Isolamento microbiológico do canal auditivo de cães saudáveis e com otite externa na região metropolitana de Recife, Pernambuco / Microbiological isolation from the ear canal of healthy dogs and with otitis externa in the metropolitan region of Recife, Pernambuco

Otite externa (OE) é o termo utilizado para definir a inflamação do conduto auditivo externo; esta doença possui diversas etiologias, ocorre em várias espécies e é particularmente frequente em cães. Os microrganismos da microbiota residente comumente estão envolvidos na etiopatogenia da OE, sendo apontados como agentes perpetuadores da doença. O objetivo deste estudo foi investigar o perfil microbiológico de cães com conduto auditivo saudável e com otite na região metropolitana do Recife. Com o auxílio de suabes estéreis foram coletadas amostras das orelhas direita e esquerda de 41 cães, sendo 11 com OE e 30 sem OE. Foi realizado o isolamento bacteriano e fúngico das amostras cultivadas; observou-se positividade em 80% dos cães com orelhas saudáveis e presença de mais de um microrganismo em 38 amostras (63,3%); já nos cães com OE, a positividade foi 95,3%, com infecção polimicrobiana em 77,3% das amostras. No que se refere aos gêneros bacterianos, o perfil de isolamento microbiológico foi idêntico entre os cães otopatas e sadios. Os microrganismos isolados foram Staphylococcus sp., Micrococcus, Bacillus sp., Streptococcus sp. e Malassezia sp.

Otitis externa (OE) is the term used to describe inflammation of the external ear canal. This disease has many etiologies, occurs in several species and is particularly common in dogs. The resident microbiota microorganisms are commonly involved in the OE etiopathogenesis, being frequently appointed as perpetuator agents. The aim of this study was to investigate the microbiological profile of dogs with healthy ears and of others with otitis in the metropolitan region of Recife, Pernambuco, Brazil. With the aid of sterile swabs, samples of right and left ear of 41 dogs, 11 with and 30 without OE, were collected. Bacterial and fungal isolation was performed with cultured samples; positivity was observed in 80% of animals with healthy ears, with the presence of more than one microrganism in 38 samples (63.3%), whereas in dogs with OE, the positivity was 95.3% with polymicrobial infection in 77.3% samples. With regard to the genus, the microbiological profile was identical between healthy and diseased dogs. The microrganisms isolated were Staphylococcus sp., Micrococcus, Bacillus sp., Streptococcus sp. and Malassezia sp.

Perfil clínico e microbiológico de cães com e sem otoacaríase / Clinical and microbiological profile of dogs with and without otoacariasis

Os objetivos do estudo foram identificar a presença de microrganismos nos condutos auditivos dos cães através dos exames citológico e microbiológico, assim como avaliar a associação destes à otoacaríase e seus sinais clínicos. O diagnóstico da infestação por Otodectes cynotis foi realizado através de otoscopia bilateral e pela coleta de material e visualização do parasito sob microscópio esterioscópico, constituindo o exame parasitológico. Outras coletas de secreção otológica de cada orelha foram realizadas para confecção de lâminas para a citologia e para o isolamento microbiológico, sendo este último material coletado através de "swab" estéril. Dos 250 animais examinados, em 15 (6%) foi identificado o ácaro O. cynotis.Observou-se associação entre a presença do parasito e a ocorrência de otite clínica externa caracterizada especialmente por eritema auricular (P<0,001) e a produção excessiva de secreção otológica (P=0,0016), assim como a observação, pelos proprietários, de prurido ótico nos cães (P<0,001). Sugere-se a possibilidade de essas associações serem efeito da infestação. Houve também a associação (P<0,01) entre a otoacaríase e a ocorrência de microrganismos nos dois condutos auditivos de cada animal, detectados através da citologia. No entanto, não houve associação (P=0,04 e p=0,07) entre a presença do ácaro O. cynotis e a ocorrência de microrganismos no exame microbiológico das orelhas direita e esquerda, respectivamente.

