No description available.

No description available.

Thesis (MFamMed)--Stellenbosch University, 2015. / Background: An increased incidence of acute group A ß-hemolytic Streptococcal (GABHS) pharyngitis has been reported anecdotally at the Welcare Hospital in Dubai. Aim: To describe the outcomes of patients with acute GABHS pharyngitis who received standard therapy at the Welcare hospital emergency unit in Dubai. Objectives To determine the time elapsed before patients experience a clinically significant reduction in pain. To describe the side-effect profile of standard treatment received for acute GABHS pharyngitis. Methods: This is a cross-sectional study design. Consecutive sampling of 123 patients was done from December, 2013 to March, 2014. A questionnaire was used to record demographic data and severity of GABHS before patients received standard treatment. The Visual Analogue Scale (VAS) was used to measure pain severity at baseline and during follow-up. Adults diagnosed with GABHS pharyngitis who received dexamethasone as part of standard treatment offered were included. Results: Clinical pain relief, which was suggested as a VAS score of 4, was achieved by 5.7% of the patients at 12 hours. At 24 hours, 55.3% of the patients reported a VAS score of 4. The mean VAS score of the patients at this time was 4.12. A total of 99.2% of the patients reported a VAS score of 4 or lower at 36 and 48 hours. Paired t-test revealed statistically significant difference between the VAS scores at 12, 24, 36 and 48 hours and baseline (p=0.000). This suggests that clinical pain relief was achieved by 55.3% of the patients at 24 hours. At 48 hours, 21.1% of the patients reported a VAS score of 0. None of the patients reported any side effects associated with the one dose use of dexamethasone. Conclusion: The findings suggest that dexamethasone is safe and effective to use as adjuvant for management of pain associated with acute GABHS pharyngitis. Almost all patients experienced significant pain relief by 36 and 48 hours and no side-effects related to dexamethasone use were recorded. Further definitive randomised controlled trials are needed to establish these findings as evidence for practice. / AFRIKAANSE OPSOMMING: Nie beskikbaar

Abstract Recurrent pharyngitis causes doctor visits, antibiotics use and absences from school or work and thus worsens patients’ quality of life (QOL). Even though tonsillectomy is often performed for recurrent pharyngitis, there is limited evidence of the tonsillectomy benefit concerning both researcher- and patient-recorded outcomes. The intent of this work was to find out if tonsillectomy reduces numbers of pharyngitis episodes or symptom days, if tonsillectomy improves patients’ QOL and if there are any clinical factors predicting QOL benefit after tonsillectomy. Seventy adult patients with recurrent streptococcal pharyngitis (2001–2005) and 86 patients with recurrent pharyngitis of any origin (2007–2010) were enrolled for two randomised controlled trials. Patients with recurrent pharyngitis of any origin were followed up either before (control group, n=40) or after (tonsillectomy group, n=46) tonsillectomy. At five months of follow-up, 17 (43%) patients in the control group and 2 (4%) patients in the tonsillectomy group consulted a physician for pharyngitis. Thirty-two (80%) patients in the control group and 18 (39%) patients in the tonsillectomy group