1/29. erythema multiforme after application of aural Gentisone HC drops. erythema multiforme is an uncommon acute self-limiting condition characterized by mucocutaneous lesions of varying severity with a variable pattern of recurrence. This is a case of a four-year-old girl who developed erythema multiforme secondary to topical aural application of Gentisone HC drops (hydrocortisone acetate one per cent, gentamicin 0.3 per cent (as sulphate)) prescribed as a treatment for otorrhoea following grommet insertion. The clinical features are described and the literature reviewed. To my knowledge, this is the first reported case in the literature, of erythema multiforme secondary to a topical aminoglycoside/steroid preparation. ( info) |
2/29. Drug-resistant tuberculous mastoiditis in 2 children. tuberculosis of the middle ear and mastoid is uncommon nowadays. Two cases of drug-resistant tuberculous mastoiditis in immunocompetent Greek native children are reported and the diagnostic and therapeutic difficulties of this rare condition are discussed. ( info) |
| 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. ( info) |
4/29. Anaphylactoid reaction caused by moxifloxacin. We report on a patient who suffered an anaphylactoid reaction because of moxifloxacin. ( info) |
| facial nerve schwannomas are clinically challenging tumors. This is a case study of a young woman with an extensive facial nerve schwannoma. The clinical presentation, radiographic diagnosis, pathological confirmation, and treatment options for this relatively rare tumor are discussed. ( info) |
| A girl with coloboma of the iris, sensorineural deafness, growth delay, distinctive face, and cranial nerve dysfunction was diagnosed of CHARGE association in the first year of life. She presented with repeated otitis. At 3 yr of age, the patient suffered a septicemia (streptococcus pneumoniae, corynebacterium sp.). The immunoglobulin g (IgG) and IgA serum levels were decreased, IgM increased and cellular immunity parameters were normal, supporting the diagnosis of hyper-IgM (HIM) syndrome. The sequence of cd40 ligand and cytidine deaminase genes were normal. From then on, she was receiving immunoglobulin intravenously with an excellent outcome. Here, we report the first case of CHARGE association and HIM syndrome in the same patient. Although the cause could not be identified, a non-random link is likely. ( info) |
| OBJECTIVE: To describe the clinical features of serum sickness-like diseases (SSLD) in cefaclor-treated patients. DESIGN: Analysis of a case series spontaneously reported to Lyons pharmacovigilance Center. SETTING: General and hospital practitioners and the French Network of Regional pharmacovigilance Centers (FNRPC). patients: All reported cases with a possible causative relationship between cefaclor treatment and SSLD. MAIN RESULTS: Eight cases of SSLD following cefaclor treatment are described. The clinical features included cutaneous reactions, arthralgias, and moderate hyperthermia. In 50 percent of the patients, hospitalization was required because of incapacitating symptoms. The outcome was benign in all cases following discontinuation of the offending drug. All eight cases were reported in children under five years of age. Among 137 cefaclor-associated drug reactions collected by FNRPC, 27 cases of SSLD have been reported; 23 of these patients were younger than five years of age. A literature survey confirmed the higher reporting of SSLD in children with cefaclor compared with other antibiotics and suggested an incidence of 0.024-0.2 percent of SSLD per drug course of cefaclor. CONCLUSIONS: The case reports and epidemiologic studies confirmed the presumed role of age (patients under five years of age) in cefaclor-induced SSLD and the benign outcome despite severe clinical presentations in some reports. ( info) |
8/29. Conductive hearing loss with normal tympanic membrane: fibrous change of long process of the incus. This is a case of conductive hearing loss with the normal tympanic membrane due to fibrosis caused by potential inflammation of the long process of the incus. High resolution CT was a useful tool for the detection of ossicular disorder. ( info) |
9/29. A case of relapsing polychondritis associated with hemolytic anemia. Relapsing Polychondritis (RPC) is a rare disorder of unknown etiology which affects mucopolysaccharide-rich tissues such as cartilage. A 64-year-old man developed auricular and nasal chondritis with complaints of arthralgia of the hands and cervical pain. The auricular biopsy established the diagnosis of RPC. The hematological data revealed normocytic, slightly hypochromic anemia, a persistently elevated reticulocyte count, slightly increased bilirubin, and decreased haptoglobin. The presence of hemolytic anemia was confirmed by the shortened half-life of erythrocytes and erythroid hyperplasia of the bone marrow. This case illustrates the coexistence of RPC and hemolytic anemia which has been only rarely reported. The pathogenesis of RPC is also discussed may elucidate the pathogenesis of this disease. ( info) |
10/29. Cholestatic hepatitis due to an amoxycillin/clavulanic acid preparation. Two cases of reversible cholestatic hepatitis after treatment with an amoxycillin/clavulanic acid preparation (Augmentin) are described. ( info) |