The goals of this study were to identify microorganisms in dogs' ear canals through cytological and microbiological examination, and evaluate their association with otoacariasis and its clinical signs. Otodectes cynotis infestation diagnosis was achieved by bilateral otoscopy, and by parasite viewing on cerumem under stereoscopic microscope, representing the parasitological exam. Ear discharge was also collected from each canal to fix cytology slides and for microbiological isolation, but this last sample was collected with sterile swab. Among the 250 studied animals, 15 (6%) had ear mites. There was an association between the parasite and external clinical otitis specially as established by auricular erythema (P<0,001) and excessive production of ear discharge (P=0,0016), as well as ear pruritus observed by the owners (P<0,001). It has been suggested that these associations can be an effect of the infestations. There was also an association (P<0,01) between otoacariasis and microorganisms detected by cytological exam in both ear canals of each dog. However, there was no association (P=0,04 e P=0,07) between the presence of ear mite and microorganisms detected by microbiological exam of right and left ears.

Tympanic membrane disintegration by otomycosis

To report ear drum disintegration in cases of otomycosis. Case series study. E.N.T and Head and Neck Surgery Department PNS Shifa Hospital Karachi and E N T Department of Combined Military Hospital, Quetta Cantt from August 2009 to October 2010. 242 patients with clinical diagnosis of otomycosis were registered over a period of 15 months. On registration ear was meticulously cleaned under microscope removing fungal debris to establish the integrity of eardrum. In the same sitting cream with combination of triamcinolone acetonide, neomycin sulphate, gramicidin, nystatin was applied all around within external auditory meatus [EAM] on effected walls and same drops were advised locally thrice daily for 3 to 5 days. Every patient was advised to report back immediately on occurrence of irritation, earache, ear discharge, blockage of ear and pain. Out of 242patients [140 males and 102 females] 110 [45.45%] were cured after single visit as outpatient adopting a regimen of single application of antifungal cream and thrice daily antifungal ear drops for 5 days after proper cleaning of fungal debris from EAM. 73 [30.16%] cases were cured of otomycosis after two sittings of same regimen. 59 [24%] patients neglected the otomycosis for days to weeks till the time pain became unbearable. In 18 [7.43%] patients ear drum was perforated by otomycosis and all these patients had neglected the disease. Neglected Qtomyeosis has all the potentials to create a defect in ear drum causing chronic disability .Meticulous cleaning and local antifungal therapy still remains the gold standards for curing otomycQsis

Efficacy of Argentine propolis formulation for topical treatment of canine otitis externa / Eficácia da formulação da propólis Argentina para o tratamento tópico de otite externa canina

The therapeutic effects of Argentine propolis ear drop formulation on canine otitis externa were evaluated. Forty-eight dogs with symptoms of otitis externa were randomly assigned to double-blinded, controlled clinical trial to evaluate the efficacy of topical formulation with propolis versus a topical placebo in the treatment of otitis externa. The propolis preparation and placebo were administrated into both external ear canals, twice daily for 14 days. Throughout the study, clinical examination and microbiological analysis of dogs ear exudates were made. The most frequent microorganisms isolated in culture media were: Malassezia pachydermatis (54.2 percent), Staphylococcus aureus (43.8 percent), coagulase-negative Staphylococcus (25.0 percent), Pseudomonas aeruginosa (20.8 percent), Candida albicans (18.8 percent), Proteus mirabilis (16.7 percent), Streptococcus spp. (16.7 percent), Enteroccocus faecalis (12.5 percent), Escherichia coli (12.5 percent), Staphylococcus intermedius (6.3 percent), Klebsiella spp. (4.2 percent), andCandida glabrata (2.1 percent). Whereas the control group did not recover from the infectious ear disease, the propolis preparation exhibited antimicrobial activity against most of the microorganisms isolated from samples of the treated group. In addition, no propolis-adverse effects were observed. This allowed propolis-treated patients to show a significant improvement of the clinical parameters. Thus, this new Argentine propolis ear drop formulation may be used for topical treatment of otitis externa in dogs.

