RESUMEN
OBJECTIVES/HYPOTHESIS: To investigate causative viruses in patients with postviral olfactory disorders (PVOD). STUDY DESIGN: Case-control study. METHODS: One hundred fifty-one consecutive patients diagnosed with PVOD were enrolled, and samples from 38 patients who visited the doctor within 3 months of symptom onset were collected and analyzed. Thirty-two individuals who underwent surgery for nasal septal deviation during the same time period were collected as the control group. The Sniffin' Sticks psychophysical olfactory test was used to evaluate olfactory function. Olfactory cleft specimens were collected using nasopharyngeal flocked swabs (COPAN FLOQSwabs). Eighteen viruses were tested for with the Luminex xTAG RVP FAST v2 Assay Kit. RESULTS: Out of the 38 patients with PVOD, rhinoviruses were detected in 13 patients, and coronavirus OC43 was detected in one patient. The frequency of positive virus detection in the patients with anosmia was higher than in those with hyposmia (58.8% vs. 19.0%, P = 0.018). In control group, rhinovirus was identified in one patient (3.1%). Nasal obstruction was the most common symptom and was experienced by 71.0% of patients. CONCLUSIONS: Rhinovirus and coronavirus are more commonly identified in PVOD. Our methods represent an approach to screen for viruses that may be involved in PVOD. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:158-164, 2021.
Asunto(s)
Trastornos del Olfato/diagnóstico , Infecciones del Sistema Respiratorio/diagnóstico , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Virus/aislamiento & purificación , Adulto , Anciano , Estudios de Casos y Controles , Coronavirus Humano OC43/genética , Coronavirus Humano OC43/aislamiento & purificación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obstrucción Nasal/diagnóstico , Obstrucción Nasal/virología , Trastornos del Olfato/virología , Infecciones del Sistema Respiratorio/virología , Rhinovirus/genética , Rhinovirus/aislamiento & purificación , Olfato , Virus/genéticaRESUMEN
PURPOSE: To determine the frequency and severity of general and ear nose throat (ENT)- related symptoms, especially smell and/or loss of sense of taste (STL) in COVID-19 disease, as well as to investigate the recovery process of STL. MATERIALS AND METHODS: Patients with a positive COVID-19 diagnosis were given a questionnaire consisting of general questions (age, sex, date of symptoms, smoking history, concomitant diseases), questions about the most obvious symptom at presentation (one option only), the severity and frequency of symptoms (general and ENT), and STL (recovery time and degree of recovery). RESULTS: The study population consisted of 172 patients, 18-65 years old (mean age, 37.8 ± 12.5 years; 51.2% female; 76.2% nonsmokers). Cough (n = 30, 17.4%) and loss of sense of smell (n = 18, 10.4%) were the most obvious general and ENT symptoms, respectively. Eighty-eight patients (51.2%) reported loss of sense of smell, and 81 patients (47.1%) reported loss of sense of taste. The mean recovery times for loss of sense of smell and loss of sense of taste were 8.02 ± 6.41 and 8.20 ± 7.07 days, respectively. The loss of sense of smell and loss of sense of taste were the unique symptoms in four (4.54%) and one (1.23%) patients, respectively. CONCLUSION: STL is a common symptom in COVID-19 and may be the first and/or only symptom of this disease. In patients presenting with STL complaints, surveillance for possible COVID-19 disease and screening tests will facilitate the struggle against the disease.
