ABSTRACT
Reportamos el caso de una paciente de 7 años de edad que presentó otitis media aguda complicada con otomastoiditis crónica quien fue operada de una timpanomastoidectomía a los dos meses y medio de enfermedad, a los tres meses presentó fiebre, signos de hipertensión endocraneana y paresia del miembro superior izquierdo. La tomografía espiral multicorte mostró absceso en el lóbulo temporal ipsilateral. Recibió tratamiento antibiótico de amplia cobertura y fue sometida a resección quirúrgica del absceso. Seis semanas después de la intervención quirúrgica salió de alta con monoparesia del brazo izquierdo con desempeño independiente.
We report a case of a seven year old patient who had acute media otitis complicated with chronic otomastoiditis, who was operated of timpanomastoidectomy after two months and a half of illness, at three months she had fever, endocraneal hypertension signs and paresia of the left upper limb. The multislice spiral tomography showed the presence of an abscess on the ipsilateral temporal lobe. She received extended-spectrum antibiotic therapy and surgical excision of the abscess. Six weeks after the surgery she was discharged from the hospital with left upper limb monoparesia with independent performance.
Subject(s)
Humans , Female , Child , Brain Abscess/surgery , Cholesteatoma/therapy , Delayed Diagnosis , Mastoiditis/therapy , Otitis Media/therapyABSTRACT
La tuberculosis (TBC), es una de las patologías infecciosas más estudiadas en medicina. En Chile, la incidencia de TBC en 2008 fue de 13,7 por 100,000 habitantes, situando al país en fase de eliminación y con la menor incidencia en América Latina. Las publicaciones internacionales consideran que la otitis media por TBC (OMT) es una forma de presentación clínica muy infrecuente de TBC con una incidencia que oscila entre un 0,05 y un 0,9 por ciento de las otitis media crónicas. La población más afectada es la menor de quince años, lo que constituye el 85 por ciento de los casos. En Chile no se cuenta con datos epidemiológicos de dicha patología. El objetivo de esta publicación es dar a conocer un caso clínico de OMT complicada con otomastoidistis, en un paciente del hospital de niños Dr. Roberto de Río de Santiago, Chile y revisar la información disponible en la literatura para concientizar a la población médica.
Tuberculosis (TB) has been one of the infectious diseases most studied in the history of medicine. In Chile, TB incidence was 13.7 per 100,000 inhabitants in 2008, being the country with the lowest incidence in Latin America. World-wide publications consider tuberculous otitis media (TOM) as a very rare form of TB presentation, constituting 0.05 to 0.9 percent of chronic otitis media. Population younger than 15 years old is the most vulnerable, 85 percent of the cases belongs to this range of age. Chile has not epidemiological data available on this pathology. The aims of this article are to show a clinical case of TOM and posterior otomastoiditis, in an infant hospitalized in Roberto del Rio Children's Hospital in Santiago de Chile and review the literature about this pathology, in order to raise awareness for doing an opportune diagnosis of this condition.
Subject(s)
Humans , Male , Infant , Mastoiditis/etiology , Mastoiditis/therapy , Otitis Media/etiology , Otitis Media/therapy , Tuberculosis, Pulmonary/complicationsABSTRACT
Tsukamurella spp. es un bacilo gram positivo, aeróbico, catalasa positivo, no móvil, no esporulado, que pertenece al orden de los actinomicetales. Los géneros incluidos en este orden son Nocardia, Gordonia, dietza, Skermania, Williamsia, Turicella, Streptomyces y Rhodococcus. Otros géneros relacionados son Corynebacterium y Mycobacterium. Las infecciones por esos microorganismos se han asociado con neumopatías crónicas, inmunodepresión (leucemia, tumores, infección por el HIV) e infecciones postoperatorias de heridas. Se notificó la presencia de tsukamurella en hemocultivos asociada al uso de sondas o catéteres, otros dispositivos médicos y en casos individuales de tenosinovitis necrosante con abscesos subcutáneos, infecciones óseas y cutáneas, meningitis, peritonitis y conjuntivitis y también como germen colonizante. Se presenta un caso de otomastoiditis en un paciente HIV positivo causado por este germen.
Subject(s)
Humans , Male , Adult , Antiretroviral Therapy, Highly Active , Diplopia/pathology , HIV , Mastoiditis/therapy , Nocardiaceae/immunologyABSTRACT
A mastoidite aguda que se apresenta de forma atípica, com edema temporal e/ou facial, é a chamada mastoidite escamozigomática. Existem poucos relatos sobre essa forma de mastoidite que ocorre devido à propagação do processo inflamatório à raiz da apófise zigomática, quando a pneumatização da mastóide atinge o zigoma ou a porção escamosa do osso temporal. O diagnostico é feito pela história, exame físico e tomografia computadorizada de mastóides. O tratamento é realizado com antibioticoterapia e cirurgia. OBJETIVO: Apresentar um caso de mastoidite escamozigomática e fazer revisão da literatura. PACIENTES E MÉTODOS: Relato de um caso avaliado em nosso hospital no ano de 2003 e revisão da literatura via internet; também foram usados livros de otorrinolaringologia de autores conhecidos. DISCUSSÃO: A mastoidite escamozigomática é uma das formas de apresentação atípica de mastoidite. Ocorre propagação do processo inflamatório até a apófise zigomática. A infecção atinge a escama do osso temporal e fistuliza-se entre esta e o músculo temporal, deslocando o pavilhão auricular para baixo e a podendo atingir face, olhos e pálpebra. O diagnóstico é feito através da historia, exame físico e tomografia computadorizada de mastóides. O tratamento é cirúrgico e associado à antibioticoterapia.
