1/53. lemierre syndrome and acute mastoiditis.lemierre syndrome seldom follows an episode of pharyngotonsillitis. Characteristically, it is comprised of septic thrombosis of the internal jugular vein and bacteremia, leading to lung emboli and metastatic abscess formation. We describe lemierre syndrome that complicates an acute mastoiditis, with considerations regarding its pathogenesis and management. Despite its sporadic occurrence, awareness of lemierre syndrome is important, since early recognition reduces both the morbidity and mortality associated with it.- - - - - - - - - - ranking = 1keywords = abscess (Clic here for more details about this article) |
2/53. Neonatal meningitis and mastoiditis caused by Hemophilus influenzae.A newborn infant developed Hemophilus influenzae meningitis associated with acute coalescent mastoiditis and a cutaneous abscess in the mastoid region. Mastoidectomy was followed by prompt recovery from the meningitis, which had failed to clear previously despite antibiotic therapy. mastoiditis may exist as an infective focus in neonatal meningitis more frequently than has been appreciated. Mastoid roentgenograms are usually the only clue to diagnosis of this infection and should be obtained in patients with neonatal meningitis responding poorly to antibiotic therapy.- - - - - - - - - - ranking = 1keywords = abscess (Clic here for more details about this article) |
3/53. When a mastoid swelling is not mastoiditis.A case is reported of swelling over the mastoid process due to subgaleal abscess possibly secondary to trivial cutaneous trauma. The diagnosis was difficult as subgaleal abscess is an extremely rare condition especially after the advent of the antibiotic era. The route of entry of the infection to the subgaleal space was unclear as there was no skin puncture. The absence of substantial trauma excluded subgaleal haematoma as a precondition. We would like to discuss the possible aetiologies and the management of this rare case in the light of the limited information available in the world literature.- - - - - - - - - - ranking = 2keywords = abscess (Clic here for more details about this article) |
4/53. Acute mastoiditis and cholesteatoma.Acute coalescent mastoiditis is an uncommon sequela of acute otitis media. It occurs principally in the well-pneumatized temporal bone. The findings of fever, pain, postauricular swelling, and otorrhea are classic. cholesteatoma, on the other hand, being associated with chronic infection, usually occurs in the sclerotic temporal bone. The signs and symptoms are isidious in nature and consist of chronic discharge and hearing loss which result from its mass, bone erosion, and secondary infection. Of 17 consecutive cases of acute mastoiditis over a six-year period, four were atypical because they were complications of chronic otitis media and cholesteatoma, yet they had the physical findings of acute mastoiditis-subperiosteal abscess and purulent otorrhea, plus radiographic evidence of mastoid coalescence.- - - - - - - - - - ranking = 1keywords = abscess (Clic here for more details about this article) |
5/53. Otogenic lateral sinus thrombosis--a case report.INTRODUCTION: We portray and discuss a case of lateral sinus thrombosis following acute otitis media and mastoiditis. CLINICAL PICTURE: The patient presented with otorrhoea, otalgia, neck pain, fever and chills. TREATMENT: Cortical mastoidectomy was performed. Intravenous antibiotics and heparin were administered. OUTCOME: The patient had a complete recovery with no sequelae. CONCLUSIONS: Neurotologic complications of suppurative otitis media like meningitis, cerebral abscess, extradural abscess and dural sinus thrombosis are rare in the antibiotic era. Hence, doctors today have to maintain extra vigilance and a high index of suspicion for such complications.- - - - - - - - - - ranking = 2keywords = abscess (Clic here for more details about this article) |
6/53. Endogenous endophthalmitis and necrotising pneumonia caused by klebsiella pneumoniae in a child with beta-thalassaemia major.A case beta-thalassaemia major complicated with klebsiella pneumoniae endogenous endophthalmitis is presented to increase physician awareness of the association of the two clinical conditions. Severe morbidity including subretinal abscess and retinal detachment may develop despite aggressive intravenous and intravitreal ceftriaxone therapy, along with vitrectomy and external drainage.- - - - - - - - - - ranking = 1keywords = abscess (Clic here for more details about this article) |
