RESUMEN
OBJECTIVE: To analyze the cases of acute mastoiditis, characteristics, management and complications in children attended in the emergency department. METHODS: Retrospective study of acute mastoiditis in a Spanish tertiary hospital over a 6-year period (2018-2023). RESULTS: One hundred two episodes of acute mastoiditis were analyzed (54% males, median age 1.8 years). Microorganisms were isolated in one third of cases, mainly Streptococcus pyogenes (64% of ear secretion cultures). Complications occurred in 27.5%, primarily subperiosteal abscess. A younger age, absence of vaccination schedule, previous history of otitis, cochlear implant carriers or white blood cell counts and C-reactive protein levels were not associated with complications. Complicated cases had longer hospitalizations. Treatment included antibiotics, corticosteroids, and surgery in 50% of cases. CONCLUSIONS: This study shows an increase of acute mastoiditis during 2023, with a relevant role of S. pyogenes. A younger age, absence of vaccination, personal history of otitis or cochlear implant, blood cell counts and C-reactive protein levels were not associated with complications.
Asunto(s)
Servicio de Urgencia en Hospital , Mastoiditis , Humanos , Mastoiditis/epidemiología , Mastoiditis/microbiología , Estudios Retrospectivos , Masculino , Femenino , España/epidemiología , Lactante , Preescolar , Enfermedad Aguda , Niño , AdolescenteRESUMEN
Objectives: Sinus venous thrombosis (SVT) is a rare complication of acute otitis media (AOM) with acute mastoiditis (AM), which during recent years has been associated with Fusobacterium necrophorum (Fn) infection. Our objective was to review clinical, microbiologic, and hematologic features of paediatric otogenic SVT, with a specific focus on the role of Fn. Methods: A retrospective database review in a tertiary paediatric hospital between 2000-2019. Results: Fifty children aged 6-155 months were treated for AM with SVT. Forty-seven (94%) underwent cortical mastoidectomy. Forty-six children received low-molecular-weight heparin (LMWH). Follow-up imaging revealed recanalisation in 92% of cases. No long-term neurologic or haematologic complications were observed. Since 2014, when anaerobic cultures and PCR were routinely used in our institute, Fn was isolated from 15/21 children with SVT. Their time to recanalisation was longer, and the rate of lupus anticoagulant antibodies (LAC) was higher than in the 6 non-Fn patients. Children positive for LAC also had a longer time to recanalisation. Conclusions: Fn is a common pathogen in AM with SVT; its thrombogenic role was demonstrated by a higher prevalence of LAC and a longer time to recanalisation.
Asunto(s)
Infecciones por Fusobacterium , Mastoiditis , Otitis Media , Trombosis de la Vena , Niño , Humanos , Infecciones por Fusobacterium/complicaciones , Infecciones por Fusobacterium/terapia , Fusobacterium necrophorum , Heparina de Bajo-Peso-Molecular , Inhibidor de Coagulación del Lupus , Mastoiditis/complicaciones , Mastoiditis/microbiología , Otitis Media/complicaciones , Estudios Retrospectivos , Trombosis de la Vena/complicaciones , Lactante , PreescolarRESUMEN
OBJECTIVES: Streptococcus pneumoniae is the leading bacterial etiologic agent in acute otitis media (AOM), and it produces a more severe inflammatory response than other otopathogens. Additionally, the presence of multidrug-resistant (MDR) S. pneumoniae is an important issue in the management of AOM. The present pilot study aimed to ascertain whether MDR S. pneumoniae is associated with a higher inflammatory response and/or a more severe disease. METHODS: This was a prospective, single-center study on nonpneumococcal conjugate vaccine-immunized pediatric patients with severe AOM. Demographic and clinical characteristics were recorded. Middle ear fluid was obtained and cultured for each patient; antibiotic-resistance profiling was tested for S. pneumoniae isolates. The C-reactive protein (CRP) level and complete blood count were determined. Patients with positive middle ear fluid culture for S. pneumoniae were divided into 2 groups according to antibiotic resistance profile: MDR and non-MDR. RESULTS: MDR S. pneumoniae was identified in 15 (35.7%) of the 42 eligible patients. Children in this group had significantly higher CRP levels (72.23 ± 62.92 vs. 14.96 ± 15.57 mg/L, p < 0.001), higher absolute neutrophil count (8.46 ± 3.97 vs. 5.22 ± 4.5 × 103/mm3, p = 0.004), higher percentage of neutrophils (52.85 ± 13.49% vs. 38.34 ± 16.16%, p = 0.004), and were more prone to develop acute mastoiditis (p = 0.01). Receiver operating characteristic analysis identified CRP as the best biomarker to discriminate between the 2 groups of patients (AUC = 0.891). CONCLUSION: MDR S. pneumoniae was associated with a more severe inflammatory response and a higher incidence of mastoiditis.
