, resulting in apical membrane depolarization and the subsequent tyrosine phosphorylation of ZO-1.
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Affiliation(s)
- Minkyoung Kim
- Department of Physiology, School of Dentistry, Seoul National University and Dental Research Institute, Seoul, South Korea
| | - Sang-Woo Lee
- Department of Physiology, School of Dentistry, Seoul National University and Dental Research Institute, Seoul, South Korea
| | - Junchul Kim
- Department of Physiology, School of Dentistry, Seoul National University and Dental Research Institute, Seoul, South Korea
| | - Yonghwan Shin
- Department of Physiology, School of Dentistry, Seoul National University and Dental Research Institute, Seoul, South Korea
| | - Fengjiao Chang
- Department of Physiology, School of Dentistry, Seoul National University and Dental Research Institute, Seoul, South Korea
| | - Jin Man Kim
- Department of Physiology, School of Dentistry, Seoul National University and Dental Research Institute, Seoul, South Korea
| | - Xin Cong
- Department of Physiology and Pathophysiology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Guang-Yan Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - Kyungpyo Park
- Department of Physiology, School of Dentistry, Seoul National University and Dental Research Institute, Seoul, South Korea
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Lindburg M, Ogden MA. Infectious Sialadenitis. CURRENT OTORHINOLARYNGOLOGY REPORTS 2021. [DOI: 10.1007/s40136-020-00315-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Suh HB, Kim HJ. Platysma Infiltration on CT or MRI in Parotid Pathology. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2021; 82:152-161. [PMID: 36237469 PMCID: PMC9432418 DOI: 10.3348/jksr.2020.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/18/2020] [Accepted: 06/23/2020] [Indexed: 11/25/2022]
Abstract
목적 CT나 MRI에서 이하선의 양성종양, 악성종양 및 염증 질환에서 나타나는 활경근 침윤의 빈도와 어떤 상황에서 잘 일어나는지 그 조건을 알아보고자 하였다. 대상과 방법 이하선에서 발생한 양성종양 314명, 악성종양 52명 그리고 염증 22명을 대상으로 하였다. CT나 MRI에서 활경근 침윤의 빈도 및 병변의 위치, 피막침범 유무, 국소성에 따른 활경근 침윤 유무를 후향적으로 알아보았다. 결과 활경근 침윤의 빈도는 양성종양에서 0%, 악성종양에서 19.2% (10/52), 염증 환자에서 50% (11/22)였다. 피막을 침범한 염증 환자 13명 중 10명에서 활경근 침윤을 보였다. 활경근 침윤을 보인 염증 환자 11명 중 10명이 미만성을, 1명은 국소성을 보였다. 활경근 침윤을 보인 악성종양 총 10명 모두에서 피막을 침범하였으며, 그중 미만성 병변이 7명, 국소성이 3명이었다. 결론 이하선 질환에서 활경근 침윤은 악성종양보다 염증 질환에서 더 흔하게 일어났다. 염증 질환에서의 활경근 침윤은 이하선 피막을 침범하거나 미만성 병변일 경우 더 잘 나타났다.
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Affiliation(s)
- Hie Bum Suh
- Department of Radiology, Pusan National University College of Medicine, Pusan National University Hospital, Busan, Korea
| | - Hak Jin Kim
- Department of Radiology, Pusan National University College of Medicine, Pusan National University Hospital, Busan, Korea
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Tang S, Huang Y, Zheng J. Salivary Excretion of Renal-Clearable Silver Nanoparticles. Angew Chem Int Ed Engl 2020; 59:19894-19898. [PMID: 32705738 PMCID: PMC8635779 DOI: 10.1002/anie.202008416] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/18/2020] [Indexed: 11/05/2022]
Abstract
Salivary elimination is an important pathway for the body to excrete small molecules with digestive enzymes. However, very few engineered nanoparticles can be excreted through salivary glands, which often host bacteria or viruses during infection and involve in disease transmission. Herein, we report that renal clearable glutathione coated AgNPs (GS-AgNPs) can selectively accumulate in the submandibular salivary gland, followed by being excreted in its excretory duct. By conducting head-to-head comparison on in vivo transport and interactions of both GS-AgNPs and glutathione coated gold nanoparticles (GS-AuNPs) with the same sizes, we found that low-density GS-AgNPs showed much higher vascular permeability than GS-AuNPs and can rapidly penetrate into submandibular salivary glands, be efficiently taken up by striated and excretory duct cells, and eventually secreted into saliva.
