Otite externa maligna / Malignant external otitis

A otite externa maligna é uma forma rara de infecção necrotizante do meato auditivo externo, cujo diagnostico e tratamento continua sendo um desafio. Neste artigo serão detalhadas as características clínicas e os métodos diagnósticos e terapêuticos atualmente disponíveis para esta doença.

Otomycosis: a retrospective study / Otomicoses: um estudo retrospectivo

Otomycosis is a fungal infection of the external ear canal with only a few studies about its real frequence in Brazil. AIM: to evaluate otomycosis frequence and characteristics in patients with clinical suspicion of external otitis. STUDY DESIGN: Retrospective study with transversal cohort (2000-2006). MATERIALS AND METHODS:103 patients were assigned to mycological diagnosis (direct microscopic examination and culture). RESULTS: Otomycosis was diagnosed in 19.4 percent of the patients. Patient age varied from 2 to 66 years (an average of 23.5 years of age), and 60 percent of otomycosis cases were seen in women between 2 to 20 years of age. Chronic otitis, previous antibiotic therapy and the lack of cerumen were predisposing factors; itching, otalgia, otorrhea and hypoacusis were the symptoms reported by the patients. The most frequently isolated species were C. albicans (30 percent), C. parapsilosis (20 percent), A. niger (20 percent), A. flavus (10 percent), A. fumigatus (5 percent), C. tropicalis (5 percent), Trichosporon asahii (5 percent) and Scedosporium apiospermum (5 percent). CONCLUSIONS: Otomycosis is endemic in João Pessoa-PB. Clinical exam and mycological studies are important for diagnostic purposes because otomycosis symptoms are not specific.

Otomicose é uma infecção fúngica do conduto auditivo externo com poucos estudos sobre sua real frequência no Brasil. OBJETIVO: Avaliar a frequência e características das otomicoses em pacientes com suspeita clínica de otite externa. DESENHO DO ESTUDO: Estudo retrospectivo com corte transversal (2000-2006). MATERIAL E MÉTODOS: 103 pacientes foram atendidos para diagnóstico micológico (exame microscópico direto e cultivo). RESULTADOS: Otomicoses foram diagnosticadas em 19,4 por cento dos pacientes. A idade desses pacientes variou de 2 a 66 anos (média de 23,5 anos) e 60 por cento das otomicoses foram observadas em mulheres entre 2 a 20 anos de idade. Otite crônica, antibioticoterapia prévia e ausência de cerume foram os fatores predisponentes e prurido otológico, otalgia, otorreia e hipoacusia os sintomas relatados pelos pacientes. As espécies mais frequentemente isoladas foram C. albicans (30 por cento), C. parapsilosis (20 por cento), A. niger (20 por cento), A. flavus (10 por cento), A. fumigatus (5 por cento), C. tropicalis (5 por cento), Trichosporon asahii (5 por cento) e Scedosporium apiospermum (5 por cento). CONCLUSÃO: Otomicose é endêmica em João Pessoa - PB. O acompanhamento clínico e o diagnóstico micológico são importantes uma vez que a sintomatologia de otomicose não é específica.

Perfil de isolamento microbiano em cães com otite média e externa associadas / Profile of microorganisms isolated from dogs with associated media and extern otitis

Comparou-se o perfil de isolamento microbiano de amostras coletadas de cães com otite média (OM) e externa (OE) associadas. Sessenta e quatro cães com otite média e externa foram avaliados durante 10 meses. Amostras dos condutos auditivos externos foram coletadas com auxílio de swabs estéreis e aquelas do ouvido médio pela técnica cirúrgica da osteotomia da bula timpânica. Os microrganismos foram cultivados e identificados de acordo com os métodos previamente descritos, e a susceptibilidade a antimicrobianos avaliada pelo método de difusão em ágar estabelecido pelo National Committee for Clinical Laboratory Standards. Bactérias anaeróbias estritas não foram isoladas em qualquer amostra. Todas as amostras de OE mostraram crescimento bacteriano e/ou fúngico. Na OM, a positividade nas culturas foi de 48 por cento. Os microrganismos mais isolados na OE foram: Bacillus sp. (26,9 por cento), M. pachydermatis (22,2 por cento) e S. intermedius (21,7 por cento); na OM foram: S. intermedius (32,5 por cento), S. aureus subsp. aureus (22,5 por cento) e bacilos Gram-negativos não fermentadores (10,0 por cento). Observou-se alguma diferença no perfil de isolamento entre os quadros de OM e OE em 96,7 por cento dos animais. Verificou-se elevada resistência de cepas de S. intermedius à penicilina G, ampicilina, eritromicina, tetraciclina e clindamicina.

