scholarly journals Paediatric Autoimmune Neuropsychiatric Disorder Associated with Group A Beta-Haemolytic Streptococcal Infection: An Indication for Tonsillectomy? A Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Amarkumar Dhirajlal Rajgor ◽  
Navid Akhtar Hakim ◽  
Sanah Ali ◽  
Adnan Darr
Keyword(s):  
Streptococcal Infection ◽  
Group A Streptococcus ◽  
Case Reports ◽  
Neuropsychiatric Symptoms ◽  
Case Series ◽  
Acute Onset ◽  
Neuropsychiatric Disorder ◽  
Inclusion Criteria ◽  
Definitive Evidence ◽  
Group A

Background. Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection (PANDAS) is the acute onset of neuropsychiatric symptoms following group A beta-haemolytic streptococcal infection. The aetiology remains elusive. However, with group A streptococcus being the most common bacterial cause of tonsillitis, surgical intervention in the form of tonsillectomy has often been considered as a potential therapy. Methods. A MEDLINE® search was undertaken using keywords “PANDAS” or “paediatric autoimmune neuropsychiatric disorders associated with streptococcus” combined with “tonsillectomy”. Results. Six case reports and 3 case series met the inclusion criteria. Demesh et al. (case series) reported a dramatic reduction in neuropsychiatric symptom severity in the patient cohort undergoing tonsillectomy. Two case series suggest that there is no association between tonsillectomy and resolution of PANDAS. Conclusion. Due to the lack of uniform data and sporadic reports, tonsillectomy should be carefully adopted for the treatment of this disorder. In particular, tonsillectomies/adenoidectomies to alleviate neuropsychiatric symptoms should be avoided until more definitive evidence is at our disposal. This review highlights the importance of a potential collaborative prospective study.

scholarly journals Delirium and Cognitive Impairment as Predisposing Factors of COVID-19 Infection in Neuropsychiatric Patients: A Narrative Review

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1244
Author(s):  
Michele Fabrazzo ◽  
Antonio Russo ◽  
Alessio Camerlengo ◽  
Claudia Tucci ◽  
Mario Luciano ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Case Reports ◽  
Neuropsychiatric Symptoms ◽  
Case Series ◽  
Potential Effect ◽  
Acute Onset ◽  
Predisposing Factors ◽  
Narrative Review ◽  
Predisposing Factor ◽  
Altered Level

SARS-CoV-2 neuroinvasive and neurotropic abilities may underlie delirium onset and neuropsychiatric outcomes. Only a limited number of studies have addressed the potential effect of SARS-CoV-2 infection on mental health so far. Most studies mainly reported the acute onset of mixed neuropsychiatric conditions in patients infected with SARS-CoV-2, characterized by agitated behavior, altered level of consciousness, and disorganized thinking, regardless of psychological or socioeconomic triggering factors. The present narrative review aims to analyze and discuss the mechanisms underlying the neuroinvasive/neurotropic properties of SARS-CoV-2 and the subsequent mental complications. Delirium appeared as a clinical manifestation of SARS-CoV-2 brain infection in some patients, without systemic or multiple organ failure symptoms. A small number of studies demonstrated that neuropsychiatric symptoms associated with COVID-19, initially presenting as a confused state, may subsequently evolve in a way that is consistent with the patients’ neuropsychiatric history. A literature analysis on this topic prevalently showed case reports and case series of patients presenting delirium or delirium-like symptoms as the main outburst of COVID-19, plus a cognitive impairment, from mild to severe, which pre-existed or was demonstrated during the acute phase or after infection. Dementia appeared as one of the most frequent predisposing factors to SARS-CoV-2 infection complicated with delirium. Instead, contrasting data emerged on the potential link between COVID-19 and delirium in patients with cognitive impairment and without a neuropsychiatric history. Therefore, clinicians should contemplate the possibility that COVID-19 appears as delirium followed by a psychiatric exacerbation, even without other systemic symptoms. In addition, cognitive impairment might act as a predisposing factor for COVID-19 in patients with delirium.

Poststreptococcal Movement Disorders

2017 ◽  
Author(s):  
Davide Martino ◽  
Gavin Giovannoni
Keyword(s):  
Movement Disorders ◽  
Streptococcal Infection ◽  
Group A Streptococcus ◽  
Neuropsychiatric Symptoms ◽  
Causal Link ◽  
Obsessive Compulsive ◽  
Behavioral Abnormalities ◽  
Group A ◽  
Obsessive Compulsive Disorders ◽  
Compulsive Disorders

The spectrum of “poststreptococcal” movement disorders and other behavioral abnormalities has expaanded and the array of neuropsychiatric features associated with rheumatic fever (RF) has been broadened. However, it is difficult to establish a causal link between Group A Streptococcus (GAS) and neuropsychiatric symptoms beyond RF, which has fuelled a long-lasting, and still unsolved, debate as to whether putative “poststreptococcal” disorders such as the PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection) phenotype are distinct entities or not. This chapter provides an up-to-date overview of the conditions that are well established (Sydenham’s chorea) or proposed (poststreptococcal tic and obsessive-compulsive disorders) as secondary to an immune response toward GAS.

scholarly journals A rare case of osteomyelitis of the clavicle in a child due to Group A streptococcal infection

2019 ◽  
Vol 12 (4) ◽  
pp. e227090
Author(s):  
Molla Imaduddin Ahmed ◽  
Muhammad Nadeem ◽  
Srini Bandi
Keyword(s):  
Rare Case ◽  
Streptococcal Infection ◽  
Case Reports ◽  
Left Shoulder ◽  
Age Group ◽  
Incision And Drainage ◽  
Left Clavicle ◽  
Paediatric Age ◽  
Group A ◽  
Medial Clavicle