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Affiliation(s)
- Shaoheng Tang
- Department of Chemistry, The University of Texas at Dallas, 800 W. Campbell Rd., Richardson, TX 75080 (USA)
| | - Yingyu Huang
- Department of Chemistry, The University of Texas at Dallas, 800 W. Campbell Rd., Richardson, TX 75080 (USA)
| | - Jie Zheng
- Department of Chemistry, The University of Texas at Dallas, 800 W. Campbell Rd., Richardson, TX 75080 (USA)
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14
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Peritonsillar abscess may not always be a complication of acute tonsillitis: A prospective cohort study. PLoS One 2020; 15:e0228122. [PMID: 32243441 PMCID: PMC7122714 DOI: 10.1371/journal.pone.0228122] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/09/2020] [Indexed: 11/19/2022] Open
Abstract
The present study aimed to specify diagnostics for peritonsillar abscesses (PTAs) and to clarify the role of minor salivary glands. This prospective cohort study included 112 patients with acute tonsillitis (AT) and PTA recruited at a tertiary hospital emergency department between February and October 2017. All patients completed a questionnaire concerning their current disease. Serum amylase (S-Amyl) and C-reactive protein (S-CRP) levels, tonsillar findings, and pus aspirate samples and throat cultures were analyzed. Eight of 58 PTA patients (13.8%) had no signs of tonsillar infection. The absence of tonsillar erythema and exudate was associated with low S-CRP (p<0.001) and older age (p<0.001). We also observed an inverse correlation between S-Amyl and S-CRP levels (AT, r = -0.519; PTA, r = -0.353). Therefore, we observed a group of PTA patients without signs of tonsillar infection who had significantly lower S-CRP levels than other PTA patients. These findings support that PTA may be caused by an etiology other than AT. Variations in the S-Amyl levels and a negative correlation between S-Amyl and S-CRP levels may indicate that minor salivary glands are involved in PTA development.
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Olzowy B, Al-Nawas B, Havel M, Karbach J, Müller R. Calculated parenteral initial treatment of bacterial infections: Infections in the ear, nose, throat and mouth and jaw area. GMS INFECTIOUS DISEASES 2020; 8:Doc14. [PMID: 32373439 PMCID: PMC7186809 DOI: 10.3205/id000058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This is the sixth chapter of the guideline "Calculated initial parenteral treatment of bacterial infections in adults - update 2018" in the 2nd updated version. The German guideline by the Paul-Ehrlich-Gesellschaft für Chemotherapie e.V. (PEG) has been translated to address an international audience. The chapter deals with the antibacterial treatment of more severe infections of the ear, the nose, the throat and the maxillofacial region, including odontogenic and salivary gland infections.
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Affiliation(s)
| | - Bilal Al-Nawas
- Klinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätsmedizin Mainz, Germany
| | - Miriam Havel
- Klinik und Poliklinik für HNO-Heilkunde, Klinikum der Universität München, Munich, Germany
| | - Julia Karbach
- Klinik für Mund-, Kiefer- und Gesichtschirurgie, Universitätsmedizin Mainz, Germany
| | - Rainer Müller
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Carl Gustav Carus Dresden, Germany
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Acute Bacterial Parotitis in Adult Hematologic Malignancy. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2019. [DOI: 10.1097/ipc.0000000000000764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Vivino FB, Bunya VY, Massaro-Giordano G, Johr CR, Giattino SL, Schorpion A, Shafer B, Peck A, Sivils K, Rasmussen A, Chiorini JA, He J, Ambrus JL. Sjogren's syndrome: An update on disease pathogenesis, clinical manifestations and treatment. Clin Immunol 2019; 203:81-121. [PMID: 31022578 DOI: 10.1016/j.clim.2019.04.009] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 04/19/2019] [Indexed: 12/23/2022]
Affiliation(s)
- Frederick B Vivino
- Penn Sjögren's Center, Penn Presbyterian Medical Center, University of Pennsylvania Perelman School of Medicine, 3737 Market Street, Philadelphia, PA 19104, USA.
