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Year: 2003  Vol. 7   Num. 1  - Jan/Mar Print:
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Pharyngotonsillitis – Clinical and Surgical Aspects
Faringotonsilites - Aspectos Clínicos e Cirúrgicos
Author(s):
Edigar Rezende de Almeida*, Vera Andiara Rezende Campos**, Tania Sih***, Signe Schuster Grasel**.
Key words:
pharyngotonsillitis, tonsils, adenoid tissue.
Abstract:

Introduction: Upper respiratory tract infections are common in humans and have substantial morbidity, having public health and socioeconomic implications. Objective: To review the literature for clinical and surgical aspects relevant for the specialist’s daily practice. Methods: Our goal was to study the frequency of pharyngotonsillitis episodes, the most common causes, emphasizing the correct identification of the etiologic agent and its importance for adequate treatment. We primarily focused on the Group A beta-hemolytic Streptococcus , its prevalence in the general population and angina patients, and its relation to rheumatic fever. The fundamentals of antimicrobial treatment were discussed. Regarding indications of tonsillectomy, we highlighted those which may be questionable or overlooked, and current indications in case of organ transplantation. Conclusions: The non-streptococcal pharyngotonsillitis may be treated with symptomatic drugs, except for specific cases. In streptococcal infections, penicillin remains the first choice, followed by amoxicillin; in failures, amoxicillinclavulanate or first or second generation cephalosporins are employed. In case of penicillin allergy macrolides/ azalydes are used. Surgical indications include patients with enlarged tonsils which may or may not be associated with other diseases like Down’s syndrome, cerebral palsy, obesity with respiratory distress, craniofacial growth anomalies, decreased olfaction and gustation, speech disorders and changes in quality of life, not to forget candidates for liver transplantation with a history of upper respiratory tract infections, as well as patients with systemic diseases aggravated by such infections.

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