Acute osteomyelitis of the clavicle is rare in the paediatric age group. We treated a 5-year-old boy who presented initially with fever and left shoulder pain, and subsequently developed swelling in the region of the left clavicle. Group AStreptococcus(GAS) was isolated in blood culture. MRI of the clavicle showed osteomyelitis of the medial clavicle. The child had incision and drainage of his clavicular collection. The child received intravenous benzylpenicillin and oral cephalexin in the initial presentation; he was treated with 2 weeks of intravenous ceftriaxone and 4 weeks of oral penicillin thereafter with the resolution of his symptoms. There are no previous case reports of osteomyelitis of the clavicle in children caused by GAS. This case highlights the importance of identifying the microbial aetiology in these children to ensure early initiation of treatment with appropriate antibiotics.

scholarly journals Familial Transmission of a Serious Disease–Producing Group A Streptococcus Clone: Case Reports and Review

1997 ◽  
Vol 24 (6) ◽  
pp. 1118-1121 ◽  
Author(s):  
M.‐A. Gamba ◽  
M. Martinelli ◽  
H. J. Schaad ◽  
R. A. Streuli ◽  
J. DiPersio ◽  
...  
Keyword(s):  
Group A Streptococcus ◽  
Case Reports ◽  
Familial Transmission ◽  
Group A ◽  
Serious Disease

scholarly journals Trends in the publication of infantile hypertrophic pyloric stenosis in Africa: A systematic review

2021 ◽  
Vol 2 ◽  
pp. 3
Author(s):  
Olakayode Olaolu Ogundoyin ◽  
Akinlabi Emmanuel Ajao
Keyword(s):  
Pyloric Stenosis ◽  
Case Reports ◽  
Hypertrophic Pyloric Stenosis ◽  
Case Series ◽  
Rare Condition ◽  
Operative Management ◽  
Infantile Hypertrophic Pyloric Stenosis ◽  
Mucosal Perforation ◽  
Group A ◽  
Group B

There are still global variations in the epidemiology of infantile hypertrophic pyloric stenosis, although the clinical presentations may be similar. Outcome of management, however, may depend on the degree of evolution of management of the anomaly. This review aimed at evaluating the trends of reporting of infantile hypertrophic pyloric stenosis from Africa. An evaluation of all publications from Africa on infantile hypertrophic pyloric stenosis focusing on epidemiology, evolution of management of the anomaly was carried out. Literature search of all publications from Africa on Infantile hypertrophic pyloric stenosis was conducted from January 1, 1951, to December 31, 2018. The articles were sourced from the databases of African Index Medicus, OvidSP, PubMed, African Journal Online, and Google Scholar. Extracted from these publications were information on the type of article, trend of reporting, the country of publication, demographic details of the patients, number of cases, clinical presentation, pre-operative management, type of surgical approach, and the outcome of management. Overall, 40 articles were published from 11 countries. Of these, 16 (40.0%) were published in the first 35 years (Group A, 1951–1985) and 24 (60.0%) published in the later 33 years (Group B, 1986– 2018). Case reports 8 (20.0%) and case series 5 (12.5%) were predominant in Group A, whereas retrospective studies 12 (30.0%) predominated in Group B. The countries of publication included Nigeria (27.5%), South Africa (15.0%), Egypt (12.5%), Tanzania (10.0%), and Zimbabwe (10.0%). A total of 811 patients diagnosed and managed for infantile hypertrophic pyloric stenosis (IHPS) were reported. Their ages ranged from 1 day to 1 year with an incidence that ranged from 1 in 550 to 12.9 in 1000. There were 621 boys and 114 girls (M:F – 5.5:1). All the patients were breastfed with an average birth rank incidence of 42.4% among firstborns, 19.5% in second borns, 15.2% in third borns, 13.2% among fourth borns, and 10.0% among fifth borns and beyond. Associated congenital anomalies were reported in 5 (12.5%) studies with an incidence of 6.9–20% occurring in a total of 28 patients. All but 3 (7.5%) studies reported that open surgery was adopted to perform Ramstedt’s pyloromyotomy on the patients. Reported post-operative complications include mucosal perforation in 8 (20.0%) studies, surgical site infection in 7 (17.5%), gastroduodenal tear 2 (5.0%), and hemorrhage and incisional hernia in 1 (2.5%) study each. Mortality was reported in 26 (65.0%) studies with a range of 1.8–50% and a mean mortality rate of 5.2%. There has been a change in the trend of reporting IHPS in Africa over the years, with increasing comparative studies on the modalities of management compared to case reports and series. Still very limited work has been done in the aspect of genetics and etiology of IHPS among Africans. There is a need to increase funding in this regard and to encourage multi-center collaborations in the study of this relatively rare condition.

Streptococcal Submandibular Cellulitis in Young Infants

PEDIATRICS ◽  
1981 ◽  
Vol 67 (3) ◽  
pp. 378-380 ◽  
Author(s):  
Pisespong Patamasucon ◽  
Jane D. Siegel ◽  
George H. McCracken
Keyword(s):  
Clinical Presentation ◽  
Streptococcal Infection ◽  
Group A Streptococcus ◽  
Hemolytic Streptococcus ◽  
Young Infants ◽  
Group A ◽  
Ludwig’S Angina ◽  
Group B ◽  
Ludwig's Angina

Six infants with streptococcal submandibular cellulitis and bacteremia were managed in our institution during a seven-month period. Five uncomplicated cases were caused by group B β-hemolytic Streptococcus, and one rapidly progressive case of Ludwig's angina was caused by group A Streptococcus. Recognition of this characteristic clinical presentation of group B streptococcal infection may be beneficial in the management of such patients.

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