| | - Vatinee Y Bunya
- Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine, 51 N. 39(th) Street, Philadelphia, PA 19104, USA.
| | - Giacomina Massaro-Giordano
- Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine, 51 N. 39(th) Street, Philadelphia, PA 19104, USA.
| | - Chadwick R Johr
- Penn Sjögren's Center, Penn Presbyterian Medical Center, University of Pennsylvania Perelman School of Medicine, 3737 Market Street, Philadelphia, PA 19104, USA.
| | - Stephanie L Giattino
- Penn Sjögren's Center, Penn Presbyterian Medical Center, University of Pennsylvania Perelman School of Medicine, 3737 Market Street, Philadelphia, PA 19104, USA.
| | - Annemarie Schorpion
- Penn Sjögren's Center, Penn Presbyterian Medical Center, University of Pennsylvania Perelman School of Medicine, 3737 Market Street, Philadelphia, PA 19104, USA.
| | - Brian Shafer
- Scheie Eye Institute, University of Pennsylvania Perelman School of Medicine, 51 N. 39(th) Street, Philadelphia, PA 19104, USA.
| | - Ammon Peck
- Department of Infectious Diseases and Immunology, University of Florida College of Veterinary Medicine, PO Box 100125, Gainesville, FL 32610, USA.
| | - Kathy Sivils
- Oklahoma Medical Research Foundation, Arthritis and Clinical Immunology Program, 825 NE 13th Street, OK 73104, USA.
| | - Astrid Rasmussen
- Oklahoma Medical Research Foundation, Arthritis and Clinical Immunology Program, 825 NE 13th Street, OK 73104, USA.
| | - John A Chiorini
- NIH, Adeno-Associated Virus Biology Section, National Institute of Dental and Craniofacial Research, Building 10, Room 1n113, 10 Center DR Msc 1190, Bethesda, MD 20892-1190, USA.
| | - Jing He
- Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing 100044, China
| | - Julian L Ambrus
- Division of Allergy, Immunology and Rheumatology, SUNY at Buffalo School of Medicine, 100 High Street, Buffalo, NY 14203, USA.
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Elewa YHA, Mizoguchi T, Ichii O, Nakamura T, Kon Y. Morphofunctional analysis of antigen uptake mechanisms following sublingual immunotherapy with beads in mice. PLoS One 2018; 13:e0201330. [PMID: 30571699 PMCID: PMC6301667 DOI: 10.1371/journal.pone.0201330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 12/03/2018] [Indexed: 11/19/2022] Open
Abstract
Background Recently, sublingual immunotherapy (SLIT) has been used as a safe and efficient method for the treatment of and immunization against asthma and various allergies. However, the routes of antigen/allergen (particulate antigen) uptake through the mucosa of the oral cavity remain incompletely understood, as do the roles of sex and age in the process. For this purpose, to elucidate the mechanism and efficacy of SLIT among different sexes and ages, microbeads were dripped into the sublingual region to mimic particulate antigen uptake by the sublingual mucosa. Methods Twenty microliters of either phosphate buffered saline (PBS) or fluorescently labelled microbeads (latex and silica beads) were placed under the tongue of both male and female C57BL/6 mice at young (3 months) and old (6 months) ages. The lower jaw was examined 30 min after administration, and beads were detected with a fluorescence stereomicroscope. Morphological observations of the mucosa of the fluorescent areas were made with a scanning electron microscope (SEM) and an all-in-one light fluorescence microscope (LM). Fluorescence intensity was compared between both sexes and ages. Results Stereomicroscopic observation revealed fluorescent illuminations in three compartments of the sublingual mucosa: the sublingual caruncles (SC), the oral rostral mucosa (OR) and the buccal mucosa (BM). Interestingly, the fluorescence intensity tended to be higher among females than among males in the SC region in particular. However, there were no significant age-related differences. SEM and LM revealed beads in the lumina of both mandibular ducts and sublingual ducts (Sd). Additionally, the apical cytoplasm of some Sd cells contained silica beads. However, there was no specification in the OR mucosa or BM. Conclusions This study reveals the major role Sd plays in local immunity via the antigen uptake mechanisms. Furthermore, our data suggest that the efficacy of SLIT in humans could be affected by sex.
