Asunto(s)
Faringitis/diagnóstico , Faringitis/tratamiento farmacológico , Guías de Práctica Clínica como Asunto , Infecciones Estreptocócicas/diagnóstico , Infecciones Estreptocócicas/tratamiento farmacológico , Tonsilitis/diagnóstico , Tonsilitis/tratamiento farmacológico , Enfermedad Aguda , Adolescente , Antibacterianos/uso terapéutico , Niño , Preescolar , Farmacorresistencia Bacteriana , Femenino , Humanos , Masculino , Faringitis/microbiología , Faringitis/virología , Factores de Riesgo , Tonsilitis/microbiología , Tonsilitis/virologíaRESUMEN
The role of human adenovirus (HAdV) infection in different acute diseases, such as febrile exudative tonsillitis, conjunctivitis, and pharyngoconjunctival fever is well established. However, the relationships, if any, of HAdV persistence and reactivation in the development of the chronic adenotonsillar disease is not fully understood. The present paper reports a 3-year cross-sectional hospital-based study aimed at detecting and quantifying HAdV DNA and mRNA of the HAdV hexon gene in adenoid and palatine tonsil tissues and nasopharyngeal secretions (NPS) from patients with adenotonsillar hypertrophy or recurrent adenotonsillitis. HAdV C, B, and E were detectable in nearly 50% of the patients, with no association with the severity of airway obstruction, nor with the presence of recurrent tonsillitis, sleep apnea or otitis media with effusion (OME). Despite the higher rates of respiratory viral coinfections in patients with HAdV, the presence of other viruses, including DNA and RNA viruses, had no association with HAdV replication or shedding in secretions. Higher HAdV loads in adenoids showed a significant positive correlation with the presence of sleep apnea and the absence of OME. Although this study indicates that a significant proportion (~85%) of individuals with chronic adenotonsillar diseases have persistent nonproductive HAdV infection, including those by HAdV C, B, and E, epithelial and subepithelial cells in tonsils seem to be critical for HAdV C production and shedding in NPS in some patients, since viral antigen was detected in these regions by immunohistochemistry in four patients, all of which were also positive for HAdV mRNA detection.
Asunto(s)
Tonsila Faríngea/virología , Infecciones por Adenovirus Humanos/virología , Tonsila Palatina/virología , Replicación Viral , Tonsila Faríngea/patología , Infecciones por Adenovirus Humanos/diagnóstico , Adenovirus Humanos/clasificación , Adenovirus Humanos/aislamiento & purificación , Adenovirus Humanos/fisiología , Adolescente , Niño , Preescolar , Estudios Transversales , ADN Viral/aislamiento & purificación , Femenino , Humanos , Hipertrofia , Lactante , Masculino , Tonsila Palatina/patología , Tonsilitis/virologíaRESUMEN
INTRODUCTION: Epstein-Barr Virus (EBV) infection prevails in underdeveloped and developing countries. The tonsils seem to be candidate replication sites for EBV and some studies have exposed a close association among viral infections and chronic tonsillitis. The objective of this study was identifying the EBV prevalence in Mexican patients who had undergone tonsillectomy because of chronic tonsillitis. METHODOLOGY: Frozen tissues and medical records were obtained from 50 Mexican patients. DNA was extracted and subjected to PCR to amplify the EBER-2 region of EBV. Next, the patients were classified according to general and clinical characteristics searching a relation with the EBV-DNA positivity. RESULTS: EBV genome was detected in 46% (23/50) of the analysed tonsil tissues. Trends were found regarding the relationship of viral presence with lower values in terms of age (6.1 ± 2.8 vs 7.6 ± 3.7) , a greater degree of hypertrophy (3.5 ± 0.4 vs 3.0 ± 0.6) and an increase in the number of episodes of tonsillitis (11 ± 7.4 vs 9 ± 6.5). CONCLUSIONS: The prevalence found of EBV-DNA positivity in tonsillar tissues from patients diagnosed with chronic tonsillitis , supports the fact that palatine tonsils can be occupied by EBV and highlights the importance of conducting future studies focused on understanding the role of the EBV infection in chronic inflammatory processes in the population involved in this study.