experienced any kind of pharyngitis episode. Only one episode was considered severe. The numbers of days with throat pain and fever were significantly lower in the tonsillectomy group. QOL of 142 responders measured by Glasgow Benefit Inventory (GBI) six months after tonsillectomy showed improvement: median GBI total score was +27. However, GBI total scores varied considerably between the patients (range −19 to +69). Only one patient reported declined QOL. The number of prior pharyngitis episodes, frequent throat pain, untreated dental caries and chronically infected tonsils were the best clinical factors predicting QOL improvement. The precision of these predictions was still quite low. The results of this work suggest that tonsillectomy reduces numbers of acute pharyngitis episodes and symptoms. Although most of the episodes are not severe, tonsillectomy still generally improves patients’ QOL. The distribution of QOL benefit is broad, however. Throat-related morbidity before tonsillectomy is the only clinical factor that was associated with patient satisfaction. / Tiivistelmä Toistuvat nielutulehdukset aiheuttavat paljon lääkärikäyntejä, antibioottihoitoja sekä poissaoloja töistä tai opinnoista ja huonontavat potilaiden elämänlaatua. Toistuvien nielutulehdusten vuoksi päädytään usein nielurisaleikkaukseen, vaikka tutkimusnäyttö leikkauksen hyödystä on vähäistä. Tämän väitöskirjatyön tavoitteena oli tutkia, vähentääkö nielurisaleikkaus nielutulehdusten määrää tai oireita sekä selvittää leikkauksenjälkeistä elämänlaatua ja siihen liittyviä ennustekijöitä. Tutkimusaineisto koostui kahta eri satunnaistettua kliinistä koetta varten rekrytoiduista potilaista: 70 potilasta, joiden toistuvien nielutulehdusten aiheuttaja oli A-ryhmän streptokokki (2001–2005) ja 86 potilasta, joiden toistuvien nielutulehdusten etiologialle ei asetettu vaatimuksia (2007–2010). Potilaat, joilla nielutulehdusten etiologia oli avoin, satunnaistettiin kahteen ryhmään: kontrolliryhmää (n=40) seurattiin ennen nielurisaleikkausta ja leikkausryhmää (n=46) sen jälkeen, molempia 5 kuukauden ajan. Seurannassa 17 (43 %) kontrolliryhmän potilasta ja 2 (4 %) leikkausryhmän potilasta hakeutui lääkäriin nielutulehduksen vuoksi. Kontrolliryhmän potilaista 32 (80 %) ja leikkausryhmän potilaista 18 (39 %) sairasti nielutulehduksen vähintään kerran. Vain yksi episodi luokiteltiin vaikeaksi. Nielukipu- ja kuumepäiviä oli merkittävästi vähemmän leikkausryhmässä. Nielurisaleikkauksen vaikutusta elämänlaatuun tutkittiin Glasgow Benefit Inventory (GBI) -kyselyllä kuusi kuukautta leikkauksen jälkeen. Yhteensä 142 potilasta vastasi kyselyyn. GBI:n mediaanitulos +27 osoitti leikkauksen parantavan elämänlaatua. GBI-tulokset kuitenkin vaihtelivat huomattavasti potilaiden välillä (−19 – +67), vaikkakin vain yksi potilas raportoi elämänlaatunsa heikentyneen. Aiempien nielutulehdusten määrä, usein toistuva nielukipu, hoitamaton karies ja kroonisesti tulehtuneet nielurisat ennustivat parhaiten potilastyytyväisyyttä leikkauksen jälkeen, mutta näidenkin tekijöiden ennustearvo oli melko heikko. Tulosten perusteella nielurisaleikkaus vähentää akuutteja nielutulehduksia sekä oirepäiviä. Vaikka sairastamisjaksot ovat harvoin vaikeaoireisia, leikkaus parantaa useimmiten elämänlaatua, mutta hyödyn määrä vaihtelee merkittävästi potilaiden välillä. Ainoastaan leikkausta edeltävä nielun oireilun määrä ennustaa leikkaushyötyä jossain määrin.