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Affiliation(s)
- Yaser Hosny Ali Elewa
- Department of Histology and Cytology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
- Faculty of Veterinary Medicine, Basic Veterinary Sciences, Laboratory of Anatomy, Hokkaido University, Sapporo, Japan
- * E-mail: ,
| | - Tatsuya Mizoguchi
- Faculty of Veterinary Medicine, Basic Veterinary Sciences, Laboratory of Anatomy, Hokkaido University, Sapporo, Japan
| | - Osamu Ichii
- Faculty of Veterinary Medicine, Basic Veterinary Sciences, Laboratory of Anatomy, Hokkaido University, Sapporo, Japan
| | - Teppei Nakamura
- Faculty of Veterinary Medicine, Basic Veterinary Sciences, Laboratory of Anatomy, Hokkaido University, Sapporo, Japan
- Section of Biological Science, Chitose Laboratory, Japan Food Research Laboratories, Chitose, Japan
| | - Yasuhiro Kon
- Faculty of Veterinary Medicine, Basic Veterinary Sciences, Laboratory of Anatomy, Hokkaido University, Sapporo, Japan
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Kessler AT, Bhatt AA. Review of the Major and Minor Salivary Glands, Part 1: Anatomy, Infectious, and Inflammatory Processes. J Clin Imaging Sci 2018; 8:47. [PMID: 30546931 PMCID: PMC6251248 DOI: 10.4103/jcis.jcis_45_18] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 10/06/2018] [Indexed: 11/18/2022] Open
Abstract
The major and minor salivary glands of the head and neck are important structures that contribute to many of the normal physiologic processes of the aerodigestive tract. The major salivary glands are routinely included within the field of view of standard neuroimaging, and although easily identifiable, salivary pathology is relatively rare and often easy to overlook. Knowledge of the normal and abnormal imaging appearance of the salivary glands is critical for forming useful differential diagnoses, as well as initiating proper clinical workup for what are often incidental findings. The purpose of this review is to provide a succinct image-rich article illustrating relevant anatomy and pathology of the salivary glands via an extensive review of the primary literature. In Part 1, we review anatomy as well as provide an in-depth discussion of the various infectious and inflammatory processes that can affect the salivary glands.
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Affiliation(s)
- Alexander T Kessler
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Alok A Bhatt
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York, USA
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Salivary calculi microbiota: new insights into microbial networks and pathogens reservoir. Microbes Infect 2018; 21:109-112. [PMID: 30385304 DOI: 10.1016/j.micinf.2018.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 10/11/2018] [Accepted: 10/15/2018] [Indexed: 11/22/2022]
Abstract
Sialolithiasis represents the most common disorders of salivary glands in middle-aged patients. It has been hypothesized that the retrograde migration of bacteria from the oral cavity to gland ducts may facilitate the formation of stones. Thus, in the present study, a microbiome characterization of salivary calculi was performed to evaluate the abundance and the potential correlations between microorganisms constituting the salivary calculi microbiota. Our data supported the presence of a core microbiota of sialoliths constituted principally by Streptococcus spp., Fusobacterium spp. and Eikenella spp., along with the presence of important pathogens commonly involved in infective sialoadenitis.
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Bugshan A, Farag AM, Desai B. Oral Complications of Systemic Bacterial and Fungal Infections. Atlas Oral Maxillofac Surg Clin North Am 2017; 25:209-220. [PMID: 28778309 DOI: 10.1016/j.cxom.2017.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Amr Bugshan
- Division of Oral Medicine, Department of Diagnostic Sciences, Tufts University School of Dental Medicine, 1 Kneeland Street, 6th Floor, Boston, MA 02111, USA; Collage of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Kingdom of Saudi Arabia.