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Infecciones por Coronavirus/complicaciones , Trastornos del Olfato/virología , Neumonía Viral/complicaciones , Trastornos del Gusto/virología , Adolescente , Adulto , Anciano , Betacoronavirus , COVID-19 , Tos/virología , Dolor Facial/virología , Fatiga/virología , Femenino , Fiebre/virología , Cefalea/virología , Humanos , Masculino , Persona de Mediana Edad , Mialgia/virología , Obstrucción Nasal/virología , Pandemias , Recuperación de la Función , SARS-CoV-2 , Fumar/epidemiología , Factores de Tiempo , Adulto JovenRESUMEN
BACKGROUND: Clinical features of pandemic H1N1 have been derived from lab-confirmed, hospitalized, or critically ill subjects. This report describes the clinical features of H1N1 and their prevalence from non-confirmed subjects according to seroprevalence status in México. The objective was to determine the prevalence of these clinical features from non-confirmed cases of pandemic H1N1 and to compare them according to seroprevalence status in northern Monterrey, México, during 2009, and to identify the predictive signs and symptoms; there have been no prior serologic studies in México. METHODS: During November-December 2009, 2,222 volunteers, ages 6-99 years, were categorized into 3 symptomatic groups: influenza-like illness, respiratory illness, and non-respiratory illness. Antibodies against influenza A/H1N1/2009 were determined by a virus-free enzyme-linked immunosorbent assay (ELISA) method. Demographics and clinical presentation were assessed through face-to-face questionnaire, and the association with seroprevalence status was determined and compared. RESULTS: Overall seroprevalence was 39%. Of the seropositive subjects, 67% were symptomatic and 33% were asymptomatic. Seventy-one percent of seropositive symptomatic subjects reported respiratory illness, 17% reported non-respiratory symptoms, and 12% reported influenza-like illness. The most common symptoms were rhinorrhea/nasal congestion (93%) and headache (83%). No significant difference was found between the symptom profiles of the seropositive group, compared to the seronegative one, nor of the median duration of symptoms. The seropositive group had a significantly elevated proportion of influenza-like illness (12%), compared to the seronegative group (8%). The proportion of subjects who took days off and who sought medical attention was significantly higher in the seropositive group. No single symptom was associated as a predictor of seropositiveness. CONCLUSIONS: One third of the seropositive subjects were asymptomatic, and few had an influenza-like illness. No difference was found in the symptom profiles of the seropositive and seronegative groups. No single symptom predicted seropositiveness. Large scale population studies are needed, especially in México, to characterize clinical syndromes.
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Infecciones Asintomáticas/epidemiología , Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Artralgia/epidemiología , Artralgia/virología , Niño , Femenino , Cefalea/epidemiología , Cefalea/virología , Humanos , Gripe Humana/fisiopatología , Gripe Humana/virología , Masculino , México/epidemiología , Persona de Mediana Edad , Dolor Musculoesquelético/epidemiología , Dolor Musculoesquelético/virología , Obstrucción Nasal/epidemiología , Obstrucción Nasal/virología , Aceptación de la Atención de Salud/estadística & datos numéricos , Enfermedades Respiratorias/epidemiología , Enfermedades Respiratorias/virología , Estudios Seroepidemiológicos , Ausencia por Enfermedad/estadística & datos numéricos , Encuestas y Cuestionarios , Adulto JovenRESUMEN
PROBLEM: Post-transplant lymphoproliferative disorders (PTLD) are a potentially fatal complication after solid organ transplantation. The majority of cases are associated with Epstein Barr virus infection (EBV). The first manifestations of PTLD are frequently observed in the ENT area with adenoidal and/or tonsillar enlargement. METHODOLOGY: We present the case of a 12-year old girl with a total nasal obstruction and tonsillitis five months after a kidney transplantation for bilateral congenital kidney hypoplasia. RESULTS: The EBV genome was detected by polymerase reaction three months after surgery. Fiberoptic examination revealed an obstructive necrotic mass in the naso-pharynx. The anatomic-pathologic analysis revealed necrotic adenoids. CONCLUSIONS: Necrotic tonsillitis is common. Necrosis of the adenoids, although rarer, can also occur and explains the important respiratory distress. Since two thirds of PTLD patients present with clinical symptoms in the ENT area, the otorhinolaryngologist should be aware of this complication.