INTRODUÇÃO: A Faringotonsilite é doença comum nos consultórios e prontosocorros de pediatria. OBJETIVOS: Avaliar o impacto da realização rotineira da prova rápida para pesquisa de estreptococo do grupo A (PRE) no diagnóstico e tratamento da faringotonsilite aguda em crianças e adolescentes atendidos em um Hospital Geral. MÉTODOS: Trata-se de um estudo prospectivo, observacional, de protocolo de atendimento, instituído no Pronto-Socorro do Hospital Universitário da Universidade de São Paulo para o atendimento de crianças e adolescentes com diagnóstico de faringotonsilite aguda. RESULTADOS: Foram estudadas 1039 crianças e adolescentes. Com base no quadro clínico, antibiótico seria prescrito em 530 pacientes (51%), e com o uso da PRE e/ou cultura de orofaringe foi prescrito em 268 (25,8%) pacientes. Das 509 crianças que não receberiam antibiótico pelo quadro clínico, 157 tiveram PRE e/ou cultura de orofaringe positiva. O diagnóstico baseado no quadro clínico apresentou sensibilidade de 63,06% (IC-95%:62,95-63,17%); especificidade de 57,33% (IC-95%:57,25-57,41%); valor preditivo positivo de 50,57% (IC-95%:50,47-50,66%) e valor preditivo negativo de 69,16% (IC-95%: 50,47-50,66%). CONCLUSÕES: Neste estudo o diagnóstico clínico da faringotonsilite estreptocócica mostrou baixa sensibilidade e especificidade. O uso rotineiro da prova rápida para pesquisa de estreptococo permitiu uma redução do uso de antibiótico e a identificação de crianças e adolescentes com faringotonsilite estreptocócicas que não receberiam antibiótico e estariam sob o risco das complicações da infecção estreptocócica / BACKGROUND: Sore throat is a common disease in the pediatric emergency room. OBJECTIVES: The objective of this study was to evaluate the impact of routine performance of rapid antigen detection test (RADT) in the diagnosis and treatment of acute pharyngitis in children treated at an academic hospital. METHODS: This is a prospective, observational, protocol compliance, established at the Emergency of Hospital Universitário - Universidade de São Paulo for the care of children and adolescents diagnosed with acute pharyngitis. RESULTS: We studied 1039 children and adolescents. Based on clinical findings, antibiotic would be prescribed in 530 patients (51%) and using the RADT or sore throat culture was prescribed in 268 patients. Of the 509 children who did not receive antibiotics for the clinical, 157 had positive RADT or sore throat culture. The diagnosis based on clinical sensitivity was 63,06% (IC 95% 62,95- 63,17%), specificity 57,3% (IC 95% 57,25-57,41%), positive predictive value of 50,57% (IC 95% 50,47-50,66%) and negative predictive value of 69,16% (IC 95% 50,47-50,66%). CONCLUSIONS: In this study the clinical diagnosis of streptococcal pharyngitis had low sensitivity and specificity. The routine use of rapid test for streptococcal research led to a reduction of antibiotic use and the identification of a risk group for complication of streptococcal infection

INTRODUÇÃO: A Faringotonsilite é doença comum nos consultórios e prontosocorros de pediatria. OBJETIVOS: Avaliar o impacto da realização rotineira da prova rápida para pesquisa de estreptococo do grupo A (PRE) no diagnóstico e tratamento da faringotonsilite aguda em crianças e adolescentes atendidos em um Hospital Geral. MÉTODOS: Trata-se de um estudo prospectivo, observacional, de protocolo de atendimento, instituído no Pronto-Socorro do Hospital Universitário da Universidade de São Paulo para o atendimento de crianças e adolescentes com diagnóstico de faringotonsilite aguda. RESULTADOS: Foram estudadas 1039 crianças e adolescentes. Com base no quadro clínico, antibiótico seria prescrito em 530 pacientes (51%), e