| | - Arwa M Farag
- Division of Oral Medicine, Department of Diagnostic Sciences, Tufts University School of Dental Medicine, 1 Kneeland Street, 6th Floor, Boston, MA 02111, USA; Department of Oral Medicine, Faculty of Dentistry, King AbdulAziz University, 1 Umm Al Muminin Road, Jeddah 21589, Kingdom of Saudi Arabia
| | - Bhavik Desai
- Division of Oral Medicine, Department of Diagnostic Sciences, Tufts University School of Dental Medicine, 1 Kneeland Street, 6th Floor, Boston, MA 02111, USA
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Schrøder SA, Bardow A, Eickhardt-Dalbøge S, Johansen HK, Homøe P. Is parotid saliva sterile on entry to the oral cavity? Acta Otolaryngol 2017; 137:762-764. [PMID: 28125321 DOI: 10.1080/00016489.2016.1272002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
CONCLUSION The present study indicates that parotid saliva is sterile on entry to the oral cavity. OBJECTIVES The objective was to investigate if parotid saliva is sterile on entry to the oral cavity and, thus, prior to contamination by oral bacteria. METHOD Forty healthy volunteers were included in sterile parotid saliva collection. Parotid saliva was collected using a sterile Lashley cup, placed over the papilla of the Stensen´s duct, as well as sterile tubes and syringes for collection. All collections were followed by collection of a positive control sample where some of the sterile obtained parotid saliva had been exposed to the contralateral mucosal membranes. All samples parotid saliva, as well as the positive controls, were cultivated, and 10 randomly selected parotid saliva samples underwent polymerase chain reaction (PCR) analyses. RESULTS In 33 of 40 parotid saliva samples there were no cultivable bacteria, whereas bacteria were cultivated in all positive control samples. In eight of 10 PCR samples no bacterial DNA was detected. The most frequent bacteria in the remaining non-sterile parotid saliva samples and positive control samples were non-haemolytical streptococci and the coagulase negative staphylococci.
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Affiliation(s)
- Stine A. Schrøder
- Department of Otorhinolaryngology, Nordsjaellands University Hospital, Hillerød, Denmark
| | - Allan Bardow
- Department of Oral Medicine, Dental School of Copenhagen, University of Copenhagen, Copenhagen N, Denmark
| | - Steffen Eickhardt-Dalbøge
- Costerton Biofilm Center, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark
| | - Helle K. Johansen
- Department of Clinical Microbiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen Ø, Denmark
| | - Preben Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
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Antimicrobial susceptibility of bacterial isolates from patients presenting with ear, nose and throat (ENT) infections in the German community healthcare setting. Eur J Clin Microbiol Infect Dis 2017; 36:1685-1690. [PMID: 28429163 DOI: 10.1007/s10096-017-2985-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 04/05/2017] [Indexed: 10/19/2022]
Abstract
Empiric initial antibiotic therapy of bacterial infections is based primarily upon the susceptibility of the most common causative pathogens. The purpose of this study was to provide susceptibility data on six bacterial species known to cause ear, nose and throat (ENT) infections. A total of 1066 isolates collected during a nationwide laboratory-based surveillance study were analysed. All Streptococcus pyogenes isolates were penicillin (PEN)-susceptible, indicating that natural penicillins can still be recommended as the first-line treatment for group A streptococcal tonsillopharyngitis. Of the S. pneumoniae isolates, 92.9% were PEN-susceptible and of the Haemophilus influenzae isolates, 89.7% were amoxicillin-susceptible, retaining aminopenicillins as the first-line treatment for acute otitis media (AOM) and acute rhinosinusitis (ARS), in case antibiotic therapy is considered. In contrast, cefuroxime axetil seems less likely to be suitable for the treatment of AOM or ARS, as all Moraxella catarrhalis and >99% of the H. influenzae isolates were categorised as intermediate or resistant. The susceptibility rates of Pseudomonas aeruginosa were 97-100% for the drugs tested, except for the fluoroquinolones (87.6%). Overall, bacterial isolates from outpatients presenting with ENT infections showed low frequencies of resistance in Germany. However, given the emergence of multidrug resistance to standard antibiotics in Escherichia coli and other pathogens, inappropriate use of broad-spectrum antibiotics for the treatment of ENT infections has to be avoided.
