1/81. Severe otitis and mastoiditis due to rhodococcus equi in a patient with AIDS. Case report.We report a case of otitis media associated with pneumonia due to rhodococcus equi. A 31-year-old patient with AIDS presented with cough and right facial palsy. Imaging revealed right otitis media and severe temporal bone destruction, associated with pneumonia. R. equi was isolated from ear secretions, blood, and sputum. The radiologic findings are described. This unusual pathogen should be included in the differential diagnosis of the immunocompromised patient with aggressive otitis.- - - - - - - - - - ranking = 1keywords = otitis (Clic here for more details about this article) |
2/81. Tuberculous otitis media in a four-month-old infant.Tuberculosis of the middle ear is currently a rare disease but still occurs and may cause permanent hearing loss. A four-month-old infant with chronic left-ear drainage was diagnosed with tuberculous otitis media by biopsy examination and PPD positivity without BCG. He was treated successfully with antituberculous therapy. Tuberculosis should be considered in the differential diagnosis of chronic ear infection, especially in young infants.- - - - - - - - - - ranking = 0.71428571428571keywords = otitis (Clic here for more details about this article) |
3/81. streptococcus pyogenes meningitis: report of a case and review of the literature.streptococcus pyogenes is a very uncommon cause of bacterial meningitis beyond the neonatal period. A case report and a review of the recent literature is presented. We report on a previously healthy 7-year-old boy who developed S. pyogenes meningitis following a 2-day history of otitis media. A CT scan revealed right-sided mastoiditis as a possible focus of infection. The patient was treated with penicillin g for 14 days. The clinical course was uneventful, and the recovered without sequelae. By means of the polymerase chain reaction, the presence of streptococcal pyrogenic exotoxin (SPE) B and SPE C, but not SPE A genes was discovered from the bacterial dna. CONCLUSION: streptococcus pyogenes is a rare cause of bacterial meningitis but has to be considered as the causative pathogen beyond the neonatal period.- - - - - - - - - - ranking = 0.14285714285714keywords = otitis (Clic here for more details about this article) |
4/81. methicillin-resistant staphylococcus aureus: pediatric otitis.BACKGROUND: methicillin-resistant staphylococcus aureus (MRSA) is a potentially lethal organism in pediatric patients. MRSA is an uncommon otologic pathogen that requires special diagnostic and therapeutic intervention. methods: Three pediatric patients with community-acquired MRSA otologic infections were identified during 1999. SETTING: Tertiary care ear institution. RESULTS: All patients required intravenous antibiotic therapy to achieve resolution of the infections. CONCLUSIONS: MRSA in children can be community acquired and can cause otitis externa, otitis media with otorrhea, or acute mastoiditis; intravenous therapy that includes vancomycin is necessary for resolution.- - - - - - - - - - ranking = 0.85714285714286keywords = otitis (Clic here for more details about this article) |
5/81. Clinical experiences with acute mastoiditis--1988 through 1998.The incidence of acute mastoiditis has declined dramatically during the postantibiotic era. Even so, antibiotic-resistant or unusual pathogens can still cause this disease entity. At our hospital, we documented an increase in antibiotic-resistant and atypical pathogens such as actinomyces spp. and mycobacterium tuberculosis. In this paper, we discuss the optimal diagnosis and treatment strategy for acute mastoiditis, and we describe our retrospective review of 13 patients with mastoiditis who were treated at our hospital from 1988 through 1998. Eight of these patients recovered following treatment with intravenous antibiotics, with or without myringotomy, and five who had complications of disease were managed surgically. Among these five, one developed chronic otitis media and one developed cholesteatoma 3 years later. For patients with acute mastoiditis, we emphasize the need to be aware of any unusual pathogens that do not respond to empiric antibiotic therapy.- - - - - - - - - - ranking = 0.14285714285714keywords = otitis (Clic here for more details about this article) |
6/81. Turicella otitidis mastoiditis in a healthy child.Turicella otitidis, a coryneform bacterium, has been associated with acute otitis media. A 5-year-old girl developed acute mastoiditis. Turicella was isolated from the right and left middle ear fluid.- - - - - - - - - - ranking = 0.14285714285714keywords = otitis (Clic here for more details about this article) |
7/81. 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 = 0.28571428571429keywords = otitis (Clic here for more details about this article) |
8/81. 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 = 0.28571428571429keywords = otitis (Clic here for more details about this article) |
9/81. Fungal malignant otitis externa due to scedosporium apiospermum.Malignant otitis externa (MOE) is an infection of the external auditory canal that invades the skull base. aspergillus species fungi were the pathological organism in 21 of 23 reported cases of fungal MOE. We report on a 21-year-old man with end-stage acquired immunodeficiency syndrome (AIDS) and fungal MOE caused by scedosporium apiospermum. Fungal MOE is most common in patients with end-stage AIDS and hematologic malignancies. granulation tissue is not a common finding in these patients, and the infectious process often starts in the mastoid air cells or middle ear space, as opposed to the external auditory canal. Surgical debridement and amphotericin b are the mainstays of therapy; resolution of the infection depends greatly on the severity of the underlying disease.- - - - - - - - - - ranking = 0.71428571428571keywords = otitis (Clic here for more details about this article) |
10/81. 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 = 0.42857142857143keywords = otitis (Clic here for more details about this article) |
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