ABSTRACT
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.
Subject(s)
Otitis Media/cerebrospinal fluid , Tuberculosis/cerebrospinal fluid , Adult , Aged , Amoxicillin/therapeutic use , Antitubercular Agents/therapeutic use , Cerebrospinal Fluid Otorrhea/cerebrospinal fluid , Cerebrospinal Fluid Otorrhea/microbiology , Drug Combinations , Ear Diseases/cerebrospinal fluid , Ear Diseases/drug therapy , Ear Diseases/microbiology , Female , Humans , Isoniazid/therapeutic use , Male , Mycobacterium Infections/drug therapy , Mycobacterium Infections/microbiology , Mycobacterium tuberculosis/isolation & purification , Otitis Media/drug therapy , Otitis Media/microbiology , Penicillins/therapeutic use , Proteus Infections/drug therapy , Proteus Infections/microbiology , Proteus mirabilis/isolation & purification , Pyrazinamide/therapeutic use , Rifampin/therapeutic use , Staphylococcal Infections/drug therapy , Staphylococcal Infections/microbiology , Staphylococcus aureus/isolation & purification , Tuberculosis/drug therapy , Tuberculosis/microbiologyABSTRACT
La otitis media tuberculosa (OMT) es una causa rara de otorrea crónica. La escasa especificidad de su sintomatología, a menudo indistinguible de la de otras causas de otitis media crónica, y el bajo índice de sospecha, hacen que en muchas ocasiones su diagnóstico se retrase e incluso se realice tras la aparición de complicaciones, como la parálisis facial o la laberintitis. Habitualmente responde bien al tratamiento con fármacos antituberculosos. Presentamos 3 casos de otitis media tuberculosa diagnosticado y seguidos en nuestro Servicio, desde enero de 1993 a julio de 2001. Se revisan retrospectivamente las 3 historias clínicas haciendo hincapié en los datos clínicos, la exploración, los exámenes complementarios, el tratamiento y la respuesta clínica. Realizamos una revisión bibliográfica del tema recalcando la necesidad de incluir la OMT en el diagnóstico diferencial de la otitis media crónica (AU)
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Subject(s)
Adult , Aged , Male , Female , Humans , Staphylococcus aureus , Staphylococcal Infections , Rifampin , Tuberculosis , Mycobacterium tuberculosis , Penicillins , Otitis Media , Proteus Infections , Proteus mirabilis , Pyrazinamide , Antitubercular Agents , Ear Diseases , Drug Combinations , Amoxicillin , Isoniazid , Mycobacterium Infections , Cerebrospinal Fluid OtorrheaABSTRACT
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.
Subject(s)
Carcinoma/diagnosis , Nasal Cavity/diagnostic imaging , Nasal Cavity/pathology , Nose Neoplasms/diagnosis , Aged , Carcinoma/radiotherapy , Female , Humans , Neoplasm Staging , Nose Neoplasms/radiotherapy , Tomography, X-Ray ComputedABSTRACT
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.
Subject(s)
Abscess/etiology , Enterococcus , Gram-Positive Bacterial Infections/complications , Mastoiditis/complications , Peptostreptococcus , Pneumococcal Infections/complications , Abscess/diagnosis , Acute Disease , Female , Gram-Positive Bacterial Infections/diagnosis , Humans , Infant , Male , Mastoiditis/diagnosis , Pneumococcal Infections/diagnosisABSTRACT
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.
Subject(s)
Bacterial Infections , Cellulitis/microbiology , Neck , Adult , Anti-Infective Agents/therapeutic use , Bacterial Infections/drug therapy , Cellulitis/drug therapy , Humans , Male , Middle Aged , Severity of Illness Index , Tomography, X-Ray ComputedABSTRACT
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.
