Otitis externa difusa infecciosa: revisión de la literatura / Infectious diffuse external otitis: literature review

External otitis (EO) is a skin infection of the external auditory canal (EAC). It's a frequent complaint to the otolaryngologist affecting 10% of the population at least once in their life time. EO is associated with an increased humidity of the EAC, local trauma and allergic skin conditions. The diagnosis is based on clinical symptoms and signs such as earache and positive tragus sign. Infections EO are mostly bacterial infections caused by P. aeruginosa and S. aureus, and in a lower percentage fungal infection by A. niger and C. albicans. Treatment of acute infectious EO is essentially local and should be active against most common agents. The aim of this review is to update the current reality of this common clinical entity in our environment. (AU)

Pseudomonas aeruginosa isolated from otitis externa associated with recreational waters in some public swimming pools in Tehran

Pseudomonas aeruginosa is the most significant bacteria capable of multiplying in water especially in recreational waters. This bacterium is also the most commonly bacterial pathogen in ear infections. Although the bacterium is infrequently found in the normal ear, but the users of swimming pools may be at risk of acquiring disease. The bacteriological quality and health risk of the water of eleven public outdoor and indoor swimming pools in East and North-East of Tehran was assayed. Useful information was recorded at the time of sampling. Samples tested for aerobic colony count, coliforms, Escherichia coli and P. aeruginosa according to the standard method. Ear swabs were collected from 179 users with a history of ear problems during the previous two weeks. An adequate control group was chosen randomly from those who never used the investigated pools. P. aeruginosa was isolated from 9 [81.8%] of the pools. P. aeruginosa was the only bacterium grew in 7 [63.6%] swimming pools, while in the other 2 [18.2%] swimming pools high rates of total bacterial count, total coliforms and fecal coliform counts were also found besides P. aeruginosa. Meanwhile, P. aeruginosa was isolated from the ear swabs of 142 [79.3%] swimming pool users, as compared to 4% of the controls. Results revealed that otitis externa was strongly associated with swimming in pools, due to P. aeruginosa. Furthermore, contamination of the swimming pools with P. aeruginosa and often the chlorination process could not remove the pollution, especially when high numbers of people led to overuse of the pools, hence, more strict bathing water standards should be met in the public swimming pools in the city

Otological problems among professional divers in Basrah

To determine the otological problems among professional divers in Basrah, and to study the risk factors which might be associated with diving. The retrospective cohort study carried out in Basrah Governorate from November 2002 to March 2003 to detect the otological problems among divers in comparison to non-divers group, and to determine the association between otological problems and some risk factors. The study involved 120 divers chosen randomly from Iraqi Military Navy and Iraqi Port Company, compared to 120 non-divers were matched to divers regarding age, education, residence and years of service chosen from the same units. Both groups were interviewed by the researcher using special questionnaire form designed for the study. Otological examination of the studied group was performed by E.N.T. specialist, while the audio-metric examination was done by audiologic technician. The study showed that 80.8% of divers had otological problems [otalgia 55.8%, itching 55.8%, hearing problems 45.8%, tinnitus 41.7%, vertigo 39.2% and discharge 26.7%]. Otoscopic examination showed abnormal findings in 60.8% of divers [otitis externa 28.3%, otitis media 19.2%, impacted wax 8.3% and retracted tympanic membrane 5.0%]. Audiometric examination showed that 44.2% of divers had some degree of hearing loss, presented as bilateral, mild, high frequency sensorineural hearing loss. The study showed that years of service was the most significant risk factor associated with otological problems. Maximum time spent under water was the second significant factor associated with sensrineural hearing loss. The prevalence of otological problems among studied divers was higher than that among non-divers with a ratio of 2.2

Un caso de otomicosis causada por Aspergillus niger, Aspergillus sp. y Candida albicans / One case of otomicosis by Aspergullus niger, Aspergillus sp and Candida albins

se registra un caso de otitis crónica no asociada a infección bacteriana, rebelde al tratamiento convencional, causada por Aspergillus niger, Aspergillus sp. y Candida albicans.