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Abstract
Staphylococcus aureus, although generally identified as a commensal, is also a common cause of human bacterial infections, including of the skin and other soft tissues, bones, bloodstream, and respiratory tract. The history of S. aureus treatment is marked by the development of resistance to each new class of antistaphylococcal antimicrobial drugs, including the penicillins, sulfonamides, tetracyclines, glycopeptides, and others, complicating therapy. S. aureus isolates identified in the 1960s were sometimes resistant to methicillin, a ß-lactam antimicrobial active initially against a majority S. aureus strains. These MRSA isolates, resistant to nearly all ß-lactam antimicrobials, were first largely confined to the health care environment and the patients who attended it. However, in the mid-1990s, new strains, known as community-associated (CA-) MRSA strains, emerged. CA-MRSA organisms, compared with health care-associated (HA-) MRSA strain types, are more often susceptible to multiple classes of non ß-lactam antimicrobials. While infections caused by methicillin-susceptible S. aureus (MSSA) strains are usually treated with drugs in the ß-lactam class, such as cephalosporins, oxacillin or nafcillin, MRSA infections are treated with drugs in other antimicrobial classes. The glycopeptide drug vancomycin, and in some countries teicoplanin, is the most common drug used to treat severe MRSA infections. There are now other classes of antimicrobials available to treat staphylococcal infections, including several that have been approved after 2009. The antimicrobial management of invasive and noninvasive S. aureus infections in the ambulatory and in-patient settings is the topic of this review. Also discussed are common adverse effects of antistaphylococcal antimicrobial agents, advantages of one agent over another for specific clinical syndromes, and the use of adjunctive therapies such as surgery and intravenous immunoglobulin. We have detailed considerations in the therapy of noninvasive and invasive S. aureus infections. This is followed by sections on specific clinical infectious syndromes including skin and soft tissue infections, bacteremia, endocarditis and intravascular infections, pneumonia, osteomyelitis and vertebral discitis, epidural abscess, septic arthritis, pyomyositis, mastitis, necrotizing fasciitis, orbital infections, endophthalmitis, parotitis, staphylococcal toxinoses, urogenital infections, and central nervous system infections.
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Medical Management for the Treatment of Nontuberculous Mycobacteria Infection of the Parotid Gland: Avoiding Surgery May Be Possible. Case Rep Med 2016; 2016:4324525. [PMID: 27340407 PMCID: PMC4908259 DOI: 10.1155/2016/4324525] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 04/21/2016] [Indexed: 11/17/2022] Open
Abstract
Infection with nontuberculous mycobacteria (NTM) is uncommon in the head and neck; therefore there is no clear consensus on treating these infections. Our objective was to report our experience with a unique case of NTM infection of the parotid in an immunocompetent patient, in order to determine appropriate management through our experience with this pathology. A 57-year-old man, known for numerous comorbid diseases, presented to our institution complaining of right parotid swelling and pain. A computed tomography (CT) of the neck showed a multiloculated collection in the inferior portion of the right parotid gland, compatible with abscess formation. This abscess was drained by interventional radiology (IR) but required repeat drainage twice due to lack of initial improvement. He was treated with several antibiotics as culture results initially indicated Gram-positive bacilli and then Mycobacterium species, with final identification by a reference laboratory as Mycobacterium abscessus. Imipenem was initiated with amikacin and clarithromycin. His infection clinically and radiologically resolved after 5 months of antibiotherapy. In our case, the patient improved following intravenous antibiotic therapy. Our experience demonstrates that appropriate antibiotherapy can lead to resolution of Mycobacterium abscessus infection in the parotid without the risks associated with surgical intervention.