The isolation pattern of samples collected from dogs with both media (OM) and extern otitis (OE) was compared. Sixty-four dogs suffering from those conditions were studied over a 10-month period. Samples from the external ear were collected with sterile swabs while those from the middle ear were collected by osteotomy of the tympanic bulla. The microorganisms were cultured and identified according to methods previously described and to the susceptibility of antimicrobials according to the National Committee for Clinical Laboratory Standards agar diffusion test. Anaerobic bacteria were not isolated in any sample. All samples from OE showed bacterial and/or fungal growth. Concerning media otitis, this percentage was 48 percent. The most common microorganisms isolated from OE were Bacillus sp. (26.9 percent), M. pachydermatis (22.2 percent) and S. intermedius (21.7 percent) and those from OM were S. intermedius (32.5 percent), S. aureus subsp. aureus (22.5 percent) and non-fermentative Gram-negative rods (10.0 percent). Some difference was observed in the isolation pattern between media and extern otitis in 96.7 percent of the animals. High resistance rates of S. intermedius strains to penicillin G, ampicillin, erythromycin, tetracycline and clindamycin were found.

Isolation and antimicrobial susceptibility of bacteria from external ear canal of cancer patients at Shafa Cancer Hospital-Ahwaz.

A bacteriological study of external ear canal was performed in 52 hospitalized cancer patients and 42 non hospitalized cancer patients at Shafa hospital, Ahwaz. Study was under taken to find out the normal flora changes in the external ear canals and to observe the prevalence of external otitis among these cancer patients. The control group consisted of 40 non-cancer patients. We observed the following bacteria among hospitalized cancer patients. Staphylococcus Coagulase negative (51.9%), Staphylococcus aureus (15.7%) and Streptococcus pneumoniae (11.9%). Similarly, among non hospitalized cancer patients, Staphylococcus Coagulase negative (45.2%), S. aureus (9.5%) and Streptococcus pneumoniae (4.7%). Incidence of Staphylococcus Coagulase negative and Streptococci pneumoniae is higher in control group than that in cancer patients. We have concluded that cancer patients probably suffer from external otitis more frequently because of enhanced colonization by S. aureus (P < 0.05). The antimicrobial susceptibility of these organisms to various antibiotics was determined by disk diffusion method using Muller Hinton agar. In hospitalized cancer patients Staphylococcus Coagulase negative was 25% and 85% resistant to Vancomycin and Penicillin G and in non hospitalized cancer patients, Staphylococcus Coagulase negative were 45% and 80% resistant to Vancomycin and Penicillin G. S. aureus of both the groups (hospitalized & non hospitalized) were resistant to Penicillin G. Similarly, both the groups were 55% and 50% resistance to Vancomycin.

Etiological and microbiological features of otitis externa at military hospitals in Amman

To investigate the relationship between infection, water exposure, trauma and allergy and the development of otitis externa. This study included 100 patients with acute external otitis and 200 participants as a control group, matched in age and sex. All patients were asked about the frequency of different social habits and presence or absence of any allergic disorder. Otoscopy and microbiological analysis were carried out. It was found that 55% of cases revealed positive microbiological analysis. There was no apparent difference between the two groups regarding frequency of swimming, showering and hair washing. Allergic disorders were nearly four times more common in the otitis externa group, suggesting possible immunological etiology. A significant difference was found between the two groups regarding the use of agents capable of traumatizing the external canal. Eczematous otitis externa and viral causes accounted for 45% of the cases. Conclusions: Trauma to the external canal was proven to be statistically significant in the development of otitis externa. Allergic and viral causes also play an important role

Otomycosis in Sao Paulo

Em vista da escassez de publicacoes sobre otomicoses no Brasil, foi projetada uma pesquisa para conhecer a incidencia, caracteristicas clinicas, fatores predisponentes e agentes etiologicos da micose. Durante um ano, 22 casos suspeitos foram estudados, 20 dos quais corresponderam a otomicoses. As especies mais frequentemente isoladas foram Aspergillus niger (35 por cento) e Candida albicans (20 por cento). O genero Aspergillus representou 75 por cento dos isolamentos. Os sinais clinicos mais comuns foram prurido e hiperemia (70 por cento), otalgia (65 por cento), hipoacusia (50 por cento). Falta de cerumen (70 por cento), otite cronica (30 por cento), antibioticoterapia previa e eczema (25 por cento) foram os fatores predisponentes mais relevantes.

Clinical and microbiological study of otitis externa

Sixty patients with external otitis were studied to define the different clinical patterns, establish the relative incidence of bacteria and fungi, and to investigate the role of some predisposing factors in the development of otitis externa in Alexandria. Associated skin disease was found to be the most predisposing factor and Staph. aureus was the commonest isolated [46%], Pseudomonas aeruginosa [8.3%] and fungi [25%]