1/33. Tissue expander infections in children: look beyond the expander pocket.Infection of the expander pocket is the most common complication encountered with soft-tissue expansion. It is usually due to direct inoculation with skin flora either at the time of expander insertion or from extrusion of the device. The authors report two cases of infection of tissue expanders in which the children had concomitant infected sites distant from the prosthesis. Etiological bacteria of common pediatric infections like otitis media and pharyngitis were cultured from the infected expander pocket, raising suspicion that translocation of the organism to the expander had occurred. Aggressive antibiotic treatment, removal of the prosthesis, and flap advancement is advocated.- - - - - - - - - - ranking = 1keywords = otitis (Clic here for more details about this article) |
2/33. Labyrinthine involvement and multiple perforations of the tympanic membrane in acute otitis media due to group A streptococci.We present here three cases of acute otitis media caused by a virulent group A streptococcal infection that rapidly led to deterioration in hearing. Two of the three cases presented with severe sensorineural and mixed hearing loss with multiple tympanic membrane perforations, and the third presented with severe bilateral sensorineural hearing loss following acute otitis media involving group A streptococci. All patients were treated with systemic (piperacillin) and topical antibiotics (ofloxacin ear drops): one patient also received a systemic steroid (betamethasone). deafness persisted in one patient but in the other two, hearing gradually recovered. Severe cytotoxicity was considered to have occurred in all patients, resulting in multiple perforations of the tympanic membrane and necrosis in the middle ear.- - - - - - - - - - ranking = 6keywords = otitis (Clic here for more details about this article) |
3/33. 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 = 1keywords = otitis (Clic here for more details about this article) |
4/33. Juvenile relapsing periarteritis nodosa and streptococcal infection.Classic polyarteritis nodosa is a multisystem inflammatory disease associated with necrotizing vasculitis of small and medium arteries. In most cases, the causes of polyarteritis nodosa remain unknown, but viruses (HBV, HCV, hiv) and microbes (especially streptococcus) have been considered as etiologic or contributing factors. A 13-year-old boy was admitted with fever, skin lesions, polyarthritis and muscle involvement. A muscle biopsy demonstrated a necrotizing vasculitis and antistreptolysin titre was tremendously increased. His condition improved following the administration of oral steroids but he experienced relapses 5 and 12 years later when penicillin withdrawal was attempted. The flares were accompanied by a major increase of antistreptolysin titre and response to corticosteroid was obtained. He is currently 38 years old and he remains well on prophylactic penicillin. polyarteritis nodosa in children may occur after a streptococcal infection. It may be prudent to consider penicillin prophylaxis in patients with periarteritis nodosa when a streptococcal etiology is documented or highly suspected.- - - - - - - - - - ranking = 0.14939889122187keywords = medium (Clic here for more details about this article) |
5/33. Group A beta-haemolytic streptococcal acute chest event in a child with sickle cell anaemia.acute chest syndrome is a major cause of death and hospitalisation in children with sickle cell anaemia. It is often initiated by an infection, particularly pneumonia. Microbial agents previously not associated with acute chest syndrome are becoming increasingly important. Group A beta-haemolytic Streptococcus (GABHS) is thought to be an uncommon cause of pneumonia in children with sickle cell anaemia. We report a 15-year-old African-American girl who presented with an acute chest event characterised by fever, cough, chest pain, shortness of breath, right upper abdominal quadrant pain, jaundice and otitis media. Chest radiograph showed multi-lobar pneumonia with left pleural effusion. Group A beta-haemolytic Streptococcus was isolated from culture of pleural and middle ear fluids. She responded to therapy that included antibiotics, exchange blood transfusion, oxygen, thoracotomy chest tube drainage and decortication. In a child with sickle cell anaemia presenting with fever and an acute chest event, pneumonia should be considered and GABHS recognised as a possible aetiological agent. In addition, a chest X-ray should be obtained and antibiotics against agents causing community-acquired pneumonia instituted.- - - - - - - - - - ranking = 1keywords = otitis (Clic here for more details about this article) |