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Nagai Y, Shiraishi D, Tanaka Y, Nagasawa Y, Ohwada S, Shimauchi H, Aso H, Endo Y, Sugawara S. Transportation of sublingual antigens across sublingual ductal epithelial cells to the ductal antigen-presenting cells in mice. Clin Exp Allergy 2015; 45:677-86. [PMID: 24773115 DOI: 10.1111/cea.12329] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 11/29/2013] [Accepted: 03/07/2014] [Indexed: 01/10/2023]
Abstract
BACKGROUND Sublingual immunotherapy (SLIT) has proven to be safe and efficient for the treatment of type I allergies. However, the mechanisms underlying allergen transportation within the sublingual compartment, the localization of antigens, and the identities of the cells responsible for this immunization remain incompletely understood. OBJECTIVE In this study, we focused on the sublingual ductal system and analysed the localization and transportation of antigens after their sublingual application. METHODS In mice given adjuvant-free antigens sublingually, tissues were removed at 0, 0.5, 1, or 2 h after the application and subjected to immunohistochemistry. Cells isolated from the sublingual duct and mucosa were analysed by flow cytometry. RESULTS Substantial immunoreactivity to ovalbumin (OVA) was evident in sublingual ductal epithelial cells at 30 min and 1 h after sublingual administration of OVA, but it had disappeared at 2 h. The ductal epithelial cells incorporated not only OVA, but also particulate antigens such as latex or silica beads and microbes. MHC class II (MHCII)(+) antigen-presenting cells (APCs) were located around the sublingual ductal system, and MHCII(+) cells were co-localized with, and around, antigen-incorporated sublingual duct cells. CD11b(+) CD11c(-) cells were present among CD45(+) MHCII(+) cells at greater frequency in the sublingual duct than in the sublingual mucosa, and they were the main contributors to the incorporation of OVA in vitro. CONCLUSIONS AND CLINICAL RELEVANCE This study reveals that sublingual antigens can be transported across sublingual ductal epithelial cells to the ductal APCs. If the system is the same in humans as in mice, the ductal APCs may prove to be important target cells for SLIT.
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Affiliation(s)
- Y Nagai
- Division of Oral Immunology, Department of Oral Biology, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Deep neck infections originating from the major salivary glands. Am J Otolaryngol 2015; 36:559-64. [PMID: 25630849 DOI: 10.1016/j.amjoto.2015.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 01/06/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Before the widespread use of antibiotics, most deep neck infections (DNIs) stemmed from complicated pharyngeal infections. Nowadays, they seem to be due mainly to dental infections. In 2010, our group reported that DNIs originated from a major salivary gland in 14% of cases. The main endpoint of the present investigation was to review our experience of the diagnosis and treatment of DNIs of salivary gland origin. We also compared the characteristics of DNIs originating from salivary glands with those originating elsewhere. METHODS Between 2000 and 2011, 44 patients were treated for DNIs of salivary origin at our institution. These patients were compared with 191 cases of DNI diagnosed as having other sites of origin. RESULTS/CONCLUSIONS In the present series, DNIs originating from a major salivary gland accounted for 19% of all cases of DNI of known origin. Patients with DNI of salivary gland origin were more likely to be elderly than those whose DNI originated from elsewhere (p=0.000). Our multivariate statistical model showed that comorbidities (p=0.051, statistical trend) and the need for surgical treatment (p=0.028) independently predicted long-term hospitalization for DNIs originating from a major salivary gland.
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Coutaz M. Acute Bacterial Parotitis in the Frail Elderly Subject: A Harbinger of Death? J Am Med Dir Assoc 2014; 15:369-70. [DOI: 10.1016/j.jamda.2014.01.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 01/29/2014] [Indexed: 11/16/2022]
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Shetty PV, Kannappan O, Sarma YS. Salivary gland nocardiosis in an immunocompetent patient. Asian J Surg 2012; 34:99-101. [PMID: 21723475 DOI: 10.1016/s1015-9584(11)60028-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Revised: 12/24/2010] [Accepted: 04/14/2011] [Indexed: 10/28/2022] Open
Abstract
We report a case of nocardiosis in an immunocompetent patient who presented with pain and multiple swellings in the face. Nocardia asteroides was isolated from the parotid and submandibular salivary glands. The patient was successfully treated by surgical drainage and oral administration of trimethoprim and sulfamethoxazole. To the best of our knowledge, this is the first reported case from India on N. asteroides affecting the salivary gland.
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Affiliation(s)
- Prashanth V Shetty
- Department of General Surgery, Kasturba Medical College, Manipal, Karnataka, India.
