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1.
J Int Adv Otol ; 19(3): 223-227, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37272640

RESUMEN

BACKGROUND: Necrotizing otitis externa is an invasive infection, affecting older patients, with significant associated morbidity. Despite this, there are no randomized controlled trials that address management, and therefore, treatment approaches may vary considerably. We describe the management and outcomes of 37 patients managed using a multidisciplinary treatment pathway for necrotizing otitis externa over a 5-year period. The pathway is based on a standardized antibiotic regime of 3 weeks of intravenous ceftazidime plus oral ciprofloxacin, followed by a further 3 weeks of ciprofloxacin. METHODS: This is a retrospective review of all patients diagnosed with necrotizing otitis externa since the introduction of our pathway in 2016. We include data on patient demographics, comorbidities, microbiology, length of stay, and length of antimicrobial treatment. Outcome data, including mortality, relapse and treatment failure, and adverse effects of treatment, are presented. RESULTS: The median age of our patients was 82 years. About 54% of patients had diabetes mellitus or another cause of immunocompromise. Pseudomonas aeruginosa was isolated in 68%. The median duration of inpatient stay was 9 days, and median treatment duration was 6 weeks. Of 37 patients, 32 were cured (86%), and of the remaining 5 patients, there were 2 mortalities unrelated to necrotizing otitis externa and 3 patients with recurrent infections due to anatomical abnormalities. CONCLUSION: We note favorable treatment outcomes when using a standardized multidisciplinary pathway and a 6-week course of antibiotic therapy.


Asunto(s)
Otitis Externa , Infecciones por Pseudomonas , Humanos , Anciano de 80 o más Años , Otitis Externa/tratamiento farmacológico , Otitis Externa/microbiología , Estudios Retrospectivos , Ciprofloxacina/uso terapéutico , Antibacterianos/uso terapéutico , Ceftazidima/uso terapéutico , Infecciones por Pseudomonas/tratamiento farmacológico , Infecciones por Pseudomonas/complicaciones
2.
Access Microbiol ; 4(4): 000230, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35812713

RESUMEN

Treatment of ventriculitis caused by enterococci can be challenging, and antibiotic options are limited. We describe a case of device-related ventriculitis caused by vancomycin-resistant Enterococcus faecium , refractory to initial antibiotics. Our management approach included intrathecal daptomycin. There were no attributable adverse events, and the patient remained infection-free following ventriculo-peritoneal shunt insertion and cessation of antibiotics.

3.
Am J Trop Med Hyg ; 103(5): 1927-1929, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32959758

RESUMEN

Visceral leishmaniasis (VL) is a systemic infection caused by the protozoal parasite Leishmania, spread via the bloodstream to the reticuloendothelial system, through the bite of the sand fly. It is endemic in parts of Africa, South America, Asia, and Europe, including the Mediterranean. Here, we describe a case of VL that was initially diagnosed as Q fever based on positive Coxiella burnetii serology and showed a partial response to doxycycline treatment.


Asunto(s)
Coxiella burnetii/inmunología , Doxiciclina/uso terapéutico , Leishmania donovani/inmunología , Leishmaniasis Visceral/diagnóstico por imagen , Abdomen/diagnóstico por imagen , Animales , Diagnóstico Diferencial , Hepatomegalia/diagnóstico por imagen , Humanos , Leishmania donovani/aislamiento & purificación , Leishmaniasis Visceral/tratamiento farmacológico , Leishmaniasis Visceral/parasitología , Masculino , Fiebre Q/diagnóstico por imagen , Esplenomegalia/diagnóstico por imagen , Tórax/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Adulto Joven
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