tetracycline and Rhinitis

Mucosal changes have been well described in chronic sinusitis, yet little is known about the underlying bone, despite clinical and experimental evidence suggesting that bone may be involved in chronic sinusitis. Techniques of undecalcified bone analysis were used for detailed histologic examination of ethmoid bone in chronic sinusitis compared with controls. Bone synthesis, resorption, and inflammatory cell presence were specifically assessed. Additionally, histomorphometry techniques were used to determine ethmoid bone physiology in individuals undergoing surgery for chronic sinusitis. Overall, individuals undergoing surgery for chronic sinusitis were found to have evidence of marked acceleration in bone physiology with histologic changes including new bone formation, fibrosis, and presence of inflammatory cells. These findings are compared with osteomyelitis in long bone and the jaw. The suggestion that underlying bone may serve as a catalyst for chronic sinusitis is supported and implications for therapy are discussed.

Topics: Adult; Anti-Bacterial Agents; Antibiotic Prophylaxis; Bone Remodeling; Bone Resorption; Chronic Disease; Coloring Agents; Demeclocycline; Edema; Endoscopy; Ethmoid Bone; Ethmoid Sinusitis; Female; Fibrosis; Humans; Male; Mandibular Diseases; Mucous Membrane; Osteitis; Osteogenesis; Osteomyelitis; Prospective Studies; Rhinitis; Single-Blind Method; Tetracycline; Turbinates

Rhinoscleroma is a chronic granulomatous disease of the respiratory tract endemic to Eastern Europe and Central America which is being recognized with increasing frequency in other countries, including the United States. It was initially described as a lesion of the nose and upper respiratory tract, but is now known to involve the larynx, trachea and bronchi as well to cause slowly progressive asphyxia. Eleven cases of rhinoscleroma with varying degrees of involvement of the lower respiratory tract (larynx, trachea and bronchi) are presented. Present day treatment is both medical, consisting primarily of streptomycin and tetracycline, and endoscopic dilatation. Prolonged medication with careful dose control is necessary. Lower respiratory tract involvement should be considered in patients with chronic destructive granulomatous nasal pathology. This should be especially emphasized if they have an Eastern European or Central American background, or have travelled in these areas in which rhinoscleroma is endemic.

Topics: Adult; Europe; Female; Humans; Klebsiella Infections; Klebsiella pneumoniae; Laryngitis; Male; Mexico; Middle Aged; Pharyngitis; Recurrence; Rhinitis; Rhinoscleroma; Streptomycin; Tetracycline; Time Factors; United States

During the winter months 1974/75 we were able to observe a number of unusual respiratory tract infections particularly in children over 6 years of age which appeared as pneumonias. Characteristic clinical findings included a dry, hacky cough, refractive to the usual antitussives, starting 1--2 weeks prior to admission, fever up to 104, malaise, headache, anorexia, shortness of breath and cyanosis. Several Pts were treated prior to admission with a number of antibiotics and failed to respond. Laboratory findings showed a peripheral polymorphonuclear leucocytosis with toxic granulations of neutrophiles. A sedimentation rate above 40 in the first hour occurred in most Pts. X Ray of the lung revealed a characteristic mottled appearance with patchy infiltrations, atelectasis and nodular densities. Frequently a shift of the mediastinum towards the infiltrate was seen. One of the hallmarks on physical examination was the discrepancy between the severity of the clinical illness and the paucity of physical findings. Decreased breath sounds over affected lung areas were often the only findings on auscultation; find rales, rhonchi or dullness on percussion were less often heard. The combination of a typical history, physical examination, laboratory tests and X Ray findings enabled us to make a presumptive clinical diagnosis of Mycoplasma pneumonia before serologic test results were available and to start with the appropriate antibiotic (Erythromycin, Tetracycline) early in the course of the disease. Complement fixation tests with a titer of 1 : 20 and a fourfold rise over the next two weeks or an initial titer of 1 : 80 and above were considered significant for acute disease.

Topics: Adolescent; Child; Child, Preschool; Erythromycin; Female; Humans; Male; Mycoplasma Infections; Otitis Media; Pneumonia; Rhinitis; Serologic Tests; Sinusitis; Tetracycline; Tonsillitis

Topics: Adult; Arteritis; Dental Caries; Dexamethasone; Fluorescent Dyes; Gingivitis; Humans; Hypersensitivity; Male; Phlebitis; Photography; Radiography; Remission, Spontaneous; Retinal Vessels; Rhinitis; Streptomycin; Tetracycline; Tonsillitis

Topics: Adolescent; Adult; Aged; Child; Female; Humans; Laryngitis; Male; Middle Aged; Otitis; Rhinitis; Tetracycline

Topics: Adolescent; Anti-Bacterial Agents; Chloramphenicol; Humans; India; Klebsiella; Oxytetracycline; Penicillins; Rhinitis; Rhinitis, Atrophic; Rhinoscleroma; Streptomycin; Tetracycline

Topics: Bilirubin; Child; Humans; Hyperbilirubinemia; Infant; Infant, Newborn; Infant, Premature; Infant, Very Low Birth Weight; Novobiocin; Rhinitis; Staphylococcal Infections; Staphylococcus; Tetracycline