Asunto(s)
ADN Viral/análisis , Infecciones por Virus de Epstein-Barr/epidemiología , Infecciones por Virus de Epstein-Barr/virología , Herpesvirus Humano 4/aislamiento & purificación , Tonsila Palatina/virología , Tonsilitis/epidemiología , Tonsilitis/virología , Adolescente , Niño , Preescolar , Enfermedad Crónica , ADN Viral/genética , Femenino , Herpesvirus Humano 4/genética , Humanos , Lactante , Recién Nacido , Masculino , México/epidemiología , Reacción en Cadena de la Polimerasa , PrevalenciaRESUMEN
Chronic tonsillar diseases are an important health problem, leading to large numbers of surgical procedures worldwide. Little is known about pathogenesis of these diseases. In order to investigate the role of respiratory viruses in chronic adenotonsillar diseases, we developed a cross-sectional study to determine the rates of viral detections of common respiratory viruses detected by TaqMan real time PCR (qPCR) in nasopharyngeal secretions, tonsillar tissues and peripheral blood from 121 children with chronic tonsillar diseases, without symptoms of acute respiratory infections. At least one respiratory virus was detected in 97.5% of patients. The viral co-infection rate was 69.5%. The most frequently detected viruses were human adenovirus in 47.1%, human enterovirus in 40.5%, human rhinovirus in 38%, human bocavirus in 29.8%, human metapneumovirus in 17.4% and human respiratory syncytial virus in 15.7%. Results of qPCR varied widely between sample sites: human adenovirus, human bocavirus and human enterovirus were predominantly detected in tissues, while human rhinovirus was more frequently detected in secretions. Rates of virus detection were remarkably high in tonsil tissues: over 85% in adenoids and close to 70% in palatine tonsils. In addition, overall virus detection rates were higher in more hypertrophic than in smaller adenoids (pâ=â0.05), and in the particular case of human enteroviruses, they were detected more frequently (pâ=â0.05) in larger palatine tonsils than in smaller ones. While persistence/latency of DNA viruses in tonsillar tissues has been documented, such is not the case of RNA viruses. Respiratory viruses are highly prevalent in adenoids and palatine tonsils of patients with chronic tonsillar diseases, and persistence of these viruses in tonsils may stimulate chronic inflammation and play a role in the pathogenesis of these diseases.
Asunto(s)
Tonsila Faríngea/virología , Tonsila Palatina/virología , Tonsilitis/virología , Virosis/virología , Tonsila Faríngea/patología , Adenovirus Humanos/genética , Adolescente , Niño , Preescolar , Enfermedad Crónica , ADN Viral/genética , Femenino , Bocavirus Humano/genética , Humanos , Lactante , Masculino , Tonsila Palatina/patología , Virus ARN/genética , ARN Viral/genética , Reacción en Cadena en Tiempo Real de la Polimerasa , Tonsilitis/epidemiología , Tonsilitis/genética , Tonsilitis/patología , Virosis/epidemiología , Virosis/genética , Virosis/patologíaRESUMEN
UNLABELLED: Recurrent tonsillitis has been the subject of frequent investigation. Misuse of antibiotic therapy in acute tonsillitis, changes to the tonsillar microflora, structural changes to the tonsillar crypts, and viral infections have been listed as predisposing or causal factors for recurrent tonsillitis. Epstein-Barr virus (EBV) infection usually occurs in early childhood and may persist in tonsillar lymphocytes, thus leading to the onset of recurrent tonsillitis. Little is known about the persistence and reactivation of EBV strains in immunocompetent patients. Methods such as in situ hybridization, polymerase chain reaction (PCR), and immunochemistry have been used to study the pathogenesis of the EBV. AIM: this study aims to characterize the association between EBV and recurrent tonsillitis by investigating the presence of EBV through PCR and immunohistochemistry, using viral protein LMP-1 as a target. STUDY DESIGN: this is a cross-sectional study with analysis of sample prevalence. MATERIALS AND METHOD: twenty-four paraffin-embedded tonsil specimens from the Pathology Service were selected. The specimens were removed from children aged between 2 and 12 years diagnosed with recurrent tonsillitis. RESULTS: EBV genome was detected in 13 (54.1%) specimens, whereas viral protein LMP-1 was found in 9 (37.5%) specimens. CONCLUSION: children's tonsils can be colonized by EBV and such colonies may be associated with the pathogenesis of recurrent tonsillitis.
