Determination of Biofilm-Forming Capacity of Otopathogens Isolated from Discharging Ears in Children with Chronic Otitis Media

Chronic otitis media is a common disease of the developing world with persistent ear discharge, leading to major complications. This study describes the microorganisms isolated from the middle ear and nasopharynx of children with chronically discharging ears. Middle ear and nasopharyngeal swabs from 89 children were studied, and the microorganisms isolated were assessed for biofilm-forming ability. Methicillin-susceptible Staphylococcus aureus was common in the nasopharynx, while the middle ear showed predominantly pseudomonas and Methicillin-resistant S. aureus. Pseudomonas aeruginosa showed strong biofilm formation, whereas Escherichia coli, Proteus sp. and Providentia sp. were weak biofilm producers. S. aureus isolates were negative for biofilm formation.

Tuberculosis of the temporomandibular region

Objective:@#To describe a unique case of extrapulmonary tuberculosis (TB) of the temporomandibular area focusing on its insidious and destructive course over a 2-year period with insights into the diagnostic and therapeutic pitfalls encountered throughout its clinical development. @*Methods:@#Study Design: Case Report. Setting: Tertiary Government Hospital. Patient: One. @*Results@#A 33-year old man initially presented with right pre-auricular swelling and trismus that were unresponsive to antibiotic therapy. On subsequent follow-ups, initial symptoms were accompanied by a non-healing right pre-auricular wound, right ear discharge, trismus, and right facial paralysis (House-Brackmann III). Cranial and temporal bone computed tomography scans revealed osteolytic destruction of the right temporomandibular region extending to the auditory canal and of the right mastoid bone extending to the right mandibular condyle and parotid. Infected malignancy of the parotid, mandible and temporal bone were considered, but definitive diagnosis from an incision biopsy revealed caseating granulomatous inflammation consistent with tuberculosis. He was started on anti-tuberculosis medications with significant resolution of pre-auricular swelling, non-healing pre-auricular wound, facial paralysis and ear discharge but minimal improvement in mouth opening.@*Conclusion@#Tuberculosis of temporomandibular region is rare and is associated with nonspecific manifestations. Delay in diagnosing and initiating appropriate treatment can lead to morbidity and serious complications involving destruction of the temporal bone, middle ear, mandible and parotid gland over its progression. A high index of suspicion by the physician and awareness of the patient’s health seeking behaviors could have aided in the early diagnosis and treatment of this extrapulmonary TB.

A Case of Vibrio alginolyticus Isolated from Otorrhea of Chronic Otitis Media / 감염

Vibrio alginolyticus is a microorganism of marine environment that occasionally occurs as a human pathogen. We isolated V. alginolyticus from a patient with otitis media. A 37-year-old man had been exposed to seawater one month before admission. The isolate showed typical biochemical and characteristics of this organism such as positive Voges-Proskauer reaction, fermentation of sucrose, growth on 10% sodium chloride media. In vitro susceptibility test shows the isolate was resistant to ampicillin and carbenicillin, but was susceptible to other antimicrobial agents. The patient improved with ciprofloxacin and ofloxacin therapy.