Os efeitos terapêuticos da formulação em gotas óticas de própolis procedentes da Argentina foram avaliados no tratamento da otite externa canina. Quarenta e oito cães com sintomas de otite externa foram distribuídos aleatoriamente em ensaio clínico duplo-cego controlado para avaliar a eficácia da formulação tópica com a própolis contra um placebo tópico no tratamento da otite externa. A preparação de própolis e placebo foi administrada em ambos os canais da orelha externa, duas vezes por dia, durante 14 dias. Ao longo do estudo, os cães foram submetidos a exame físico e à análise microbiológica de exsudatos auriculares. Os mais frequentes microrganismos isolados em meios de cultura foram: Malassezia pachydermatis (54,2 por cento), Staphylococcus aureus (43,8 por cento), Staphylococcus coagulase-negativo (25,0 por cento), Pseudomonas aeruginosa (20,8 por cento), Candida albicans (18,8 por cento), Proteus mirabilis (16,7 por cento), Streptococcus spp.(16,7 por cento), Enterococcus faecalis (12,5 por cento), Escherichia coli (12,5 por cento), Staphylococcus intermedius (6,3 por cento), Klebsiella spp.(4,2 por cento) e Candida glabrata (2,1 por cento). A preparação de própolis apresentou atividade antimicrobiana contra a maioria dos microrganismos isolados de amostras do grupo de tratamento, sendo que os do grupo-controle não se recuperaram da doença infecciosa auricular, e não foram observados efeitos adversos à própolis. Isso permitiu aos pacientes tratados com própolis melhora significativa dos parâmetros clínicos. Essa nova formulação da própolis argentina para o ouvido apresenta potencial utilidade no tratamento tópico da otite externa em cães.

Otitis externa micótica y perforación timpánica: reporte de dos casos / Otomycosis and perforated tympanic membrane: two cases

La otitis externa constituye entre el 5 por ciento y 30 por ciento de las consultas de urgencia ORL y afecta al 10 por ciento de la población al menos 1 vez en la vida. La gran mayoría son de causa bacteriana, sólo el 15 por ciento a 20 por ciento son atribuidas a hongos. Las complicaciones son poco frecuentes alcanzando el 10 por ciento a 20 por ciento de los casos según la serie, siendo la perforación timpánica la más frecuente. Se presenta la evolución y tratamiento de 2 casos.

External otitis constitutes among 5 percent-30 percent of urgency ORL consultations and affects 10 percent of the population at least 1 time in their life. Most of them had a bacterial origin, only 15 percent to 20 percent are attributed to fungi. Otomycosis complications are slightly frequent reaching 10 percent to 20 percent of the cases according to diferent series, being the tympanic perforation the most frequent. We present 2 cases, their evolution and treatment.

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.

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

Bacterial and fungal organisms in otitis externa patients without fungal infection risk factors in Erzurum, Turkey / Organismos bacterianos e fúngicos em pacientes com otite externa sem fatores de risco para infecção fúngica em Erzurum, Turquia

AIM: To describe the bacterial and fungal organisms in otitis externa patients without other risk factors for fungal infections. STUDY DESIGN: Cross sectional cohort descriptive study. MATERIALS AND METHODS: Ear swabs were obtained from 362 patients aged 1 to 55 years old with clinically diagnosed otitis externa in Erzurum, Turkey, between January 2006 and April 2007, and cultured for aerobic and anaerobic bacteria and fungi, using EMB, 5 percent sheep's blood, chocolate agar, anaerobic blood agar plate, thioglycollate broth and sabaroud agar using standard microbiological technique to diagnose isolates. RESULTS: 219 cultures were positive and a total of 267 isolates were obtained. Of the isolates, 68.16 percent (n: 182) were aerobic or facultative bacteria, 1.12 percent (3) were anaerobic bacteria, 30.71 percent (82) were fungi and 17.5 percent (38) were polymicrobial infections. CONCLUSION: Fungal organisms especially Candida species may be isolated from ears of otitis externa patients without fungal infection risk factors such as ear self-cleaning, local antimicrobial, antifungal or corticosteroid drops or systemic antimicrobial or antifungal agents within the preceding week. Bacterial and fungal cultures may be recommended, and anti-fungal agents may be added, to treatment regimens in patients with otitis externa.