com o uso da PRE e/ou cultura de orofaringe foi prescrito em 268 (25,8%) pacientes. Das 509 crianças que não receberiam antibiótico pelo quadro clínico, 157 tiveram PRE e/ou cultura de orofaringe positiva. O diagnóstico baseado no quadro clínico apresentou sensibilidade de 63,06% (IC-95%:62,95-63,17%); especificidade de 57,33% (IC-95%:57,25-57,41%); valor preditivo positivo de 50,57% (IC-95%:50,47-50,66%) e valor preditivo negativo de 69,16% (IC-95%: 50,47-50,66%). CONCLUSÕES: Neste estudo o diagnóstico clínico da faringotonsilite estreptocócica mostrou baixa sensibilidade e especificidade. O uso rotineiro da prova rápida para pesquisa de estreptococo permitiu uma redução do uso de antibiótico e a identificação de crianças e adolescentes com faringotonsilite estreptocócicas que não receberiam antibiótico e estariam sob o risco das complicações da infecção estreptocócica / BACKGROUND: Sore throat is a common disease in the pediatric emergency room. OBJECTIVES: The objective of this study was to evaluate the impact of routine performance of rapid antigen detection test (RADT) in the diagnosis and treatment of acute pharyngitis in children treated at an academic hospital. METHODS: This is a prospective, observational, protocol compliance, established at the Emergency of Hospital Universitário - Universidade de São Paulo for the care of children and adolescents diagnosed with acute pharyngitis. RESULTS: We studied 1039 children and adolescents. Based on clinical findings, antibiotic would be prescribed in 530 patients (51%) and using the RADT or sore throat culture was prescribed in 268 patients. Of the 509 children who did not receive antibiotics for the clinical, 157 had positive RADT or sore throat culture. The diagnosis based on clinical sensitivity was 63,06% (IC 95% 62,95- 63,17%), specificity 57,3% (IC 95% 57,25-57,41%), positive predictive value of 50,57% (IC 95% 50,47-50,66%) and negative predictive value of 69,16% (IC 95% 50,47-50,66%). CONCLUSIONS: In this study the clinical diagnosis of streptococcal pharyngitis had low sensitivity and specificity. The routine use of rapid test for streptococcal research led to a reduction of antibiotic use and the identification of a risk group for complication of streptococcal infection

Abstract Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) is a syndrome characterized by regular, high-fever episodes with healthy periods in between. In a classic phenotype of the syndrome, the fevers begin in childhood before the age of five, and fever flares are accompanied by aphthous stomatitis, pharyngitis, and/or cervical adenitis. The etiology of the syndrome is unknown, but tonsillectomy (TE) has been shown to be an effective treatment for the disease. The purposes of this study were as follows: (1) to assess the long-term outcome of PFAPA patients treated by TE with either the classic or incomplete phenotype (later onset of the disease and/or missing oropharyngeal symptoms), (2) to compare the health and growth of PFAPA patients with healthy controls, and (3) to compare the histological and microbiological findings of the tonsils of PFAPA patients with controls via conventional and modern sequencing technologies. In this approximately 9-year follow up, 97% (n = 56) of patients with the classic phenotype and all patients (n = 50) with the incomplete phenotype achieved a prompt and constant response after TE. There were no differences in either the length of fever episodes or flares between patients with both the classic and incomplete phenotypes. The health and growth of 119 PFAPA patients was compared to that of sex- and age-matched controls (n = 230), and no differences in prevalence of chronic diseases or