A Clinical Presentation and Review of the Literature

Pradeep K. Shenoy, MD, DLO, FRCS, FACS, ENT Service Chief, Campbellton Regional Hospital, NB, Campbellton, Canada.

Abstract
A case of acute tonsillitis is reported where proper antibiotic treatment was not given because of a negative throat culture, and the patient presented with complications. Review of the literature regarding acute tonsillitis, its presentation, treatment and various complications are discussed.
Keywords: acute tonsillitis, throat swab, peritonsillar abscess, retropharyngeal abscess, parapharyngeal abscess, GABHS, MRSA, PANDAS, Lemierre’s syndrome.

D.F. Gilpin, PhD, Research Fellow, School of Pharmacy, Queen’s University, Belfast, Northern Ireland.
M.M. Tunney, PhD, Senior Lecturer, School of Pharmacy, Queen’s University, Belfast, Northern Ireland.
N. Baldwin, PhD, Research Fellow, School of Pharmacy, Queen’s University, Belfast, Northern Ireland.
C.M. Hughes, PhD, Professor, School of Pharmacy, Queen’s University, Belfast, Northern Ireland.

Methicillin-resistant Staphlyococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) are responsible for substantial morbidity and mortality in acute care settings. Older residents in long-term care (LTC) facilities possess many of the risk factors for colonization with these antibiotic resistant bacteria, and the potential exists for both transmission, via transiently colonized staff, within LTC, and subsequent reintroduction into hospitals. Infection control policies in LTC are primarily based on those used in acute care and may not be appropriate for this unique environment. Studies to determine which infection control procedures are effective at reducing the prevalence and transmission of MRSA and VRE in LTC are required.
Key words: long-term care, MRSA, VRE, colonization, infection control.

Chamandeep Thind, MRCP, Department of Dermatology, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK.
Simone Laube, MD MRCP, Department of Dermatology, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK.

Skin and soft tissue infections are an important cause of morbidity and mortality in older adults. Decreased immunity, changes in skin anatomy, and comorbidities contribute to an increased susceptibility to infections. Methicillin-resistant Staphylococcus aureus is an increasingly common problem in both the community as well as hospitals. Clinical features and management of some common skin infections encountered in this population are reviewed here. Local microbiological guidelines and drug susceptibilities should be taken into account in the treatment.
Key words: bacterial skin infections, cellulitis, MRSA, fungal infection, scabies.