7/53. Intracranial complications of acute and chronic mastoiditis: report of two cases in children.OBJECTIVE: The clinical picture of mastoiditis, sigmoid sinus thrombosis and brain abscess has changed with the advent of antibiotics. A delay in the recognition of intracranial complications in children and in the institution of appropriate therapy may result in morbidity and mortality. Increased mortality of the children has been correlated with the neurological status of the patient on admission to hospital. METHOD: A retrospective study was made of two children with acute mastoiditis and sigmoid sinus thrombosis and chronic mastoiditis with cerebellar abscess treated in 1997 in the ENT Department of the Medical University of Gdansk. RESULTS: We present two cases of intracranial complications in children (13 and 11 years old) originating from acute and chronic otitis media. The first case, of a 13-year-old boy with sigmoid sinus thrombosis as a complication of acute otitis media took its course as a typical Symonds Syndrome. Mastoidectomy, thrombectomy and jugular vein ligation associated with antibiotics and edema-reducing drugs and anticoagulants proved to be successful. The second case of an 11-year-old boy with exacerbated chronic otitis media with cholesteatoma and mastoiditis, was complicated by suppurative meningitis, cerebellar abscess, perisinual abscess and sigmoid sinus thrombophlebitis. Neurosurgical approach by suboccipital craniotomy and abscess drainage was ineffective. Otological treatments of modified radical mastoidectomy, thrombectomy, jugular vein ligation, perisinual and cerebellar abscess drainage associated with wide-spectrum antibiotics and edema-reducing drugs were performed with a very good outcome. After 3 years of follow-up the patients remain without any neurological and psychiatric consequences. CONCLUSION: The authors show different courses of both presented complications and imaging techniques and surgical procedures performed in these children. The sigmoid sinus trombosis with Symonds Syndrome may be difficult to diagnose due to previous antibiotics valuable in establishing the diagnosis and the extent of disease. The successful therapy is based on understanding of pathogenesis of the intracranial complication and the cooperation of an otolaryngologist, a neurologist, a neurosurgeon and an ophthalmologist.- - - - - - - - - - ranking = 6keywords = abscess (Clic here for more details about this article) |
8/53. Bezold's abscess in children: case report and review of the literature.The introduction of antibiotics in the treatment of suppurative otitis media has significantly decreased the incidence of complications. Reports of Bezold's abscess secondary to this disorder are rare, particularly in infants and young children, in whom mastoid bone pneumatization is not yet complete. We present a case of Bezold's abscess occurring in a child aged 18 months. The literature is reviewed and methods to accurately diagnose this complication are emphasized.- - - - - - - - - - ranking = 6keywords = abscess (Clic here for more details about this article) |
9/53. Acute coalescent mastoiditis and acoustic sequelae in an infant with severe congenital neutropenia.We report a 2-month-old boy with severe congenital neutropenia (SCN), who developed acute necrotizing otitis media and coalescent mastoiditis due to methicillin-sensitive staphylococcus aureus. The infection fulminantly progressed within a day to a subtotal perforation of the tympanic membrane, destructive bony changes of ossicles, lateral subperiosteal abscess, and suppurative labyrinthitis. Despite the combined treatment with intravenous antibiotics and granulocyte colony-stimulating factor, the infection resulted in mixed hearing impairment. Much attention should be given to prompt diagnosis of otomastoiditis in SCN, a rare congenital disorder, since resultant acoustic sequelae may affect subsequent speech development and intellectual ability.- - - - - - - - - - ranking = 1keywords = abscess (Clic here for more details about this article) |
10/53. Mastoid subperiosteal abscess management in children.The management of a mastoid subperiosteal abscess has traditionally required mastoidectomy. With the improvement of antibiotic therapy current literature supports the treatment of uncomplicated acute mastoiditis with myringotomy and intravenous antibiotics. Treatment of a mastoid subperiosteal abscess with tympanostomy tube insertion, intravenous antibiotics, and postauricular incision and drainage of the abscess avoids the morbidity and potential complications of mastoid surgery in young children. Three patients diagnosed with a mastoid subperiosteal abscess were managed in this way. The outcome of their treatment has been documented with lengthy otologic follow-up. Complete resolution of the acute infectious process was achieved in all cases with no evidence of recurrent disease.- - - - - - - - - - ranking = 8keywords = abscess (Clic here for more details about this article) |
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