growth were found between the groups. Infections, oral thrush, and pollen allergy were more common in the history of the PFAPA patients than in the controls. Microbiological and histological findings of the tonsils of PFAPA patients (n = 31) were compared with the findings of the controls (n = 24) who had undergone TE for other reasons. Biofilm formation and Candida albicans were more frequently found among PFAPA patients than the controls, but Staphylococcus aureus, varicella zoster, and herpes simplex viruses were more common in the controls. While comparing the bacterial microbiota between the groups, we found significant differences in the presence and relative abundance of many bacteria. For example, Cyanobacteria were more common and abundant in the case samples than in the controls. Because the long-term outcome after TE was excellent, both in classic and incomplete PFAPA patients; a new diagnostic criteria for the syndrome is proposed. The microbes of the tonsils in PFAPA patients differ from that of the controls, which may play an important role in triggering the inflammatory processes that lead to symptoms of PFAPA. / Tiivistelmä Periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrooma, on oireyhtymä, jossa potilaat kärsivät hyvin säännöllisesti ilmaantuvista, toistuvista kuumejaksoista, joiden välillä potilaat ovat terveitä. Klassisessa tautimuodossa kuumeilut alkavat lapsuudessa ennen viiden vuoden ikää ja kuumevaiheeseen liittyy liitännäisoireita: suun limakalvojen rakkuloita, nielutulehdusta ja/tai kaulan imusolmukkeiden suurentumista. Oireyhtymän syytä ei tiedetä, mutta nielurisaleikkaus (TE) on osoittautunut tehokkaaksi hoidoksi. Tutkimuksen tarkoituksena oli (1) arvioida PFAPA potilaiden vointia pitkäaikaisseurannassa TE:n jälkeen ja vertailla taudinkuvaa niiden PFAPA potilaiden välillä, joilla oli klassinen PFAPA tai epätyypillinen PFAPA. (2) Lisäksi tutkimme myös TE:lla hoidettujen PFAPA potilaiden sairastuvuutta, yleistä terveydentilaa ja kasvua vertaamalla näitä sukupuoli- ja ikävakioituihin kontrolleihin ja (3) selvitimme mikrobiologisia ja histologisia löydöksiä PFAPA potilaiden nielurisoissa verrattuna muista syistä TE:ssa käyneiden lasten nielurisoihin. Tässä noin yhdeksän vuoden seurannassa TE:n jälkeen oli täysin parantunut 97% (n = 56) potilaista, joilla oli klassinen PFAPA, ja kaikki (n = 50) potilaat, joilla oli epätyypillinen PFAPA (tauti oli alkanut viiden ikävuoden jälkeen ja/tai klassiset liitännäisoireet puuttuivat). Kuumeprofiilit eivät muilta osin eronneet ennen nielurisaleikkausta näissä ryhmissä. PFAPA potilaiden (n = 119) kasvu ja yleinen terveydentila eivät eronneet väestökontrolleista (n = 230). Krooniset ja autoimmuunisairaudet olivat yhtä harvinaisia molemmissa ryhmissä. Potilaat raportoivat sairastaneensa enemmän infektioita ja sammasta lapsuudessa ja heillä oli enemmän siitepölyallergioita. PFAPA potilaiden (n = 31) ja muista syistä TE:ssa käyneiden lasten (n = 24) nielurisojen mikrobiologiaa ja histologiaa tutkittiin ja vertailtiin. Biofilmimuodostusta nielurisan pinnalla ja Candida albicansia löytyi enemmän tapauksilta kuin kontrolleilta, kun taas Staphylococcus aureusta, varicella zoster- ja herpes simplex -viruksia tavattiin enemmän kontrolleilla. Myös mikrobiomi erosi ryhmien välillä, esimerkiksi syanobakteerit olivat yleisempiä PFAPA risoissa kuin kontrolleilla. Klassisten ja epätyypillisten PFAPA potilaiden terveydentila TE:n jälkeen oli pitkäaikaisseurannassamme erinomainen ja siksi ehdotamme, että PFAPA –syndrooman diagnostisia kriteereitä tulisi muuttaa. Nielurisojen mikrobisto on erilainen kontrolleihin verrattuna ja tällä voi olla merkitystä PFAPA syndrooman inflammatorisessa prosessissa.