Asunto(s)
Antibacterianos/uso terapéutico , Mastoiditis/tratamiento farmacológico , Otitis Media/microbiología , Infecciones Neumocócicas/tratamiento farmacológico , Streptococcus pneumoniae/aislamiento & purificación , Enfermedad Aguda , Antibacterianos/farmacología , Proteína C-Reactiva/análisis , Preescolar , Resistencia a Múltiples Medicamentos/efectos de los fármacos , Femenino , Humanos , Lactante , Masculino , Mastoiditis/microbiología , Pruebas de Sensibilidad Microbiana , Otitis Media/tratamiento farmacológico , Proyectos Piloto , Infecciones Neumocócicas/epidemiología , Estudios Prospectivos , Streptococcus pneumoniae/efectos de los fármacosRESUMEN
BACKGROUND: Group A Streptococcus can cause serious and sometimes life-threatening disease in children. The past few years have witnessed a rise in invasive group A Streptococcus infection (iGASi) for unclear reasons. This study attempted to describe the epidemiology, the clinical and demographic characteristics and the outcomes associated with iGASi in hospitalized children in central Israel. METHODS: We retrospectively analyzed the medical records of children <18 years old discharged with a diagnosis of iGASi between January 2012 and December 2019. Clinical, laboratory and microbiologic data, and immunization status were retrieved. The patients were divided into severe and nonsevere groups based on their clinical presentation. The emm type was determined at the national reference center. RESULTS: A total of 167 patients with 206 positive cultures for group A Streptococcus were identified. Hospitalizations for iGASi increased from 701 to 958 per 100,000 admissions between 2012-2015 and 2016-2019, respectively, representing an increase of 37%. The majority of the isolates were from the otolaryngologic system followed by blood, deep soft tissue and respiratory sites. Uncomplicated mastoiditis was the most common diagnosis, followed by bacteremia. Pneumonia was the main diagnosis in the severe group (39.4%). CONCLUSIONS: The admissions because of iGASi in children <18 years old increased during the last 8 years. Surveillance systems and prospective studies should be conducted to expend our understanding of the epidemiology of iGASi in children, better assess the pathogenesis and specific risk factors and monitor changes in emm-type distribution.
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Hospitalización/estadística & datos numéricos , Infecciones Estreptocócicas/sangre , Infecciones Estreptocócicas/epidemiología , Adolescente , Distribución por Edad , Antibacterianos/uso terapéutico , Bacteriemia/epidemiología , Niño , Preescolar , Femenino , Humanos , Incidencia , Lactante , Israel/epidemiología , Masculino , Mastoiditis/epidemiología , Mastoiditis/microbiología , Neumonía Bacteriana/epidemiología , Estudios Prospectivos , Estudios Retrospectivos , Factores de Riesgo , Infecciones Estreptocócicas/complicaciones , Infecciones Estreptocócicas/tratamiento farmacológico , Streptococcus pyogenes/patogenicidad , Centros de Atención Terciaria/estadística & datos numéricosRESUMEN
We present a rare case of tuberculous mastoiditis in a 2-month-old infant. The patient presented with facial nerve palsy, fever and otorrhoea and was subsequently confirmed to have a Mycobacterium tuberculosis infection. Mastoiditis was confirmed with a CT scan of the head, and gastric aspirate analysis with the Xpert MTB/RIF assay (Cepheid, USA) rapidly confirmed tuberculosis (TB), allowing prompt initiation of anti-TB therapy. The patient is now recovering, with the initial facial nerve palsy resolved.
