RESUMO
We describe a case of nasal myiasis in an 89-year-old Brazilian patient affected by leprosy with severe nasal sequelae. An initial treatment comprising sinusectomy combined with nasal endoscopy removed more than 300 larvae, supplemented by systemic treatment using oral and topical ivermectin and levofloxacin. Infestation recurred after 2 months, was treated similarly, and resolved completely. The case could be attributed to severe nasal leprosy sequelae, with a lack of sneezing reflex, painless ulceration, atrophic rhinitis (ozena), and inability to clean the nose properly due to hand and nose impairment. This case illustrates the importance of long-term medical follow-up of patients with leprosy sequelae.
Assuntos
Hanseníase/complicações , Miíase/diagnóstico , Miíase/patologia , Rinite Atrófica/complicações , Administração Tópica , Idoso de 80 Anos ou mais , Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico , Antibacterianos/uso terapêutico , Humanos , Inseticidas/administração & dosagem , Inseticidas/uso terapêutico , Ivermectina/administração & dosagem , Ivermectina/uso terapêutico , Masculino , Miíase/cirurgiaRESUMO
Rhinoplasty in atrophic rhinitis is a difficult surgery because the dorsal skin is adherent to the underlying structures. There is also more chance of postoperative infection. The experience of various types of rhinoplasty in 15 atrophic rhinitis patients is presented here. The patients were from the age group 17 to 35 years. Most of the operations were done under local anaesthesia. Commonest graft used was conchal-cartilage. Bone graft was avoided for augmentation because of its high rate of absorption in atrophic rhinitis. Young's operation was done in 5 patients in one side along with rhinoplasty. Young's operation was done only with skin layer.
Assuntos
Deformidades Adquiridas Nasais/cirurgia , Rinite Atrófica/cirurgia , Adolescente , Adulto , Anestesia Local , Feminino , Humanos , Masculino , Deformidades Adquiridas Nasais/etiologia , Rinite Atrófica/complicações , Rinoplastia , Adulto JovemRESUMO
One hundred cases of ozena were analysed. The majority of cases were youths (86%). 50% of 33 patients had abnormal menstruation. Löwenberg's bacillus were found in most cases. The middle concha was a frequent side of this affection in our series, 25 cases of accessory sinusitis were found by roentgenographic examination of 35 cases of atrophic rhinitis. 24 cases underwent a serum cholesterol test. This revealed hypocholesterolemia in cases (50%) with an average value of 73.6 mg/100 ml. A large dose of vitamin (12500-150000 U daily or injected vitamin A 50000 U i.m. every other day or water-soluble vitamin A 300000 U twice a week) was generally favourable in most cases. Streptomycin had a beneficial result in sensitive cases. Complete cure of the disease was expected from the combined treatment with vitamin A and streptomycin. No recurrence was found in the majority of cases over a 2-year period of follow-up studies.