Acute atypical mastoiditis, with temporal and/or facial edema, is called squamozygomatic mastoiditis. There are only a few reports of this occurrence in the literature, which occurs because of an inflammatory process spread to the zygommatic apophysis, when mastoid pneumatization reaches the zygoma or the squamous portion of the temporal bone. Diagnosis is made based on clinical history, physical exam and mastoid CT scan. Treatment is carried out with antibiotic therapy and surgery. AIM: to present a case of squamozygomatic mastoiditis and review the literature. PATIENTS AND METHODS: report of a case treated in our hospital during the year of 2003 and literature review through the Internet, we also reviewed otolaryngology books from known authors. DISCUSSION: squamozygomatic mastoiditis is an atypical mastoiditis in which the inflammatory process spreads to the zygomatic apophysis. The infection reaches the temporal bone squamous portion and makes a fistula between this portion and the temporal muscle, shifting the pinna of the ear downwards and it may reach the face, eyes and eyelids. Diagnosis is carried out by clinical history, physical examination and mastoid CT Scan. Treatment is surgical, associated with antibiotic therapy.
Subject(s)
Female , Humans , Middle Aged , Mastoiditis/diagnosis , Pneumococcal Infections , Acute Disease , Mastoiditis/microbiology , Mastoiditis/therapy , Pneumococcal Infections/microbiology , Streptococcus pneumoniae/isolation & purification , Treatment OutcomeABSTRACT
La mastoïdite masquée (MM) se définit comme un état inflammatoire latent de la muqueuse et de l'os mastoïdien avecun tympan normal. Elle est révélée par une complication généralement endocrânienne. Le traitement est une mastoïdectomie associée à une antibiothérapie intraveineuse.Nous rapportons deux observations de mastoïdites masquées dont le diagnostic a été évoqué par l'examen tomodensitométrique qui a rattaché les complications endocrâniennes à leur origine mastoïdienne. Le but de notre travail est de discuter les circonstances diagnostiques, les investigations paracliniques et le traitementdes mastoïdites masquées
Subject(s)
Case Reports , Mastoiditis/complications , Mastoiditis/diagnosis , Mastoiditis/therapy , TunisiaABSTRACT
During the 5-year period 1999 - 2003; we treated 36 children with a clinical diagnosis of mastoiditis. Post-auricular tenderness; swelling or abscess was the presenting feature in all cases. Twenty of these children had acute mastoiditis; 12 had acute-onchronic mastoiditis and 4 had a post-auricular abscess and no signs of mastoiditis on mastoid exploration (pseudomastoiditis). No pathogenic organisms were cultured from 25of cases overall; but among those with positive culture Streptococcus pyogenes and Staphylococcus aureus were the commonest organisms in the acute mastoiditis group and Proteus mirabilis was the commonest in the acute-on-chronic group. In the acute mastoiditis group (20 patients) only 1 patient was successfully treated with antibiotics; the rest requiring cortical mastoidectomy. In the acute-on-chronic mastoiditis group (12 patients) 9 children had cholesteatoma and underwent an open cavity procedure and the other 3; who underwent cortical mastoidectomy; all had positive histology/culture for tuberculosis
Subject(s)
Mastoiditis/diagnosis , Mastoiditis/diagnostic imaging , Mastoiditis/therapy , Red CrossABSTRACT
To discuss the optimal diagnosis and treatment strategy for acute mastoiditis. Retrospective review of 12 patients with mastoiditis [6 males, 6 females] aged 12 to 20 years who were treated at our military hospitals from 1996 through 2001. Three diagnostic criteria were used to identify acute mastoiditis. Among our patients the most common abnormal findings on physical examination was an abnormal tympanic membrane, which was observed in the 12 patients. The second most common finding was swelling and erythema in the postauricular area. Radiological examination showed abnormal pneumatization of 8 of them. Eight of our patients were cured within 3 weeks by intravenous antibiotics, two of them underwent myringotomy. Surgery was performed on the 4 patients who did not respond to medical treatment. Our experience suggests that an accurate early diagnosis and appropriate antibiotic therapy are usually sufficient to cure acute mastoiditis. When the inflammation does not respond to medical treatment, the physician should suspect that the infection might be caused by antibiotic tolerant organisms or a typical pathogen. If complications ensue, we believe it is best to carry out surgical treatment as soon as possible
Subject(s)
Humans , Male , Female , Acute Disease , Mastoiditis/diagnostic imaging , Mastoiditis/therapy , Anti-Bacterial Agents , Surgical Procedures, Operative , Retrospective StudiesABSTRACT
A otite média aguda é uma desordem comum à infância, com pico de incidência entre os 6 meses e os 2 anos de idade. Existe uma tendência da mastoidite aguda ocorrer em crianças que não tenham estória prévia de otite média. A introdução dos antibióticos mudou completamente a visão do tratamento da otite média, resultando em considerável declínio na incidência de mastoidite aguda e subsequente mastoidectomia, apesar disto, a doença continua sendo considerada como uma séria complicação da otite média...
Subject(s)
Mastoiditis/classification , Mastoiditis/diagnosis , Mastoiditis/therapy , Otitis MediaABSTRACT
This is a report of a case of coalescent mastoiditis seen in a 3-year-old child with severe congenital neutropenia. Pseudomonas aeroginosa was the main bacterial species recovered from the affected ear. Modified radical mastoidectomy was done and appropriate antibiotics administered. Operative wound infection with delayed wound healing was the hallmark of the postoperative follow-up period. Large spectrum oral antibiotics in addition to regular wound cleansing was an effective adjunct to therapy. On last follow-up operative wound was healed and mastoid cavity was clean. Occurrence, treatment, clinical and microbiological aspects of coalescent mastoiditis were described and discussed