Asunto(s)
Parálisis Facial/etiología , Mastoiditis/diagnóstico , Mycobacterium tuberculosis/aislamiento & purificación , Tuberculosis/diagnóstico , Antibióticos Antituberculosos/uso terapéutico , Humanos , Lactante , Mastoiditis/microbiología , Tuberculosis/tratamiento farmacológicoRESUMEN
Visits to the family physician, a specialist, and the ED prompted us to look beyond the initial diagnosis of acute otitis media.
Asunto(s)
Absceso Epidural/diagnóstico por imagen , Mastoiditis/diagnóstico por imagen , Infecciones Estreptocócicas/diagnóstico por imagen , Enfermedad Aguda , Antibacterianos/uso terapéutico , Niño , Terapia Combinada , Medios de Contraste , Craneotomía , Diagnóstico Diferencial , Dolor de Oído , Absceso Epidural/microbiología , Absceso Epidural/terapia , Cefalea , Humanos , Imagen por Resonancia Magnética , Masculino , Mastoiditis/microbiología , Mastoiditis/terapia , Infecciones Estreptocócicas/microbiología , Infecciones Estreptocócicas/terapia , Streptococcus intermedius/aislamiento & purificaciónRESUMEN
INTRODUCTION: Eight new cases of chronic otomastoiditis due to nontuberculous mycobacteria were reported at Center Hospitalier Universitaire Sainte-Justine (CHUSJ) between 2008 and 2018. In the literature, only 89 cases have been described since 1972. This case series aims to define the clinical presentation, infectious pathogens, as well as diagnostic and therapeutic means employed in cases of nontuberculous mycobacteria otitis media encountered in our tertiary pediatric reference center. METHODS: All cases of otitis media caused by nontuberculous mycobacteria diagnosed at Sainte-Justine between 2008 and 2018 were reviewed. Species identification was retrieved from the Laboratoire de Santé Publique du Québec, Quebec's provincial public health and reference laboratory. RESULTS: All 8 cases occurred in immunocompetent children. Clinical features on presentation were chronic tympanostomy tube otorrhea with abundant granulation tissue in 7 cases. CT scan demonstrated coalescent mastoiditis in 3 cases. The median delay between initial presentation and identification of nontuberculous mycobacteria was 81 days. Seven patients had a Mycobacterium (M.) abscessus complex infection. Treatment consisted of weekly microscopic granulation debridement, a combined systemic antibiotic therapy for an average duration of 21 weeks, as well as instillation of boric acid into the middle ear. While 3 cases required at least one mastoidectomy, 2 cases were treated only medically. CONCLUSION: Nontuberculous mycobacteria otitis media is a rare clinical entity, for which high clinical suspicion and specific microbiological analyses could minimize diagnostic delay. The use of boric acid as a desiccating agent may allow for a better local control.