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Makhoul J, Lorrot M, Teissier N, Delacroix G, Doit C, Bingen E, Faye A. [Acute bacterial parotitis in infants under 3 months of age: a retrospective study in a pediatric tertiary care center]. Arch Pediatr 2011; 18:1284-9. [PMID: 22000273 DOI: 10.1016/j.arcped.2011.08.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Revised: 06/28/2011] [Accepted: 08/31/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND Acute bacterial parotitis is a rare infectious disease in infants under 3 months of age. OBJECTIVES To describe the clinical characteristics and the course of acute bacterial parotitis in infants less than 3 months old. PATIENTS AND METHODS Infants under 3 months of age, hospitalized at Robert Debré university hospital, Paris, France, between January 2005 and December 2009 for acute bacterial parotitis, were included in a retrospective study. RESULTS Five infants less than 3 months of age were included in this study, for a frequency of 2.5/1000 hospitalizations in this age group. All were born at term, 4 of 5 were male. Three of the 5 patients had specific clinical signs of parotitis on admission. One patient had septic shock on admission. The ultrasound confirmed the parotitis in all cases. No parotid abscess was demonstrated on imaging. All patients had at least one abnormal inflammatory biological test (WBC, CRP, PCT). Bacteria were identified in 4 of 5 cases: Staphylococcus aureus was isolated in the pus culture of the Stenon duct in 2 patients and a group B Streptococcus was isolated from blood culture of 2 other patients. The duration of intravenous antibiotic therapy varied from 4 to 13 days, and the total duration of antibiotic therapy was between 10 and 16 days. No surgical procedures were needed. CONCLUSION Acute bacterial parotitis in infants under 3 months of age might be associated with localized infections due to S. aureus, but also with a more severe clinical presentation due to group B streptococcus infection. Early diagnosis and appropriate antibiotic therapy might prevent the progression to serious complications.
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Affiliation(s)
- J Makhoul
- Service pédiatrie générale, pôle de pédiatrie aiguë et médecine interne, hôpital Robert Debré, Paris, France
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[A parotitis as primary infection of Lemierre's syndrome]. ACTA ACUST UNITED AC 2011; 30:692-5. [PMID: 21764250 DOI: 10.1016/j.annfar.2010.11.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Accepted: 11/25/2010] [Indexed: 11/22/2022]
Abstract
Lemierre's syndrome is a classical presentation of human necrobacillosis. It is characterized by a primary infection in the face including a septic thrombophlebitis of the internal jugular vein and disseminated metastatic abcesses. Fusobacterium necrophorum is the main pathogen found in that syndrome. The diagnosis is based on clinical features, then on the microbiology with positive anaerobic blood cultures as key role and finally on the computed tomography. Most of the time a well-chosen antibiotic treatment against anaerobic pathogens and Gram negative bacilli is efficient but surgery can be useful. We report a case of a 73 years old man, which seems to be unique because it is the first case reported of a Lemierre's syndrome characterized by a parotitis infected by F. necrophorum.
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Alauzet C, Marchandin H, Lozniewski A. New insights into Prevotella diversity and medical microbiology. Future Microbiol 2011; 5:1695-718. [PMID: 21133690 DOI: 10.2217/fmb.10.126] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
In light of recent studies based on cultivation-independent methods, it appears that the diversity of Prevotella in human microbiota is greater than was previously assumed from cultivation-based studies, and that the implication of these bacteria in several human diseases was unrecognized. While some Prevotella taxa were found during opportunistic infections, changes in Prevotella abundance and diversity were discovered during dysbiosis-associated diseases. As member of the microbiota, Prevotella may also be considered as a reservoir for resistance genes. Greater knowledge on Prevotella diversity, as well as new insights into its pathogenic potential and implication in dysbiosis are expected from the use of human microbe identification microarrays, from whole-genome sequence analyse, and from the NIH Human Microbiome Project data. New approaches, including molecular-based methods, could contribute to improve the diagnosis of Prevotella infections.
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Affiliation(s)
- Corentine Alauzet
- Laboratoire de Bactériologie, EA 4369, Faculté de Médecine, Nancy Université, Vandoeuvre-les-Nancy, France
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Maier H. Sialadenitis und Sialolithiasis. HNO 2010; 58:198-9. [DOI: 10.1007/s00106-009-2073-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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