A gengivoestomatite linfoplasmocítica felina (GELF) é uma síndrome clínica frequentemente observada na medicina de felinos. Trata-se de uma síndrome provavelmente multifatorial que envolve o sistema imune dos animais, agentes infecciosos e não infecciosos, de modo que a etiologia ainda não foi totalmente determinada. Diversos agentes infecciosos como o calicivírus felino (FCV), herpesvírus felino (FHV), vírus da leucemia felina (FeLV) e vírus da imunodeficiência felina (FIV) têm sido investigados. Este trabalho apresenta uma caracterização clínico, patológica, imuno-histoquímica e molecular de 27 felinos com GELF. Quanto à raça, 85,2% eram sem raça definida, 7,4% Siamês e 7,4% Maine Coon. Os machos corresponderam a 67% dos casos e fêmeas 33%. Quanto à idade, 10% apresentavam entre 1 e 3 anos, 20% entre 4 e 6 anos, 30% entre 7 e 9 anos, 15% entre 10 e 12 anos e 25% tinham mais do que 13 anos. A idade média dos felinos foi de 8,8 anos. Os principais sinais clínicos observados foram: disfagia (83,3%), halitose (72,2%), sialorreia (44,4%), emagrecimento (38,8%), intenso desconforto oral (33,3%), sangramento oral (22,2%), pelos opacos e quebradiços (11,1%) e intensa dispneia (5,5%). Macroscopicamente, eram lesões bilaterais no arco palatino e que se estendiam até a face lateral da base da língua. Em 77,8% elas eram difusas, de aspecto proliferativo, coloração vermelho intenso, friável e que sangravam facilmente durante a manipulação e em 22,2% as lesões eram multifocais a coalescentes, por vezes formando múltiplas vesículas, no arco palatino de aspecto avermelhado e edematoso. Microscopicamente, 14,8% apresentaram uma inflamação moderada (grau 2) e 85,2% dos animais apresentaram uma inflamação grave (grau 3). Os antígenos virais do FeLV foram identificados através da técnica de IHQ no epitélio e células do infiltrado inflamatório de 29,6% dos animais que apresentavam a GELF. Os antígenos virais do FIV foram identificados nas células do infiltrado inflamatório em 3,7% dos casos. Os antígenos virais do FCV não foram identificados nas lesões de GELF. Dezoito por cento dos animais foram positivos para FIV e 37% foram positivos para FeLV no exame de PCR. / Feline chronic gingivostomatitis (FCGS) is a clinical syndrome frequently observed in feline medicine. This is probably a multifactorial syndrome which involves the immune system of animals, infectious and noninfectious agent, though the causes have not been fully determined. Several infectious agents such as feline calicivirus (FCV), feline herpesvirus (FHV), feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) have been investigated. To determine clinical, pathological, immunohistochemical (IHC) and molecular characteristics of 27 cats with FCGS was developed. Regarding race, 85.2% were mixed breed, 7.4% Siamese and 7.4% Maine Coon. Males were 67% of cases and females 33%. Regarding age, 10% were between 1 and 3 years, 20% between 4 and 6 years, 30% between 7 and 9 years old, 15% between 10 and 12 years and 25% were older than 13 years. The average age of the cats was of 8.8 years. The main clinical signs were: dysphagia (83.3%), halitosis (72.2%), sialorrhoea (44.4%), weight loss (38.8%), intense oral discomfort (33.3%), oral bleeding (22.2%), hair opaque and brittle (11.1%) and severe dyspnea (5.5%). Grossly, the lesions were bilateral in the palatal arch and extending to the lateral side of the base of the tongue. In 77.7% they were diffuse, proliferative, intense red, crispy and bled easily during handling and in 22.3% lesions were multifocal to coalescing, sometimes forming multiple vesicles, the palatal arch reddish and edematous appearance. Microscopically, 14.8% showed moderate inflammation (grade 2) and 85.2% of the animals showed severe inflammation (grade 3). FeLV viral antigens were identified by IHC reaction in the epithelium and inflammatory cells of 29.6% of the animals showing FCGS. FIV viral antigens were identified in inflammatory cells in 3.7% of cases. FCV viral antigens were not identified in lesions of FCGS. Eighteen per cent of animals were positive for FIV and 37% were positive for FeLV in the PCR.

