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Pan Afr Med J ; 24: 322, 2016.
Artigo em Francês | MEDLINE | ID: mdl-28154677


Malignant otitis externa is also referred to as skull base osteomyelitis. Pseudomonas aeruginosa is the most common offending pathogen. However, fungal origin is not uncommon. 80-year-old patient having persistent left earache since two months despite adequate treatment. Otologic examination showed signs of inflammation in the auricular pavilion, ear canal stenosis with granulomas and purulent otorrhea. CT scan showed a filled otomastoid, extensive inflammatory process affecting the pre-auricular and retro-auricular tissues and lysis of the tympanic bulla. Given the lack of improvement, mycological examination was performed which revealed the presence of Candida Albicans. Cases of malignant otitis externa caused by Candida albicans are rarely reported. Fungal origin should be suspected in patients who have negative bacteriological samples and no improvement despite adequate antibiotic treatment. It should be confirmed by sometimes multiple mycological samples. Malignant otitis externa caused by Candida albicans is a rare potentially mortal infection.

Candida albicans/isolamento & purificação , Candidíase/diagnóstico , Otite Externa/diagnóstico , Idoso de 80 Anos ou mais , Candidíase/microbiologia , Feminino , Humanos , Otite Externa/microbiologia , Otomicose/diagnóstico , Otomicose/microbiologia
Pan Afr Med J ; 24: 269, 2016.
Artigo em Francês | MEDLINE | ID: mdl-28154624


External auditory canal cholesteatoma is defined as an accumulation of keratin leading to osteolytic bony erosion. It is a rare or underdiagnosed otologic entity. Our study aims to illustrate one case of external auditory canal cholesteatoma. Hypertensive diabetic patient, 65 years of age, under therapy suffering from severe right earache, insomnia, hearing loss, small purulent otorrhea and right facial paralysis grade V since 3 months. Initially the diagnosis was malignant external otitis. The patient underwent antibiotic therapy without improvement. Otologic examination showed burgeoning ulcerative lesion of the posterior wall of the right external auditory meatus. Systematic lesion biopsy was performed and confirmed the diagnosis of cholesteatoma. The patient underwent open technique tympanoplasty. External auditory canal cholesteatoma is rare, clinical symptoms are not specific, coronal CT scan makes a major contribution to a positive diagnosis showing bony crater of external auditory meatus. Treatment depends on the extent of the lesions. It can be based on simple local cares or on open technique tympanoplasty. External auditory canal cholesteatoma may have multiple clinical aspects and lend to confusion with other pathologies of the external auditory meatus.

Colesteatoma/diagnóstico , Meato Acústico Externo/patologia , Otopatias/diagnóstico , Timpanoplastia/métodos , Idoso , Biópsia/métodos , Colesteatoma/patologia , Colesteatoma/cirurgia , Otopatias/patologia , Otopatias/cirurgia , Humanos , Masculino , Otite Externa/diagnóstico
Pan Afr Med J ; 24: 272, 2016.
Artigo em Francês | MEDLINE | ID: mdl-28154627


Sinus barotrauma is the second most frequently reported injury after middle ear barotrauma. The front sinus is the most common site affected. This is a rare and specific pathology. We here report the case of a 26-year-old patient having severe left frontal pain with ipsilateral epistaxis after a dive. CT scan showed left frontal hemosinus. Patient evolution was good after therapy. Frontal sinus barotraumas are accidents related to the variations in environmental pressure. Epistaxis is a sign of serious health condition, CT scanner plays a role in evaluating potential predisposing factors and establishing monitoring procedures. Patient treatment aims to relieve symptoms and to remove predisposing factors. Frontal sinus barotraumas are a rare injury ; orbital and encephalic complications are exceptional. Their treatment coincides with that of their causal pathology.

Barotrauma/etiologia , Mergulho/lesões , Seio Frontal/lesões , Doenças dos Seios Paranasais/etiologia , Adulto , Barotrauma/diagnóstico por imagem , Barotrauma/terapia , Seio Frontal/diagnóstico por imagem , Humanos , Masculino , Doenças dos Seios Paranasais/diagnóstico por imagem , Doenças dos Seios Paranasais/terapia , Tomografia Computadorizada por Raios X/métodos