1/44. First report of cryptococcus laurentii meningitis and a fatal case of cryptococcus albidus cryptococcaemia in AIDS patients.We report the first case of cryptococcus laurentii meningitis and a rare case of cryptococcus albidus cryptococcaemia in AIDS patients. Both infections were treated with amphotericin b and flucytosine. The C. laurentii meningitis was controlled after 2 weeks of treatment with no evidence of infection 20 months later. The patient with C. albidus cryptococcaemia, despite the amphotericin b/flucytosine combination therapy, died on the 14th day of treatment. The minimum inhibitory concentrations (MICs) for C. laurentii, as determined by Etest on RPMI 1640 agar, were 0.25 microg ml(-1) of amphotericin b, 1.25 microg ml(-1) flucytosine, 4 microg ml(-1) fluconazole, 0.50 microg ml(-1) itraconazole and 1.0 microg ml(-1) of ketoconazole. The MIC of amphotericin b for C. albidus was 0.5 microg ml(-1), flucytosine 1.25 microg ml(-1), fluzonazole 4 microg ml(-1), itraconazole 0.5 microg ml(-1) and ketonazole 0.25 microg ml(-1). The agreement of the amphotericin b MIC values obtained in antibiotic medium 3 by the broth microdilution method, with those obtained on casitone medium by Etest, was within a two-dilution range for both isolates. C. laurentii may cause meningitis and may also involve the lungs in AIDS patients.- - - - - - - - - - ranking = 1keywords = medium (Clic here for more details about this article) |
2/44. Intracranial transorbital injury by a wooden foreign body: re-evaluation of CT and MRI findings.Despite modern radiological imaging, a transorbital intracranial injury with a wooden foreign body can present a vexing diagnostic problem. The orbit forms an easy path for low-velocity foreign bodies into the intracranial space. Often the severity of the injury is masked by unobtrusive superficial wounds and lack of a primary neurological deficit. Misinterpretation of CT findings may delay adequate treatment, whereas MRI is more sensitive and specific. However, MRI T1-W can demonstrate an isointense or even hyperintense signal. Findings after the use of MRI contrast medium are presented and the diagnostic features of CT and MRI are reviewed. Two cases of such injury are presented.- - - - - - - - - - ranking = 0.5keywords = medium (Clic here for more details about this article) |
3/44. fusobacterium necrophorum: a rare cause of meningitis in children.We report a case of non-fatal meningitis secondary to suppurative otitis media in a previously healthy young boy. fusobacterium necrophorum was isolated from blood; spinal fluid was cultured aerobically only but yielded no growth. After treatment with intravenous antibiotics and surgery the patient recovered, with a mild sequela of hypoglossus paresis.- - - - - - - - - - ranking = 5.6996752290058keywords = otitis (Clic here for more details about this article) |
4/44. MR demonstration of brain abscess rupture into the subarachnoid space and its possible implication in management.BACKGROUND: rupture of brain abscess into the subarachnoid space as a cause of meningitis is rare. early diagnosis improves the outcome. There is no previous report of MR demonstration of rupture of brain abscess into the subarachnoid space. CASE DESCRIPTION: Two young adults with chronic suppurative otitis media presenting with signs of increased intracranial pressure and meningeal irritation underwent magnetic resonance imaging, which showed brain abscess with evidence of rupture into the subarachnoid space and meningitis. This helped in early diagnosis and aggressive management. CONCLUSION: In cases of brain abscess where meningitis is suspected clinically, documentation of rupture of the abscess into the subarachnoid space will help in avoiding cerebrospinal fluid (CSF) examination that may be disastrous in these patients who already have increased intracranial pressure.- - - - - - - - - - ranking = 5.6996752290058keywords = otitis (Clic here for more details about this article) |
5/44. Gradenigo's syndrome--a rare complication of otitis media.Petrous apicitis is a rare intracranial complication of otitis media. A 4-year-old female child was presented with persistent ear discharge, retro-orbital pain and lateral rectus palsy (triad of Gradenigo's syndrome). A right temporal burr-hole was placed and tapping was done under antibiotic coverage. Turbid cerebrospinal fluid could be drained. Follow-up could not be done as the patient refused treatment and was discharged against medical advice.- - - - - - - - - - ranking = 28.498376145029keywords = otitis (Clic here for more details about this article) |