6/33. Lemierre's syndrome caused by viridans streptococci: a case report.A 53-year-old man had fever, chills, and a progressively enlarged mass over the left mandibular angle for one month. A chest radiograph showed two small nodules in the upper right lung field. A contrast-medium-enhanced head-and-neck computed tomograph revealed severe necrosis within the left lateral pharyngeal space and total obliteration of the left internal jugular vein. viridans streptococci were identified in the blood culture and the debrided tissue culture 2 days post-admission. The presentations were characteristic of Lemierre's syndrome and were evident in this case, however, the causative agent was viridans streptococci and the host was much older than the others previously reported. The normal flora of the oropharynx could become a fatal bacterium when the intact mucosal barrier of the mouth is impaired, regardless of the patient's age.- - - - - - - - - - ranking = 0.14939889122187keywords = medium (Clic here for more details about this article) |
7/33. meningitis in a girl with recurrent otitis media caused by streptococcus pyogenes--otitis media has to be treated appropriately.streptococcus pyogenes rarely causes meningitis. A recent increase in the incidence and severity of diseases due to S. pyogenes has been observed worldwide, without an apparent increase in the incidence of S. pyogenes meningitis. However, more recently severe and fulminant cases of S. pyogenes meningitis have been reported in the literature. This case report emphasizes the fact that S. pyogenes can cause meningitis with severe clinical sequelae such as hygromas and right-sided third cranial nerve palsy. Most importantly, it is concluded that recurrent otitis media has to be treated carefully following appropriate identification of the causing organism in order to prevent severe clinical courses of streptococcal infections.- - - - - - - - - - ranking = 9keywords = otitis (Clic here for more details about this article) |
8/33. Group a streptococcal meningitis in adults: report of 41 cases and a review of the literature.Chart review of 41 adult patients with group A streptococcal (GAS) meningitis in The netherlands revealed that this is a community-acquired disease and occurs mainly in patients with predisposing factors: of the 41 patients in this case series, 24 (60%) of 40 evaluable patients had otitis or sinusitis. fever and neck stiffness were the most common clinical manifestations of disease, but, in addition, high rates of seizures (12 [32%] of 38 patients), focal neurological findings (13 [36%] of 36 patients), and hyponatremia (20 [58%] of 35 patients) were found. In contrast with data from the literature that describes 27 adult cases, we found that GAS meningitis is a fulminant disease with a mortality rate of 27% (10 of 37 patients), and that neurological sequelae occur in 36% (12 of 38) of surviving patients.- - - - - - - - - - ranking = 1keywords = otitis (Clic here for more details about this article) |
9/33. Group-A streptococcal meningitis in an adult, secondary to purulent otitis media.Group A streptococcal meningitis is rarely encountered today, although group A streptococcal severe infections are on the increase. We present here a case of an adult male with bacterial meningitis as a complication of otitis media induced by Group A Streptococcus. The approach to diagnosis and treatment considerations are discussed.- - - - - - - - - - ranking = 5keywords = otitis (Clic here for more details about this article) |
10/33. Band infection with splenoportal venous thrombosis: an unusual but severe complication of gastric banding.BACKGROUND: Band infection after gastric banding is a relatively rare complication. In most cases, it is manifested by abdominal pain associated with fever, and/or an abscess surrounding the access port. The treatment of choice consists of band removal and antibiotic therapy, and is usually effective. methods: Among the 322 patients having undergone gastric banding in our department, we report a 31-year-old woman who developed an infection of the band complicated by splenic and portal vein thrombosis 21 months after gastric banding. RESULTS: BMI was 40.9 kg/m2 when she underwent gastric banding. Postoperative course was uneventful, and excess weight loss reached 105% after 18 months. An abdominoplasty combined with bilateral mammoplasty and thigh dermolipectomy were performed. About 3 weeks later, she developed an otitis with fever and left upper abdominal pain. Despite antibiotics, pain and fever persisted. The operative wounds showed no sign of infection, and there was no sign of peritonitis. Computerized tomography showed a left subdiaphragmatic abscess surrounding the catheter and thrombosis of the splenic and portal veins. Treatment consisted of band removal, antibiotics and heparin. Recovery was uneventful with complete resolution of the thrombosis. CONCLUSIONS: Late band infection after gastric banding is rare, and is usually secondary to band erosion. Our case demonstrates that severe band infection can be caused by any infection causing bacteremia. Prompt band removal along with antibiotic therapy is the treatment of choice. Rapid treatment of any infection is mandatory in patients with a gastric band. antibiotic prophylaxis during surgical and dental procedures could be useful in these patients.- - - - - - - - - - ranking = 1keywords = otitis (Clic here for more details about this article) |
| | Next -> |