Asunto(s)
Mastoiditis , Infecciones por Mycobacterium no Tuberculosas , Otitis Media , Niño , Diagnóstico Tardío , Humanos , Mastoiditis/diagnóstico , Mastoiditis/tratamiento farmacológico , Mastoiditis/microbiología , Infecciones por Mycobacterium no Tuberculosas/diagnóstico , Infecciones por Mycobacterium no Tuberculosas/tratamiento farmacológico , Micobacterias no Tuberculosas , Otitis Media/diagnóstico , Otitis Media/tratamiento farmacológico , Otitis Media/microbiologíaRESUMEN
OBJECTIVE: The incidence of complications due to acute otitis media (AOM) in childhood has decreased significantly with the use of new antibiotics in recent years. However, acute mastoiditis (AM) is still the most common complication that can lead to further intracranial conditions with high morbidity. Our study aimed to evaluate the clinical characteristics of children with AM and identify possible indicators for further intracranial complications associated with this condition. METHODS: Children hospitalized in our clinic with a diagnosis of AM were reviewed. Demographic data, disease-related symptoms, types of complications accompanied by AM, medical/surgical treatments modalities, and culture results were screened. The patients were divided into two groups as those with and without intracranial complications (ICCs). Routine complete blood count tests, biochemical analysis, and C-reactive protein (CRP) level measurement were evaluated and compared between the groups. RESULTS: Of the 28 AM patients, five (17.9%) had isolated AM. Complications associated with AM included sub-periosteal abscess (28.6%), facial paralysis (25%), meningitis (17.9%), meningitis with sigmoid sinus thrombosis (7.1%), and meningitis with cerebellar abscess (3.6%). Eight patients developed ICCs (28.6%), of whom three had more than one complication. Ceftriaxone was found to be the first-line medical treatment (57.1%). Streptococcus pneumoniae was the most common pathogen isolated from the cultures (42.9%). Three patients (10.7%) were treated non-surgically, eight (28.6%) with myringotomy and ventilation tube (VT) insertion, eight patients (28.6%) with abscess drainage and VT insertion, and nine (32.1%) with cortical mastoidectomy and VT insertion. There was no significant difference between the patients with and without ICCs in terms of complete blood count parameters. The CRP level and the CRP-albumin ratio were significantly higher in patients with ICCs than those without these complications (p < 0.001). CONCLUSION: AM remains to be the most common complication of AOM in childhood and can lead to further life-threatening conditions. Additional interventions according to the type of the complication with VT insertion is safe and effective in the management of AM. In patients with AM, it is of great importance to determine whether there is an accompanying ICC. The CRP-albumin ratio is a simple and reliable calculation to detect ICCs in patients with AM.
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Mastoiditis/complicaciones , Mastoiditis/terapia , Otitis Media/complicaciones , Otitis Media/terapia , Enfermedad Aguda , Adolescente , Antibacterianos/uso terapéutico , Recuento de Células Sanguíneas , Absceso Encefálico/sangre , Absceso Encefálico/etiología , Absceso Encefálico/cirugía , Proteína C-Reactiva/metabolismo , Ceftriaxona/uso terapéutico , Niño , Preescolar , Drenaje , Parálisis Facial/sangre , Parálisis Facial/etiología , Femenino , Humanos , Lactante , Masculino , Mastoidectomía , Mastoiditis/sangre , Mastoiditis/microbiología , Meningitis/sangre , Meningitis/etiología , Ventilación del Oído Medio , Otitis Media/sangre , Otitis Media/microbiología , Albúmina Sérica/metabolismo , Trombosis de los Senos Intracraneales/sangre , Trombosis de los Senos Intracraneales/etiología , Streptococcus pneumoniaeRESUMEN
Mastoiditis is a complication of the medium otitis characterized by suppuration and destruction of the mastoid cells and the pyramid petrosa; its tuberculous etiology has decreased in the last 40 years. Paralysis resulting from mastoiditis is more common in children. The incidence of mastoiditis has risen, although there are no reports in the literature associated with renal transplants. A 37-year-old man developed paralysis of the seventh cranial nerve associated with tuberculous mastoiditis 71 days after living donor-related renal transplant while on immunosuppressive therapy. The mastoiditis diagnosis was clinical and radiologic, the axial tomography being the election examination. The paralysis of the facial nerve happens for the easy destruction of the bony capsule that involves it. When treated early with tuberculostatic drugs, surgical procedures can be avoided in patients with tuberculous etiology in a mastoiditis, especially in an immunocompromised patient.
