[FEATURES OF OTOGENIC INTRACRANIAL COMPLICATIONS AT THE PRESENT STAGE].

A retrospective analysis of treatment was made in 127 adult patients with acute and chronic otitis media complicated by suppurative-inflammatory pathology of the brain. Purulent meningitis was revealed in 52 (40.9%) of hospitalized patients. Meningoencephalitis was often diagnosed in the cases of acute otitis media (15.4%) and in cases of chronic otitis (22.7%). The otogenic brain abscess was detected in 13.5% of otitis media cases and it was noted to be twice frequent (33.3%) in cases of purulent otitis media. The patients 124 (97.6%) have been operated. An extended mastoidotomy and antromastoidotomy were performed in the acute purulent otitis media. An extended radical operation on the ear was applied in case of chronic otitis media. Performance of craniotomy and complete removal of the abscess using modern systems of neuronavigation showed a higher clinical efficacy as compared with transtemporal approach during sanitizing intervention on the ear including the opening and abscess drainage in surgery of otogenic abscesses of the brain.

Características clínicas de la meningoencefalitis tuberculosa en los pacientes del Hospital Arzobispo Loayza durante el periodo 2008-2012 / Characteristics clinical of tuberculous meningoencephalitis in patients of the Hospital Arzobispo Loayza during the period 2008-2012

Se realizó un estudio retrospectivo para conocer las características clínicas de la meningoencefalitis tuberculosa en el adulto. De 162 historias clínicas con ese diagnostico en el Hospital Arzobispo Loayza entre 2008-2012, 132 cumplieron los criterios de inclusión. Se hallo que la población más afectada fueron mujeres (56.92 por ciento) de mediana edad (41.59 años) amas de casa (41.54 por ciento). El tiempo de enfermedad promedio de los pacientes fue de 15.86 días. El 10 por ciento de los pacientes tuvo historia de contacto TBC y antecedente de VIH. La forma de presentación clínica más frecuente fue cefalea (85.38 por ciento), vómitos (57.69 por ciento), fiebre (56.15 por ciento), rigidez de nuca (34.62 por ciento), estadio 2 (59.23 por ciento), hipoglucorraquia (30.06 mg/dl), hiperproteinorraquia (178.05 mg/dl), pleocitosis (81.61 por ciento), ADA (14.18). Se concluye que lo inespecífico del cuadro clínico retarda el diagnóstico específico y tratamiento oportuno.

We made a retrospective study in order to determine clinical features of TBC meningoencephalitis in adults patients. From 162 clinical records with this diagnosis at the Hospital Arzobispo Loayza of Lima, between 2008-2012, 130 records fulfilled the inclusion criteria. Most of the affected were women (56.92 per cent), of age 41.59 years, housewife (41.54 per cent). The mean time of disease of the 15.86 days. The TBC contact was 10 per cent. The most usual clinical presentation was headache (85.38 per cent), vomiting (57.69 per cent), fever (56.15 per cent), rigidity of neck (34.62 per cent), stage II (59.23 per cent), low CSF glucose (30.06 mg/dl), high CSF protein (178.05 mg/dl), CSF pleocytosis (81.61 per cent), ADA (14.18). The conclusion that the inspecify of clinic delays the specify diagnostic and opportune treatment.

Anthrax meningoencephalitis--declining trends in an uncommon but catastrophic CNS infection in rural Tamil Nadu, South India.

INTRODUCTION: Anthrax, a cattle-born zoonosis has been a serious infectious disease and its meningoencephalitic form remains a rapidly fatal illness even now. AIM: The aim of this paper is to evaluate the incidence and clinical profile of anthrax meningoencephalitis admitted to a teaching hospital predominantly serving a rural population in South India. MATERIALS AND METHODS: We made a systematic study of the case records of patients with microbiologically confirmed diagnosis of anthrax meningoencephalitis admitted over a 20-year period. We searched the internet and office records for the anthrax outbreaks and the preventive strategies in place in India. RESULTS: The admissions occurred in two clusters, four during 1992-1994 and six in 1998-2000; with no further detection unto August 2008. All patients were adult males with agriculture related occupation. Three of the 10 patients had no evidence of primary focus of infection. Majority were in coma at admission and had documented evidence of septicemia. CSF was haemorrhagic and death was the uniform outcome despite high dose intravenous penicillin G; maximum duration of hospital survival being 48 h. COMMENT: Anthrax is a rare, but catastrophic cause of meningoencephalitis. Improvement in education and life styles as well as livestock vaccination in rural areas appear to have effectively decreased the incidence of this dreaded acute zoonosis in the South Indian states of Tamilnadu and Puducherry.

Infectious disease surveillance during emergency relief to Bhutanese refugees in Nepal.

OBJECTIVE: To implement simplified infectious disease surveillance and epidemic disease control during the relocation of Bhutanese refugees to Nepal. DESIGN: Longitudinal observation study of mortality and morbidity. SETTING: Refugee health units in six refugee camps housing 73,500 Bhutanese refugees in the eastern tropical lowland between Nepal and India. INTERVENTIONS: Infectious disease surveillance and community-based programs to promote vitamin A supplementation, measles vaccination, oral rehydration therapy, and early use of antibiotics to treat acute respiratory infection. MAIN OUTCOME MEASURES: Crude mortality rate, mortality rate for children younger than 5 years, and cause-specific mortality. RESULTS: Crude mortality rates up to 1.15 deaths per 10,000 persons per day were reported during the first 6 months of surveillance. The leading causes of death were measles, diarrhea, and acute respiratory infections. Surveillance data were used to institute changes in public health management including measles vaccination, vitamin A supplementation, and control programs for diarrhea and acute respiratory infections and to ensure rapid responses to cholera, Shigella dysentery, and meningoencephalitis. Within 4 months of establishing disease control interventions, crude mortality rates were reduced by 75% and were below emergency levels. CONCLUSIONS: Simple, sustainable disease surveillance in refugee populations is essential during emergency relief efforts. Data can be used to direct community-based public health interventions to control common infectious diseases and reduce high mortality rates among refugees while placing a minimal burden on health workers.