1/15. Acute nasopharyngitis in adults: an independent clinical entity? Acute adult nasopharyngitis may exist as an independent clinical entity without preceding or following symptoms and signs of the usual and common upper respiratory tract infections. Three representative cases with color photographs are presented to support this conclusion. Routine endoscopic nasopharyngoscopy allows a better understanding of this uncommon nasopharyngeal and other disorders. ( info) |
| OBJECTIVE: To describe one patient with a puzzling therapy-resistant unilateral chronic otitis media, analyze his diagnosis, and describe three similar patients with the same symptoms and signs, i.e., a chronic ear problem together with gastroesophageal reflux disease (GERD). STUDY DESIGN: Thorough analysis of one patient with a chronic ear problem and GERD, both of which responded favorably after antireflux therapy consisting of omeprazole and conservative antireflux measures (raising the head of the bed by 20 to 25 cm, avoiding meals and drinks 3 hours before retiring, and other dietary and lifestyle modifications), and a search for more patients with similar coexisting conditions. SETTING: Tertiary referral center. methods: patients with chronic ear problems and GERD were thoroughly analyzed by the otorhinolaryngologist and the gastroenterologist. The latter used endoscopy and Savary-Miller's classification of esophagitis, a 24-hour ambulatory dual esophageal ph monitoring, and esophageal manometry. RESULTS: Four patients were identified who had a chronic ear problem and simultaneous GERD. It is reasoned that the GERD leads to nasopharyngitis and this to a chronic ear problem. All the patients responded favorably to anti-GERD therapy. CONCLUSIONS: GERD may manifest itself as an extraesophageal manifestation, such as nasopharyngitis, leading to ear disease. Therapy-resistant chronic middle ear disease may be caused by GERD. ( info) |
3/15. chromobacterium violaceum infection in children: a case of fatal septicemia with nasopharyngeal abscess and literature review. This previously healthy 5-year-old boy initially presented with fever and purulent conjunctivitis. The course evolved rapidly into preseptal and facial cellulitis, nasopharyngeal abscess and sepsis. chromobacterium violaceum was isolated from conjunctival exudate and blood cultures. He received intravenous cefazolin therapy for 2 days, followed by penicillin, oxacillin and netilmicin. However, no improvement was noted, and he died on the fifth days of illness. ( info) |
4/15. Human nasopharyngeal linguatuliasis (Pentasomida) caused by Linguatula serrata. A human nasopharyngeal linguatuliasis was reported for the second time in egypt. The patient (20 years old male) was presented with main conspicuous complaints, fever, urticaria (face and neck), coughing, vomiting and passage of small (less than 1 cm. in length) worm-like structures in his nasal discharge and vomitus. Symptomatic treatment was given followed by a single dose of praziquantel after identification of the causative parasite. Human linguatuliasis (pentastomiasis) was discussed. ( info) |
5/15. Chronic idiopathic inflammation of the retropharyngeal space presenting with sequential abducens palsies. We describe a patient who presented with sequential, bilateral abducens palsies associated with a mass of the nasopharynx. biopsy of the mass showed chronic non-specific inflammation and fibrosis. The diagnosis of idiopathic inflammatory pseudotumor was arrived at by exclusion of other known causes of inflammation of the retropharyngeal space. magnetic resonance imaging suggested that injury to the sixth cranial nerves probably occurred as they traversed the dura and subarachnoid space overlying the clivus. ( info) |
6/15. Cordylobia anthropophaga (diptera: Calliphoridae) outside africa: a case of furuncular myiasis in a child returning from congo. International travel to tropical countries accounts for an increasing incidence of imported diseases. An unusual case of furuncular myiasis due to Cordylobia anthropophaga (Blanchard) is reported in northern france in a 9-mo-old infant, after a 4-mo stay in congo. A review has been made of the major cases of imported furuncular myiasis due to Cordylobia, as well as identification of second larval instars and management of the myiasis. ( info) |
7/15. An unusual rhino-pharyngeal foreign body. BACKGROUND: foreign bodies of the upper aerodigestive tract are commonly seen in the paediatric population; however adult patients with nasal foreign bodies in particular are much less common and when sharp foreign bodies are present there is a great risk of developing complications. STUDY DESIGN: This is a case report of a 20-year-old male magician with impacted rhino-pharyngeal foreign body. He intentionally inserted two long sewing needles into the right nasal cavity during a magical act. RESULTS: The impacted foreign bodies were located in his nose/pharynx and removal was achieved per orally under general anaesthesia. Only a minimal evidence of retropharyngeal abscess was noted despite the prolonged stay of the foreign bodies. CONCLUSION: This case highlights the fact that both a deliberate and an accidental foreign body in an adult nasal cavity can get impacted as well as the significance for its early removal. ( info) |
8/15. Intranasal use of QuickClot in a patient with uncontrollable epistaxis. A 60-year-old man who presented with nasopharyngitis developed uncontrollable epistaxis following a punch biopsy of the nasopharynx. QuickClot was successfully used to arrest the haemorrhage under general anaesthesia after the usual methods employed to secure haemostasis failed. The haemostatic plug was successfully removed a week later after control of the infection. This case represents the first reported intranasal use of QuickClot. We describe our experience and a literature review on this haemostatic agent. ( info) |
9/15. Dermatological signs of nasopharyngeal linguatulosis (halzoun, Marrara syndrome)--the possible role of major basic protein. Two hours after ingestion of improperly cooked meat a German tourist in tunisia showed coughing, hoarseness, dysphagia, anosmia, frontal headache and epistaxis. At the same time a papular non-itching exanthema developed. The nasal discharge contained nymphs of Linguatula serrata. Histological examination of the papules revealed tissue eosinophilia and 'flame figures'. Nasopharyngeal and skin signs subsided spontaneously within 10 days. The possible role of major basic protein in the pathogenesis of nasopharyngeal linguatulosis is discussed. ( info) |
10/15. Rhinocerebral mucormycosis: MR manifestations. Magnetic resonance (MR) examinations of three patients with rhinocerebral mucormycosis are reviewed. The clinical course is outlined and the MR characteristics are analyzed in light of the known pathology. The major MR findings include sinus and orbital disease followed by deep facial extension. Involvement of basal portions of the hemispheres, brain stem, and hypothalamus occurred rapidly following ipsilateral facial or orbital invasion in all three cases. Regions of intracerebral inflammation were hyperintense compared with normal parenchyma on T2-weighted and proton density-weighted images. Septic cavernous sinus and internal carotid artery thrombosis was diagnosed by MR in one case. Magnetic resonance demonstrated partial resolution of intracerebral abnormalities that accompanied clinical improvement in the one surviving patient. ( info) |