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Parálisis Facial/etiología , Huésped Inmunocomprometido , Trasplante de Riñón/efectos adversos , Mastoiditis/inmunología , Otitis Media/inmunología , Adulto , Humanos , Masculino , Mastoiditis/microbiología , Otitis Media/complicacionesAsunto(s)
Infecciones por Fusobacterium/diagnóstico , Fusobacterium necrophorum/aislamiento & purificación , Mastoiditis/microbiología , Antibacterianos/uso terapéutico , Femenino , Infecciones por Fusobacterium/complicaciones , Infecciones por Fusobacterium/tratamiento farmacológico , Humanos , Lactante , Mastoidectomía , Mastoiditis/diagnóstico por imagen , Mastoiditis/tratamiento farmacológico , Mastoiditis/cirugía , Ventilación del Oído Medio , Otitis Media/microbiología , Factores de Riesgo , Tomografía Computarizada por Rayos XAsunto(s)
Síndrome de Lemierre/etiología , Mastoiditis/complicaciones , Otitis Media/complicaciones , Antibacterianos/uso terapéutico , Anticoagulantes/uso terapéutico , Humanos , Síndrome de Lemierre/diagnóstico por imagen , Síndrome de Lemierre/tratamiento farmacológico , Síndrome de Lemierre/microbiología , Masculino , Mastoiditis/diagnóstico , Mastoiditis/tratamiento farmacológico , Mastoiditis/microbiología , Persona de Mediana Edad , Otitis Media/diagnóstico , Otitis Media/tratamiento farmacológico , Otitis Media/microbiología , Resultado del TratamientoRESUMEN
OBJECTIVES: To discuss the indication for performing a mastoidectomy with catheter placement in patients with chronic tympanostomy tube otorrhea. METHODS: The Medical Literature Analysis and Retrieval System Online was searched via PubMed for relevant articles using serous mastoiditis, mastoidectomy, chronic otorrhea, tube otorrhea, tympanostomy tubes, and biofilm as keywords. RESULTS: Further understanding of the pathophysiology of otorrhea and the development of ototopical fluoroquinolones have made a draining tympanostomy tube more manageable. Nevertheless, chronic otorrhea refractory to an otolaryngologist's traditional treatment algorithm still occurs and may benefit from a mastoidectomy with antibiotic irrigation using a catheter in certain cases. We theorize that resolution of otorrhea results from this technique by decreasing the burden of diseased mucosa and providing a larger concentration or dose of antibiotic to the middle ear cleft through the antrum. High-resolution images of the technique and catheter placement are included in this review. CONCLUSIONS: Despite being an uncommon management strategy, the literature suggests an indication for performing a mastoidectomy in a small percentage of patients with a chronically draining tympanostomy tube.
Asunto(s)
Drenaje/métodos , Mastoidectomía/métodos , Ventilación del Oído Medio/efectos adversos , Otitis Media con Derrame/cirugía , Otitis/cirugía , Infecciones Relacionadas con Prótesis/cirugía , Antibacterianos/administración & dosificación , Catéteres , Niño , Preescolar , Enfermedad Crónica , Drenaje/instrumentación , Femenino , Humanos , Masculino , Mastoiditis/microbiología , Mastoiditis/cirugía , Otitis/microbiología , Infecciones Relacionadas con Prótesis/microbiología , Irrigación Terapéutica/métodosRESUMEN
Acute mastoiditis is the most common complication of acute otitis media. Although rare, the disease is carefully studied by otolaryngologists because it usually affects very young children with severe clinical course and sometimes causes serious complications. Most important risk factors are the young age (often>2 years), high fever, alteration of the laboratory findings (very high values of WBC count, absolute neutrophil count and C-reactive protein), while less important are previous antibiotic therapy or previous middle ear infections. The main pathogen of the acute mastoiditis is Streptococcus pneumoniae, followed by Streptococcus piogenes, Haemophilus influentiae, and Staphylococcus aureus. The finding of Pseudomonas aeruginosa is not uncommon, but often its presence is often considered a contamination or simultaneous infection. The complications can be extracranial (subperiosteal abscess, Bezold's abscess); intratemporal (facial nerve palsy, labyrinthitis) and intracranial (subdural abscess). The complications have often a very serious clinical course and potentially life-threatening. Antibiotic therapy is the main treatment in not complicated forms. Considering the prevalence of Streptococcus pneumoniae, cephalosporins are the antibiotic of choice, but they have to be administrated intravenously in hospitalized patients. Combinations with other antibiotic are suggested when multibacterial flora is present. In complicated forms of acute mastoiditis, the antibiotic treatment can be particularly important, in combination with other specific drugs (i.e. anticoagulants and/or corticosteroids). Surgical treatments, such as incision of abscesses, mastoidectomy, and neurosurgical procedures, are sometimes performed in combination with medical therapy in very severe complications. Data from our experience are briefly reported.