Asunto(s)
ADN Viral/análisis , Infecciones por Virus de Epstein-Barr/diagnóstico , Herpesvirus Humano 4/aislamiento & purificación , Tonsilitis/virología , Proteínas de la Matriz Viral/análisis , Niño , Preescolar , Estudios Transversales , Femenino , Herpesvirus Humano 4/genética , Humanos , Inmunohistoquímica , Masculino , Reacción en Cadena de la Polimerasa , Recurrencia , Tonsilitis/cirugíaRESUMEN
As tonsilites recorrentes têm sido objeto de muitos estudos. Eventos considerados na predisposição e causa incluem a utilização errônea de antibióticos em crises agudas, alterações da microflora, mudanças estruturais nas criptas epiteliais tonsilares e infecções virais. A infecção pelo vírus Epstein-Barr (EBV) ocorre freqüentemente na infância persistindo em linfócitos de tonsilas, podendo causar tonsilites recorrentes. Pouco se conhece sobre a persistência e reativação do EBV em pacientes imunocompetentes. Alguns métodos como a hibridização in situ, a reação em cadeia da polimerase (PCR) e a imuno-histoquímica têm sido utilizados no estudo da patogenia do vírus. OBJETIVO: Para caracterizar a associação do vírus Epstein-Barr com tonsilites recorrentes examinamos a presença do EBV pela PCR e por imuno-histoquímica usando como alvo a proteína viral LMP-1. FORMA DE ESTUDO: Estudo transversal com análise de prevalência amostral. MATERIAL E MÉTODOS: Foram selecionados 24 blocos parafinados de tonsilas, provenientes do Serviço de Anatomia Patológica, removidas de crianças de 2 a 12 anos com diagnóstico de tonsilite recorrente. Resultados: O genoma do EBV foi detectado em 13 (54,1%) e a LMP-1 em 9 (37,5%) dos casos. CONCLUSÃO: As tonsilas das crianças podem ser colonizadas pelo EBV e este pode estar associado à patogenia das tonsilites recorrentes.
Recurrent tonsillitis has been the subject of frequent investigation. Misuse of antibiotic therapy in acute tonsillitis, changes to the tonsillar microflora, structural changes to the tonsillar crypts, and viral infections have been listed as predisposing or causal factors for recurrent tonsillitis. Epstein-Barr virus (EBV) infection usually occurs in early childhood and may persist in tonsillar lymphocytes, thus leading to the onset of recurrent tonsillitis. Little is known about the persistence and reactivation of EBV strains in immunocompetent patients. Methods such as in situ hybridization, polymerase chain reaction (PCR), and immunochemistry have been used to study the pathogenesis of the EBV. AIM: this study aims to characterize the association between EBV and recurrent tonsillitis by investigating the presence of EBV through PCR and immunohistochemistry, using viral protein LMP-1 as a target. STUDY DESIGN: this is a cross-sectional study with analysis of sample prevalence. MATERIALS AND METHOD: twenty-four paraffin-embedded tonsil specimens from the Pathology Service were selected. The specimens were removed from children aged between 2 and 12 years diagnosed with recurrent tonsillitis. RESULTS: EBV genome was detected in 13 (54.1%) specimens, whereas viral protein LMP-1 was found in 9 (37.5%) specimens. CONCLUSION: children's tonsils can be colonized by EBV and such colonies may be associated with the pathogenesis of recurrent tonsillitis.