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Tonsila Faríngea/patología , Mononucleosis Infecciosa/inmunología , Trasplante de Riñón , Obstrucción Nasal/virología , Aciclovir/administración & dosificación , Antivirales/administración & dosificación , Niño , Infecciones por Virus de Epstein-Barr/inmunología , Resultado Fatal , Femenino , Humanos , Mononucleosis Infecciosa/virología , Trasplante de Riñón/inmunología , Imagen por Resonancia Magnética , Obstrucción Nasal/patología , Necrosis , Infecciones por Pneumocystis/inmunologíaRESUMEN
OBJECTIVE: Causative viruses of postviral olfactory dysfunction (PVOD) have not yet been identified. The aim of this study was to investigate causative viruses in patients with PVOD. STUDY DESIGN AND METHODS: Nasal discharge was collected from 24 patients with PVOD. We investigated the presence of 10 viruses in nasal discharge and examined the time course, with regard to changes in olfactory dysfunction and nasal obstruction in patients with PVOD, using questionnaires, acoustic rhinometry, and olfactory tests. RESULTS: Rhinoviruses were detected in 10 patients by electrophoresis. Rhinoviruses were also confirmed in four patients by nucleotide sequences. Viral serotypes were identified to be human rhinovirus (HRV)-40, HRV-75, HRV-78, and HRV-80. One of the four patients complained of anosmia, whereas another complained of dysosmia. Olfactory testing did not show significant improvement at 4, 8, 11, and 24 weeks after the first visit in the four patients, although results of acoustic rhinometry significantly improved. Two of the four patients complained of olfactory dysfunction even 6 months after the first visit. Coronavirus and parainfluenza virus were detected in one patient each, and Epstein-Barr viruses were detected in three patients. CONCLUSIONS: This study for the first time detected rhinovirus, coronavirus, parainfluenza virus, and Epstein-Barr virus in nasal discharge of patients with PVOD. Furthermore, the present study suggests that rhinoviruses can cause olfactory dysfunction through mechanisms other than nasal obstruction and that rhinoviruses can induce various severities and different time courses of olfactory dysfunction.
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Trastornos del Olfato/virología , Rhinovirus/clasificación , Adolescente , Adulto , Anciano , Niño , Coronavirus/aislamiento & purificación , Femenino , Estudios de Seguimiento , Herpesvirus Humano 4/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Moco/virología , Obstrucción Nasal/fisiopatología , Obstrucción Nasal/virología , Trastornos del Olfato/fisiopatología , Infecciones del Sistema Respiratorio/virología , Respirovirus/aislamiento & purificación , Rinitis/virología , Rinometría Acústica , Serotipificación , Olfato/fisiologíaRESUMEN
Susceptible ferrets intranasally infected with influenza virus consistently responded with maximal nasal secretion of virus, febrile reaction, and influx of inflammatory cells into nasal lumen on day 2 post infection (d.p.i.). Polymorphonuclear leucocytes were the earliest predominant cell, followed by monocytes/macrophages while lymphocytes were maintained as a minor population throughout the 7-day period. Nasal congestion level, continuously monitored by computer aided active anterior rhinomanometry, was reproducibly maximal at 2 d.p.i., diminished in intensity the next day and returned to the basal level within 7 d.p.i. Nasal congestion was effectively relieved by a single intranasal dose of 0.1% oxymetazoline or 0.2% phenylephrine, or a single intragastric administration of pseudoephedrine. Intranasal delivery of a single dose of 1% pyrilamine relieved nasal congestion while 0.8% ipratropium bromide and 30% cimetidine were ineffective. These results suggested that nasal congestion is regulated by alpha-adrenergic receptors in the mucosal vasculature or by H1 histamine receptor, but is unaffected by inhibitors of nasal secretion regulated by the cholinergic nervous system. The present study indicates that the infectious rhinitis ferret model provides a reproducible nasal congestion pattern that can be objectively measured by a refined active anterior rhinomanometric system. This labour intensive measurement, however, makes it difficult either to conduct a large population animal study or to use it for a rapid throughput screening of new drugs. The temporal relation between the influx of inflammatory cells into the nasal lumen and the onset of nasal congestion underlies the model's relevance to the exploration of the pathogenic mechanism(s) during viral rhinitis.