Asunto(s)
Mastoiditis , Enfermedad Aguda , Antibacterianos/uso terapéutico , Niño , Humanos , Mastoiditis/complicaciones , Mastoiditis/tratamiento farmacológico , Mastoiditis/microbiologíaRESUMEN
BACKGROUND: Few data on intracranial group A Streptococcus (GAS) infection in children are available. Here, we describe the demographic, clinical, and diagnostic characteristics of 91 children with intracranial GAS infection. METHODS: Cases of intracranial GAS infection in persons ≤18 years of age reported between 1997 and 2014 were identified by the Centers for Disease Control and Prevention's population- and laboratory-based Active Bacterial Core surveillance (ABCs) system. Medical charts were abstracted using a active, standardized case report form. All available isolates were emm typed. US census data were used to calculate rates. RESULTS: ABCs identified 2596 children with invasive GAS infection over an 18-year period; 91 (3.5%) had an intracranial infection. Intracranial infections were most frequent during the winter months and among children aged <1 year. The average annual incidence was 0.07 cases per 100000 children. For 83 patients for whom information for further classification was available, the principal clinical presentations included meningitis (35 [42%]), intracranial infection after otitis media, mastoiditis, or sinusitis (34 [41%]), and ventriculoperitoneal shunt infection (14 [17%]). Seven (8%) of these infections progressed to streptococcal toxic shock syndrome. The overall case fatality rate was 15%. GAS emm types 1 (31% of available isolates) and 12 (13% of available isolates) were most common. CONCLUSIONS: Pediatric intracranial (GAS) infections are uncommon but often severe. Risk factors for intracranial GAS infection include the presence of a ventriculoperitoneal shunt and contiguous infections in the middle ear or sinuses.
Asunto(s)
Encefalopatías/epidemiología , Infecciones Bacterianas del Sistema Nervioso Central/epidemiología , Meningitis Bacterianas/epidemiología , Infecciones Estreptocócicas/epidemiología , Streptococcus pyogenes , Adolescente , Distribución por Edad , Encefalopatías/microbiología , Encefalopatías/mortalidad , Infecciones Bacterianas del Sistema Nervioso Central/microbiología , Infecciones Bacterianas del Sistema Nervioso Central/mortalidad , Niño , Preescolar , Femenino , Humanos , Incidencia , Lactante , Masculino , Mastoiditis/complicaciones , Mastoiditis/microbiología , Meningitis Bacterianas/mortalidad , Otitis Media/complicaciones , Otitis Media/microbiología , Factores de Riesgo , Choque Séptico/etiología , Sinusitis/complicaciones , Sinusitis/microbiología , Infecciones Estreptocócicas/complicaciones , Infecciones Estreptocócicas/mortalidad , Streptococcus pyogenes/aislamiento & purificación , Estados Unidos/epidemiología , Derivación VentriculoperitonealRESUMEN
OBJECTIVE: To evaluate in children the clinical severity and evolution of otogenic lateral sinus thrombosis (OLST) due to Fusobacterium necrophorum compared with other bacterial otogenic thrombosis and propose a specific management flowchart for Fusobacterium OLST. DESIGN: A retrospective multicentre cohort study. SETTINGS: Four French ENT paediatric departments. PARTICIPANTS: A total of 260 under 18 years old admitted for acute mastoiditis were included. Initial imaging was reviewed to focus on complicated mastoiditis and 52 OLST were identified. Children were then divided into two groups according to bacteriological results: 28 in the "OLST Fusobacterium group" and 24 in the "OLST other bacteria group". RESULTS: There was a significant association between F necrophorum and OLST (P < .001). When compared to the OLST other bacteria group, children in the OLST Fusobacterium group were significantly younger (61 months vs 23 months, P < .01) and had a more severe clinical presentation: higher CRP (113 mg/L vs 175.7 mg/L, P = .02) and larger subperiosteal abscess (14 mm vs 21 mm, P < .01). Medical management was also more intensive in the OLST Fusobacterium group than in the OLST other bacteria group: increased number of conservative surgeries (66.7% vs 92.9%, P = .03) and longer hospital stay (13.7 days vs 19.8 days, P = .02). At the end of follow-up, the clinical course was good in both groups without any neurological sequelae. CONCLUSIONS: Thrombotic complications are very frequent in case of Fusobacterium mastoiditis and clinicians should be aware of the initial severity of the clinical presentation. Under appropriate management, the clinical course of Fusobacterium OLST is as good as that of other bacterial otogenic thrombosis.