Asunto(s)
Niño , Preescolar , Femenino , Humanos , Masculino , ADN Viral/análisis , Infecciones por Virus de Epstein-Barr/diagnóstico , /aislamiento & purificación , Tonsilitis/virología , Proteínas de la Matriz Viral/análisis , Estudios Transversales , /genética , Inmunohistoquímica , Reacción en Cadena de la Polimerasa , Recurrencia , Tonsilitis/cirugíaRESUMEN
OBJECTIVE: Herpes simplex virus (HSV) has been described as cause of acute tonsillitis. It has also been found in nasopharyngeal florid lymphoid infiltrate, mostly composed of CD4+, CD56+ T-cells, simulating lymphoma. In spite of its widespread prevalence in latent form, to the best of our knowledge no study is available on in situ detection of HSV in chronically hyperplastic nasopharyngeal lymphoid tissue. The purpose of the present study was to search for the presence of HSV 1 and 2 in 21 adenoids and 15 tonsils from children (2-12 years of age) in which these organs had been surgically removed due to hypertrophy. METHODS: Paraffin wax-embedded sections from the 36 cases were submitted to the in situ hybridization technique, using the biotinilated probe to Herpes simplex virus 1 and 2 (Pan Path, Amsterdam) and the Rembrandt Universal DISH & HRP Detection Kit (Pan Path, Amsterdam). Positive control consisted of a previously tested Herpes infected lung. RESULTS: In none of the 36 cases studied were positive nuclei detected in adenoid and tonsils, either in lymphoid, in stroma or in epithelial cells, as those seen in the positive control. CONCLUSION: HSV does not seem to be implied in tonsil or adenoid chronic lymphoid hyperplasia. These organs do not seem to harbor the virus latently, or the amount of virus is too low to be detected without amplification methods.
Asunto(s)
Tonsila Faríngea/inmunología , Tonsila Faríngea/virología , Antígenos CD4/inmunología , Antígeno CD56/inmunología , Herpes Simple/complicaciones , Herpes Simple/inmunología , Herpesvirus Humano 1/inmunología , Herpesvirus Humano 2/inmunología , Hibridación in Situ/métodos , Tonsilitis/inmunología , Tonsilitis/virología , Tonsila Faríngea/patología , Niño , Preescolar , Femenino , Humanos , Hiperplasia/inmunología , Hiperplasia/patología , Tejido Linfoide/inmunología , Tejido Linfoide/patología , Masculino , Nasofaringe/inmunología , Nasofaringe/patología , Tonsilitis/patologíaRESUMEN
Recurrent tonsillitis has been the subject of much investigation. Events considered to predispose to or cause recurrent tonsillitis (RT) include the misuse of antibiotic therapy in acute bouts, alterations in the microflora, structural changes in crypt epithelium and certain viral infections. Epstein-Barr Virus (EBV) infection usually occurs in early childhood and can persist in palatine tonsil lymphocytes to induce tonsillitis at a later date. We have examined the presence of EBV in palatine tonsils in order to assess the relationship between this virus and recurrent acute tonsillitis. Tonsils were obtained from 85 patients, 2--14 years old (mean 5.6 years old) who underwent tonsils and adenoid (T&A) removal because of recurrent tonsillitis (RT) or T&A hypertrophy (TH). Tissues specimens were processed for non-isotopic in situ hybridization (ISH) using EBER 1/2 oligonucleotides (EBER RNA). The indications for surgery were RT in 42 patients and TH in 43 patients. In 25 out of 85 cases (29.4%) a positive EBER RNA reaction (15 RT and 33 TH) was found. The chi(2)-test showed no statistically significant difference in frequency of positive results between RT and TH group. We conclude that tonsils of children can be colonized by EBV and that the virus may be implicated in RT and TH.
Asunto(s)
Infecciones por Virus de Epstein-Barr/diagnóstico , Herpesvirus Humano 4/aislamiento & purificación , Tonsila Palatina/virología , Tonsilitis/patología , Tonsilitis/virología , Adolescente , Niño , Preescolar , Técnicas de Cultivo , Femenino , Humanos , Hibridación in Situ , Masculino , Reacción en Cadena de la Polimerasa , Recurrencia , Sensibilidad y Especificidad , Tonsilectomía , Tonsilitis/cirugíaRESUMEN
Several diseases was associated with Epstein Barr virus (EBV) infection. In the next three cases, the clinical course was unusual . Case I: Polyclonal hypergammaglobulinemia, female 47 years old, she had systemic lupus erythematosus and clinical data of infectious mononucleosis but she evolved to a polyclonal gammopathy with IgM predominantly against EBV. Case II: Demyelinating encephalitis, male, 32 years old with central neurological alterations, IgM antibodies against EBV and demyelinating lesion in magnetic resonance image in brain steam. Case III. Villous leukoplakia, male, 40 years old developed right tonsil tumor. He had IgM antibodies against EBV. The antiviral and immunomodulator treatment (specific for each case) done a satisfactory clinical response in the three patients.