A gengivoestomatite linfoplasmocítica felina (GELF) é uma síndrome clínica frequentemente observada na medicina de felinos. Trata-se de uma síndrome provavelmente multifatorial que envolve o sistema imune dos animais, agentes infecciosos e não infecciosos, de modo que a etiologia ainda não foi totalmente determinada. Diversos agentes infecciosos como o calicivírus felino (FCV), herpesvírus felino (FHV), vírus da leucemia felina (FeLV) e vírus da imunodeficiência felina (FIV) têm sido investigados. Este trabalho apresenta uma caracterização clínico, patológica, imuno-histoquímica e molecular de 27 felinos com GELF. Quanto à raça, 85,2% eram sem raça definida, 7,4% Siamês e 7,4% Maine Coon. Os machos corresponderam a 67% dos casos e fêmeas 33%. Quanto à idade, 10% apresentavam entre 1 e 3 anos, 20% entre 4 e 6 anos, 30% entre 7 e 9 anos, 15% entre 10 e 12 anos e 25% tinham mais do que 13 anos. A idade média dos felinos foi de 8,8 anos. Os principais sinais clínicos observados foram: disfagia (83,3%), halitose (72,2%), sialorreia (44,4%), emagrecimento (38,8%), intenso desconforto oral (33,3%), sangramento oral (22,2%), pelos opacos e quebradiços (11,1%) e intensa dispneia (5,5%). Macroscopicamente, eram lesões bilaterais no arco palatino e que se estendiam até a face lateral da base da língua. Em 77,8% elas eram difusas, de aspecto proliferativo, coloração vermelho intenso, friável e que sangravam facilmente durante a manipulação e em 22,2% as lesões eram multifocais a coalescentes, por vezes formando múltiplas vesículas, no arco palatino de aspecto avermelhado e edematoso. Microscopicamente, 14,8% apresentaram uma inflamação moderada (grau 2) e 85,2% dos animais apresentaram uma inflamação grave (grau 3). Os antígenos virais do FeLV foram identificados através da técnica de IHQ no epitélio e células do infiltrado inflamatório de 29,6% dos animais que apresentavam a GELF. Os antígenos virais do FIV foram identificados nas células do infiltrado inflamatório em 3,7% dos casos. Os antígenos virais do FCV não foram identificados nas lesões de GELF. Dezoito por cento dos animais foram positivos para FIV e 37% foram positivos para FeLV no exame de PCR. / Feline chronic gingivostomatitis (FCGS) is a clinical syndrome frequently observed in feline medicine. This is probably a multifactorial syndrome which involves the immune system of animals, infectious and noninfectious agent, though the causes have not been fully determined. Several infectious agents such as feline calicivirus (FCV), feline herpesvirus (FHV), feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) have been investigated. To determine clinical, pathological, immunohistochemical (IHC) and molecular characteristics of 27 cats with FCGS was developed. Regarding race, 85.2% were mixed breed, 7.4% Siamese and 7.4% Maine Coon. Males were 67% of cases and females 33%. Regarding age, 10% were between 1 and 3 years, 20% between 4 and 6 years, 30% between 7 and 9 years old, 15% between 10 and 12 years and 25% were older than 13 years. The average age of the cats was of 8.8 years. The main clinical signs were: dysphagia (83.3%), halitosis (72.2%), sialorrhoea (44.4%), weight loss (38.8%), intense oral discomfort (33.3%), oral bleeding (22.2%), hair opaque and brittle (11.1%) and severe dyspnea (5.5%). Grossly, the lesions were bilateral in the palatal arch and extending to the lateral side of the base of the tongue. In 77.7% they were diffuse, proliferative, intense red, crispy and bled easily during handling and in 22.3% lesions were multifocal to coalescing, sometimes forming multiple vesicles, the palatal arch reddish and edematous appearance. Microscopically, 14.8% showed moderate inflammation (grade 2) and 85.2% of the animals showed severe inflammation (grade 3). FeLV viral antigens were identified by IHC reaction in the epithelium and inflammatory cells of 29.6% of the animals showing FCGS. FIV viral antigens were identified in inflammatory cells in 3.7% of cases. FCV viral antigens were not identified in lesions of FCGS. Eighteen per cent of animals were positive for FIV and 37% were positive for FeLV in the PCR.