6/44. petrous bone fractures in children: risk of meningitis, and indication for early Cochlear implant?The case of a 5 year old boy who had a right petrous bone fracture with right CSF otorrhea and deafness is reported. This child presented, three years after the trauma, a right side otitis media, complicated by meningitis and pneumococcal sepsis, which might have as consequence a left side deafness. The bilateral deafness and the early possibility for cochlear ossification made us decide rapidly on a cochlear implant. Benjamin was then operated for a left side cochlear implant 40 days after contracting meningitis. Two months later, this boy was able to understand a speech without lip reading. Current concepts in the management of petrous bone fractures with CSF otorrhea are reviewed in this report. We also discussed prophylactic attitudes to adopt to reduce the risk of post temporal bone fracture meningitis.- - - - - - - - - - ranking = 5.6996752290058keywords = otitis (Clic here for more details about this article) |
7/44. Gradenigo syndrome: a case-report.We report a case of sixth nerve palsy as a rare complication of acute otitis media (apical petrositis). The clinical triad of acute otitis media, pain in the distribution of the fifth cranial nerve and sixth nerve palsy is known as Gradenigo syndrome.- - - - - - - - - - ranking = 11.399350458012keywords = otitis (Clic here for more details about this article) |
8/44. Hypertrophic chronic pachymeningitis associated with chronic otitis media and mastoiditis.We describe the case history of a 70-year-old female patient presenting with bilateral hearing disturbance, facial paralysis, and vertigo. Radiological tests of temporal bone revealed soft tissue in the mastoid and tympanic cavities, and T1 weighted MRI revealed prominent Gd enhancement of the middle skull basal meninges. Middle ear inflammation appeared to induce pachymeningitis and to exacerbate associated symptoms, leading to a decline in the patient's overall condition. Bilateral mastoidectomies were effective in improving her general condition. Her hearing improved only on the right side because ossiculoplasty was performed only on that side. Her facial movement progressively improved and pachymeningitis diminished over time. We speculate that removal of the infectious granulation within the middle ears and mastoids ameliorated the acute inflammation. The etiology remains unknown in this case.- - - - - - - - - - ranking = 22.798700916023keywords = otitis (Clic here for more details about this article) |
9/44. Recurrent acute otitis media associated meningitis in a patient with a contralateral cochlear implant and bilateral cochleovestibular dysplasia.OBJECTIVE: To illustrate that a patient with a cochlear implant may be at increased risk of meningitis secondary to developmental anatomic abnormality associated with the underlying sensorineural hearing loss, as opposed to the implant itself. methods: Case report. RESULTS: Our 12-year-old patient has bilateral cochlear dysplasia, profound sensorineural hearing loss and no prior history of recurrent acute otitis media or meningitis. He underwent a left cochlear implant at 8 years of age and subsequently experienced three episodes of right acute otitis media and meningitis over the next 4 years. Middle ear exploration revealed a cerebrospinal fluid leak. A right radical mastoidectomy with closure of the external auditory canal, removal of the tympanic membrane, malleus, and incus, closure of the eustachian tube, and obliteration of the mastoid and middle ear with abdominal fat has prevented further episodes. CONCLUSION: meningitis in a patient with a cochlear implant is not necessarily related to the implant.- - - - - - - - - - ranking = 34.198051374035keywords = otitis (Clic here for more details about this article) |
10/44. Rapid evolution of acute mastoiditis: three case reports of otogenic meningitis in adults.Otogenic meningitis is the most common intracranial complication of neglected otitis media. In the western world, such complications seldom occur in children and young adults and are extremely rare in adults and elderly people. The current use of antibiotics and of more sophisticated surgery has greatly diminished the incidence of otogenic meningitis in comparison with the past. This has resulted in physicians having less experience concerning diagnosis and treatment of this complication. The authors reported 3 consecutive cases of otogenic meningitis in adults, which occurred in the space of 3 months after a 6-year absence of such pathology at their institution. In all 3 cases, conventional antibiotic therapy proved ineffective; the course of the disease worsened rapidly in contrast with the lack of symptoms during the period before treatment. Emergency surgical treatment was mandatory.- - - - - - - - - - ranking = 5.6996752290058keywords = otitis (Clic here for more details about this article) |
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