RESUMO
Tuberculous otitis media (TOM) is a rare cause of chronic suppurative infection of the middle ear. Due to that the symptoms and signs are often indistinguishable from those of nontuberculosis chronic otitis media and the fact that the index of suspicion is low, there is frequently a considerable delay prior to diagnosis. This can lead to irreversible complications such as facial nerve paralysis and labyrinthitis. Medical therapy with antituberculous drugs is usually effective. We report three cases with TOM diagnosticated and followed up in our Service from january 1993 to july 2001. Their charts were retrospectively reviewed for relevant historical data, physical findings, complementary studies, treatment and clinical response. We performed a review of the literature, emphasizing that TOM should be considered in the differential diagnosis of chronic otitis media.
Assuntos
Otite Média/líquido cefalorraquidiano , Tuberculose/líquido cefalorraquidiano , Adulto , Idoso , Amoxicilina/uso terapêutico , Antituberculosos/uso terapêutico , Otorreia de Líquido Cefalorraquidiano/líquido cefalorraquidiano , Otorreia de Líquido Cefalorraquidiano/microbiologia , Combinação de Medicamentos , Otopatias/líquido cefalorraquidiano , Otopatias/tratamento farmacológico , Otopatias/microbiologia , Feminino , Humanos , Isoniazida/uso terapêutico , Masculino , Infecções por Mycobacterium/tratamento farmacológico , Infecções por Mycobacterium/microbiologia , Mycobacterium tuberculosis/isolamento & purificação , Otite Média/tratamento farmacológico , Otite Média/microbiologia , Penicilinas/uso terapêutico , Infecções por Proteus/tratamento farmacológico , Infecções por Proteus/microbiologia , Proteus mirabilis/isolamento & purificação , Pirazinamida/uso terapêutico , Rifampina/uso terapêutico , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/isolamento & purificação , Tuberculose/tratamento farmacológico , Tuberculose/microbiologiaRESUMO
Tumors of the nasal cavity and sinuses are rather infrequent, being squamous carcinoma the predominant type, which accounts for the 80 percent of the totality of them. Maxillary sinus is the most affected, followed by nose cavity. Half of cases are originated on turbinates. We present the clinical case of a woman patient diagnosed of microcytic carcinoma of the right nasal cavity originated at the level of middle turbinate. The mass filled the width of the fossa getting in touch with the nasal septum, without encroaching it. According its extent the tumor was classified as T2, N0, M0 and treated with radiotherapy only. Microcytic carcinoma is an exceptional histological type in nasal cavity and next to its numeric meagerness in this location makes this case a very peculiar one.
Assuntos
Carcinoma/diagnóstico , Cavidade Nasal/diagnóstico por imagem , Cavidade Nasal/patologia , Neoplasias Nasais/diagnóstico , Idoso , Carcinoma/radioterapia , Feminino , Humanos , Estadiamento de Neoplasias , Neoplasias Nasais/radioterapia , Tomografia Computadorizada por Raios XRESUMO
The incidence of acute mastoiditis accounts for 0.004% of acute middle otitis. Nowadays there is a decrease of number of mastoiditis and its complications, but from time to time are seen outbreaks without logical explanation of facts. We report 4 clinical cases of acute mastoiditis complicated with subperiosteal abscess, in children between 8 and 23 month old, seen at our department during the last 3 years, three of them diagnosed in a 4-month term.
Assuntos
Abscesso/etiologia , Enterococcus , Infecções por Bactérias Gram-Positivas/complicações , Mastoidite/complicações , Peptostreptococcus , Infecções Pneumocócicas/complicações , Abscesso/diagnóstico , Doença Aguda , Feminino , Infecções por Bactérias Gram-Positivas/diagnóstico , Humanos , Lactente , Masculino , Mastoidite/diagnóstico , Infecções Pneumocócicas/diagnósticoRESUMO
Deep neck infections are charts potentially dangerous though of low incidence. Few times linked to severe complications, as mediastinitis, of high morbi-mortality. They call for emergency procedures combining neck and thorax surgery, if there is a mediastinitis, with a broad-spectrum antibiotherapy within an Intensive Care Unit, with the aim of the maintain the patients's equilibrium constant till their reestablishment. We report 3 cases seen in a term lesser than one year at the Universitary Hospital of Salamanca. The 3 presented with thoracic complication because the spread of the neck's infect. Nevertheless the pending severity all three survived. We emphasize the necessity of realizing the pressing surgery and the utilitarianism of broad-spectrum antibiotherapy as key elements in order to get the patient's reestablishment. Literature review on the subject.
Assuntos
Infecções Bacterianas , Celulite (Flegmão)/microbiologia , Pescoço , Adulto , Anti-Infecciosos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Celulite (Flegmão)/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios XRESUMO
Benign paroxysmal vertigo of childhood is a clinical disorder that usually begins at age 4. The child's otoneurological examination is normal in the intercrisis and the brief episodes of true vertigo are typical. In this paper we describe six new cases that had a follow-up of at least one year after diagnosis. Only a few of the patients had demonstrated vasomotor migraine, but all the children had a family history of migraine, which supports the hypothesis that this disorder is a migraine equivalent. The pathogenesis may be related with a transitory vascular disturbance that produces ischemia of the vestibular nuclei and pathways, as occurs in other vascular territories during typical migraine. One longer-than-usual episode is reported. Otherwise, the evolution of this condition is favorable.