Asunto(s)
Manejo de la Enfermedad , Infecciones por Fusobacterium/complicaciones , Fusobacterium necrophorum/aislamiento & purificación , Mastoiditis/complicaciones , Trombosis/etiología , Enfermedad Aguda , Preescolar , Femenino , Infecciones por Fusobacterium/microbiología , Infecciones por Fusobacterium/terapia , Humanos , Lactante , Masculino , Mastoiditis/microbiología , Mastoiditis/terapia , Estudios Retrospectivos , Trombosis/diagnósticoRESUMEN
Mycobacterium abscessus is an extensively drug-resistant opportunistic pathogen that can cause chronic otomastoiditis. There are no evidence-based treatment regimens for this severe infection. We treated four children with M. abscessus otomastoiditis with a structured regimen of topical imipenem and tigecycline, intravenous imipenem and tigecycline, and oral clofazimine and azithromycin and adjunctive surgery. This structured approach led to cure, with 1 year of follow-up after treatment. Adverse events were frequent, mostly caused by tigecycline.
Asunto(s)
Antibacterianos/administración & dosificación , Mastoiditis/tratamiento farmacológico , Infecciones por Mycobacterium no Tuberculosas/tratamiento farmacológico , Mycobacterium abscessus , Administración Oral , Adolescente , Azitromicina/administración & dosificación , Niño , Clofazimina/administración & dosificación , Terapia Combinada , Quimioterapia Combinada/efectos adversos , Femenino , Humanos , Imipenem/administración & dosificación , Inyecciones Intravenosas , Instilación de Medicamentos , Masculino , Mastoidectomía , Mastoiditis/diagnóstico por imagen , Mastoiditis/microbiología , Infecciones por Mycobacterium no Tuberculosas/diagnóstico por imagen , Infecciones por Mycobacterium no Tuberculosas/microbiología , Mycobacterium abscessus/efectos de los fármacos , Mycobacterium abscessus/aislamiento & purificación , ATPasas de Translocación de Protón , Tigeciclina/administración & dosificación , Tigeciclina/efectos adversos , TimpanoplastiaAsunto(s)
Absceso/microbiología , Infecciones por Klebsiella/complicaciones , Klebsiella pneumoniae , Síndrome de Lemierre/microbiología , Mastoiditis/microbiología , Absceso/diagnóstico por imagen , Adulto , Femenino , Humanos , Infecciones por Klebsiella/diagnóstico por imagen , Síndrome de Lemierre/diagnóstico por imagen , Mastoiditis/diagnóstico por imagenAsunto(s)
Actinomicosis/terapia , Mastoiditis/microbiología , Mastoiditis/terapia , Hueso Temporal/microbiología , Actinomicosis/diagnóstico por imagen , Actinomicosis/patología , Actinomicosis/cirugía , Antibacterianos/uso terapéutico , Preescolar , Humanos , Masculino , Mastoiditis/diagnóstico por imagen , Mastoiditis/cirugía , Hueso Temporal/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
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