A gengivoestomatite linfoplasmocítica felina (GELF) é uma síndrome clínica frequentemente observada na medicina de felinos. Trata-se de uma síndrome provavelmente multifatorial que envolve o sistema imune dos animais, agentes infecciosos e não infecciosos, de modo que a etiologia ainda não foi totalmente determinada. Diversos agentes infecciosos como o calicivírus felino (FCV), herpesvírus felino (FHV), vírus da leucemia felina (FeLV) e vírus da imunodeficiência felina (FIV) têm sido investigados. Este trabalho apresenta uma caracterização clínico, patológica, imuno-histoquímica e molecular de 27 felinos com GELF. Quanto à raça, 85,2% eram sem raça definida, 7,4% Siamês e 7,4% Maine Coon. Os machos corresponderam a 67% dos casos e fêmeas 33%. Quanto à idade, 10% apresentavam entre 1 e 3 anos, 20% entre 4 e 6 anos, 30% entre 7 e 9 anos, 15% entre 10 e 12 anos e 25% tinham mais do que 13 anos. A idade média dos felinos foi de 8,8 anos. Os principais sinais clínicos observados foram: disfagia (83,3%), halitose (72,2%), sialorreia (44,4%), emagrecimento (38,8%), intenso desconforto oral (33,3%), sangramento oral (22,2%), pelos opacos e quebradiços (11,1%) e intensa dispneia (5,5%). Macroscopicamente, eram lesões bilaterais no arco palatino e que se estendiam até a face lateral da base da língua. Em 77,8% elas eram difusas, de aspecto proliferativo, coloração vermelho intenso, friável e que sangravam facilmente durante a manipulação e em 22,2% as lesões eram multifocais a coalescentes, por vezes formando múltiplas vesículas, no arco palatino de aspecto avermelhado e edematoso. Microscopicamente, 14,8% apresentaram uma inflamação moderada (grau 2) e 85,2% dos animais apresentaram uma inflamação grave (grau 3). Os antígenos virais do FeLV foram identificados através da técnica de IHQ no epitélio e células do infiltrado inflamatório de 29,6% dos animais que apresentavam a GELF. Os antígenos virais do FIV foram identificados nas células do infiltrado inflamatório em 3,7% dos casos. Os antígenos virais do FCV não foram identificados nas lesões de GELF. Dezoito por cento dos animais foram positivos para FIV e 37% foram positivos para FeLV no exame de PCR. / Feline chronic gingivostomatitis (FCGS) is a clinical syndrome frequently observed in feline medicine. This is probably a multifactorial syndrome which involves the immune system of animals, infectious and noninfectious agent, though the causes have not been fully determined. Several infectious agents such as feline calicivirus (FCV), feline herpesvirus (FHV), feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) have been investigated. To determine clinical, pathological, immunohistochemical (IHC) and molecular characteristics of 27 cats with FCGS was developed. Regarding race, 85.2% were mixed breed, 7.4% Siamese and 7.4% Maine Coon. Males were 67% of cases and females 33%. Regarding age, 10% were between 1 and 3 years, 20% between 4 and 6 years, 30% between 7 and 9 years old, 15% between 10 and 12 years and 25% were older than 13 years. The average age of the cats was of 8.8 years. The main clinical signs were: dysphagia (83.3%), halitosis (72.2%), sialorrhoea (44.4%), weight loss (38.8%), intense oral discomfort (33.3%), oral bleeding (22.2%), hair opaque and brittle (11.1%) and severe dyspnea (5.5%). Grossly, the lesions were bilateral in the palatal arch and extending to the lateral side of the base of the tongue. In 77.7% they were diffuse, proliferative, intense red, crispy and bled easily during handling and in 22.3% lesions were multifocal to coalescing, sometimes forming multiple vesicles, the palatal arch reddish and edematous appearance. Microscopically, 14.8% showed moderate inflammation (grade 2) and 85.2% of the animals showed severe inflammation (grade 3). FeLV viral antigens were identified by IHC reaction in the epithelium and inflammatory cells of 29.6% of the animals showing FCGS. FIV viral antigens were identified in inflammatory cells in 3.7% of cases. FCV viral antigens were not identified in lesions of FCGS. Eighteen per cent of animals were positive for FIV and 37% were positive for FeLV in the PCR.