ABSTRACT
Necrotizing external otitis (NEO) is a fulminant Pseudomonas infection of the external auditory canal affecting mainly elderly diabetic patients. Since the early descriptions, many authors have related cases of NEO in non diabetic patients. We report eight cases of NEO in young children. They are less than two years old, they are undernourished and non diabetics. We get a good evolution in spite of our modest therapeutic ways. Emphasis is placed on efficiency of local remedy with colistine.
Subject(s)
Otitis Externa/microbiology , Otitis Externa/pathology , Pseudomonas Infections/pathology , Anti-Bacterial Agents/therapeutic use , Colistin/therapeutic use , Cote d'Ivoire , Female , Humans , Infant , Infant, Newborn , Male , Necrosis , Nutrition Disorders/complications , Otitis Externa/drug therapy , Pseudomonas Infections/drug therapyABSTRACT
Vertigo, instability, dizziness, or equilibrium disorders are not usually considered as consequences of ophthalmologic problems. We present data indicating that ocular disorders can be responsible for these symptoms in children. In a population of 523 pediatric patients with vertigo or disequilibrium and referred for vestibular testing in our otolaryngology department during a 5-year period, 27 children presented with normal vestibular and somatic neurologic examinations but with ophthalmologic disorders (vergence insufficiency or latent strabismus with binocular vision in 70% and anisometropia in 41%). These patients represented 24% of all vergence insufficiencies detected and 4% of all orthoptic examinations performed in the pediatric ophthalmology department. These ocular abnormalities were considered to be the initial cause of the problems. In two thirds of these patients the symptoms were completely resolved by simple ophthalmologic treatment. No other additional tests, such as magnetic resonance imaging, were required. Therefore we propose that every child complaining of vertigo or dizziness but with normal clinical somatic neurologic and vestibular examinations should have a complete ophthalmologic examination before additional, more costly, investigations. This should lead to better screening and more appropriate care of ocular disorders in children and avoid unnecessary magnetic resonance imaging.