Uso de radionuclídios no estudo da otite externa maligna / The use of radionuclides in the study of malignat external otitis

A otite externa maligna, que na forma mais grave provoca osteomielite da base do crânio, afeta aos pacientes imunocomprometidos. O diagnóstico precoce é requisito fundamental para prevenir as graves complicaçöes. Säo estudados 11 pacientes: cinco diabéticos, cinco com SIDA e um com leucemia mielóide aguda, através de tomografia computadorizada, cintilografia óssea empregando metilenodifosfonato de tecnécio (99mTc) e citrato de gálio (67-Ga), nos 15 dias após o início do tratamento e a cada três meses, evolutivamente. A TC näo mostrou definiçäo para identificar a infecçäo no conduto auditivo externo, mas foi útil no diagnóstico diferencial. A cintolografia com 99mTc-MDP mostrou sensibilidade e especificidade de 100 por cento; o estudo com 67-Ga, no acompanhamento, mostrou sensibilidade de 80 por cento e especificidade de 100 por cento.

Controversia diagnostica en un proceso inflamatorio cronico del pabellon auricular: a proposito de un caso / Diagnostic controversies in an inflamatory chronic ear process: apropos in case

Se presenta el caso de un paciente con episodios recurrentes de tumefaccion auricular unilateral. Las principales causas de patologia inflamatoria del pabellon auricular son policondritis recidivante, otitis externa maligna, pericondritis, otitis externa difusa, pseudoquiste de oreja, erisipela y dermatitis de contacto. En este caso resulta particularmente dificil llegar con certeza a la causa, planteandose por tanto un diagnostico provisorio. La evolucion permitira ratificar o rectificar esta afirmacion

Otite externa maligna / Malignant otitis externa

Os autores fazem uma revisäo a respeito da otite externa maligna, discutindo suas possíveis etiologias e métodos de diagnóstico, seu diagnóstico diferencial e terapêutica. Chamam a atençäo aos exames indispensáveis para um correto diagnóstico e prognóstico, insistindo na biópsia da lesäo e cultura para o encontro do Pseudomona aeruginosa, agente etiológico. Os exames radiológicos com Technetium e Gallium säo salientados na sua importância com relaçäo ao diagnóstico da lesäo, o seu prognóstico, assim como a duraçäo do tratamento. Apresentam 7 casos, todos em pessoas idosas e diabéticas (apenas um paciente tinha idade inferior a 70 anos e todos tinham mais de 60 anos). Sugerem o tratamento com a associaçäo de carbenicilina e um antibiótico aminoglicosídeo, por período de tempo que varia entre 4 e 6 semanas nas formas mais graves. Em nenhum dos casos apresentados a cirurgia se configurou como um procedimento indispensável, mas apenas auxiliar no tratamento clínico. Ressaltam na evoluçäo dos pacientes a importância do controle radiológico com o Gallium, a necessidade da internaçäo nos casos mais graves e o diagnóstico e tratamento precoces, assim como o controle do diabetes para se conseguir um resultado favorável. O controle clínico do paciente e em especial de sua funçäo renal deve correr paralelamente ao controle do diabetes. Dos 7 pacientes tratados (apenas um näo teve seguimento completo), 6 tiveram ótima evoluçäo com o tratamento preconizado

Diabetes y otitis / Diabetes and otitis

Se presenta el caso una paciente diabética tipo I con cuadro de "Otitis Externa Maligna". Se hace notar la importancia de conocer y sospechar esta complicación de la Diabetes en forma temprana. Se hace énfasis en la necesidad de un tratamiento enérgico a base de Gentamicina y Carbenicilina en dosis masivas, con el fin de no tener que recurrir a la cirugía, la cual a veces es necesaria, ya que, se trata de una complicación de la Diabetes Mellitus que puede conducir a la muerte del paciente