Prevalence of the Helicobacter pylori in the tonsils and adenoids / Prevalência do Helicobacter pylori em amígdalas e adenoides

INTRODUCTION: There is an ongoing debate about the existence and effects of Helicobacter pylori (Hp) in adenotonsillar tissue. OBJECTIVE: A clinical study was conducted to assess the existence of Hp in the adenoid and/or adenotonsillar tissues, which were surgically excised due to chronic adenotonsillitis. METHODS: Phosphoglucosamine mutase gene for the detection of Hp and cytotoxin-associated gene as virulence gene were examined in 84 adenotonsillar tissues obtained from 64 patients and patients' serum by using polymerase chain reaction. RESULTS: Hp IgG was detected in 57 (89%) patients' serum. A total of seven tissue samples from 64 patients (10.9%) were found positive for Hp DNA, of which five were adenoids and two were tonsil tissues. All polymerase chain reaction positive samples were also positive for the cytotoxin-associated gene, which is a virulence determinant for the organism. CONCLUSION: This study suggests that children are exposed to Hp at an early age of their life in this province. Hp may have a role in the pathogenesis of chronic adenotonsillitis, especially in endemic areas. .

INTRODUÇÃO: Há um debate atual sobre os efeitos da Helicobacter pylori (HpHp) no tecido adenotonsilar. OBJETIVO: Conduzimos um estudo clinico para avaliar a existência de Hp nos tecidos adenoideano e/ou adenotonsilar, os quais foram removidos cirurgicamente em decorrência de adenotonsilite crônica. MÉTODO: No total, 84 amostras de tecido obtidos de 64 pacientes foram analisadas para o gen fosfoglucosamina mutase para a detecção de Hp. Os casos positivos foram a seguir examinados para o gen associado à citotoxina, relacionado à virulência, usando-se o método de Reação de Polimerase em Cadeia (PCR). RESULTADOS: A IgG de Hp foi detectado em 57 (89%) soros de pacientes. Sete amostras de tecido de sessenta e quatro pacientes (10.9%) resultou positivo para o DNA de Hp, das quais cinco eram adenóides e duas eram tecido tonsilar. No PCR todas as amostras foram também positivas para o gen associado à citotoxina, o qual é um determinante de virulência. CONCLUSÃO: Esse estudo sugere que as crianças são expostas ao Hp nos primeiros anos de vida nessa província e que o Hp pode ter um papel na patogênese da adenotonsilite crônica, principalmente em áreas endêmicas. .

Retrospective review of clinical and neuroimaging observations in pyomeningitis.

The present study is a review of patients with pyogenic meningitis diagnosed by clinical and laboratory criteria in which CT scan was done to detect acute phase CT abnormalities with respect to post inflammatory hydrocephalus and ventriculomegaly. Fifty-six patients were identified between 1993 and 1996 in the Department of Pediatrics at the All India Institute of Medical Sciences, New Delhi. A CT scan was available in 30. The diagnosis was compatible with a definitive pyogenic meningitis in 17 and probable pyogenic meningitis in 13. The acute stage CT scans performed within the first four weeks of illness revealed ventriculomegaly in 10 out of 30 bacterial meningitis (33%), (41.1% of definitive meningitis compared to only 23% of the probable meningitis group). Follow-up CT scans revealed persistent ventriculomegaly in 2. Both patients with persistent ventriculomegaly had frontal atrophy. None of the patients merited a shunt or any medical measures. Cortical atrophy as an aftermath of acute bacterial meningitis may cause persistent ventriculomegaly. The frontal cortex localization may explain the frequency of seizures and other sequelae observed in pyogenic meningitis. An early recognition may help to prognosticate patient outcome.