Clinical utility of a polymerase chain reaction assay in culture-negative necrotizing otitis externa.
Otol Neurotol
; 36(4): 733-6, 2015 Apr.
Article
em En
| MEDLINE
| ID: mdl-25158617
ABSTRACT
OBJECTIVE:
This study describes a subset of necrotizing otitis externa (NOE) patients with a refractory disease and negative cultures. In these cases, we decided to use a polymerase chain reaction (PCR) assay from surgically obtained tissue under sterile conditions to improve pathogen detection sensitivity. STUDYDESIGN:
Retrospective case review.SETTING:
Academic medical center. PATIENTS Nineteen consecutive patients diagnosed with NOE between January 2008 and January 2014 inclusive. Three patients of this cohort presented a culture-negative disease.INTERVENTIONS:
Diagnostic. MAIN OUTCOMEMEASURES:
Positive detection of pathogens using a PCR assay in cases with a complicated course of NOE and clinical resolution of the disease after targeted therapy according to PCR results.RESULTS:
Surgical samples were obtained under sterile conditions from three patients with negative cultures and a refractory disease course of NOE. PCR assays were performed using pan-bacteria and pan-fungi protocols. In all three samples, a positive result for a fungal pathogen was recorded and followed by successful empirical targeted therapy.CONCLUSION:
Patients who present with a refractory culture-negative NOE should be suspected as suffering from a fungal disease. The PCR assay may be an important laboratory adjunct in detecting pathogens responsible for NOE and can aid to promote therapy and disease resolution.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Otite Externa
/
Reação em Cadeia da Polimerase
/
Otomicose
Tipo de estudo:
Guideline
/
Observational_studies
Limite:
Humans
Idioma:
En
Revista:
Otol Neurotol
Assunto da revista:
NEUROLOGIA
/
OTORRINOLARINGOLOGIA
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Israel