OBJETIVO: Descrever fungos e bactérias presentes em pacientes com otite externa sem fator de risco para infecções fúngicas. FORMA DE ESTUDO: Estudo descritivo de coorte transversal. MATERIAIS E MÉTODOS: Amostras por raspagem de cotonetes (swabs) no ouvido foram obtidas de 362 pacientes com idades entre 1 e 55 anos, com diagnóstico clínico de otite externa em Erzurum, Turquia, entre janeiro de 2006 e abril de 2007. Essas amostras foram cultivadas em meio de cultura, 5 por cento de sangue de ovelha, ágar chocolate, ágar sangue anaeróbio, banho em tioglicolato e ágar Saboroud, usando técnicas padrão de microbiologia para identificar os isolados. RESULTADOS: Obtivemos 219 culturas positivas e 267 isolados. Dos isolados, 68,16 por cento (n: 182) eram bactérias aeróbias ou facultativas, 1,12 por cento (3) eram bactérias anaeróbias, 30,71 por cento (82) eram fungos e 17.5 por cento (38) eram germes polimicrobianos. CONCLUSÃO: Fungos, especialmente espécies de Candida podem ser encontradas em ouvidos de pacientes com otite externa sem fatores de risco para infecção fúngica tais como autolimpeza do ouvido, uso de antimicrobiano local, corticosteroides ou antifúngicos tópicos ou agentes antibacterianos e antifúngicos sistêmicos na semana anterior. Culturas de bactérias e fungos podem ser recomendadas, e agentes antifúngicos podem ser acrescentados a esquemas de tratamento de pacientes com otite externa.

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.

[Mycosic malignant external otitis due to aspergillus, about 2 cases]

Malignant external otitis is a severe uncommon infectious disease of the external auditory canal. Diabetes and immunodepression constitute the principal risk factors. The Pseudomonas aeruginosa is the most common germ. Since it is often a primary bacterial disease, initial mycosic infection is exceptional. However, Aspergillus can cause severe and dangerous forms. The authors reported two cases of mycosic malignant external otitis due to aspergillus. The pretherapeutic check-up included a computed tomography and technetium bone scintigraphy practiced in order to assess the extension. The diagnosis was confirmed by a mycological analysis of auricular sample. Hyperbaric oxygenation and medical treatment associating systemic antimycosic drugs, parenteral antibiotherapy were instituted for both patients. Death occured in one case, due to skull basis osteomyelitis. After 16 months of follow up, the second patient is still alive with no obvious complications

Identificação e susceptibilidade antimicrobiana de microrganismos obtidos de otite externa aguda / Identification and antimicrobial susceptibility of acute external otitis microorganisms

Otite externa aguda é a infecção do conduto auditivo externo, geralmente causada por flora polimicrobiana. OBJETIVO: Isolar, identificar e determinar a susceptibilidade antimicrobiana dos organismos causadores da otite externa (OE). MÉTODO: 27 swabs foram obtidos de 27 orelhas de pacientes portadores de OE para cultura e 22 microrganismos foram isolados para avaliação de susceptibilidade. A susceptibilidade in vitro foi obtida através do método de ágar difusão em disco e os resultados, interpretados de acordo com critérios clínico-laboratoriais padrão. RESULTADOS: 10 culturas positivas para S. aureus, 8 culturas para P.aeruginosa, 5 para P.aeruginosa e S.aureus e 4 para fungos (Candida albicans e C. krusei). Gentamicina e as quinolonas foram ativas contra todas as cepas testadas, havendo resistência significativa contra amoxicilina/clavulanato. As espécies de Candida testadas foram sensíveis à Anfotericina B, nistatina, fluconazol e clotrimazol e resistentes à miconazol. CONCLUSÃO: A otite externa aguda é uma infecção polimicrobiana, e o conhecimento apropriado da etiologia e susceptibilidade dos microrganismos irá contribuir para o uso racional de antibióticos e o sucesso do tratamento.

Acute external otitis is a polymicrobial infectious disease. AIM: The purpose of this study was to isolate, identify and determine the Antimicrobial susceptibility of organisms causing otitis externa (OE). METHODS: twenty-seven swabs were taken from the ears of 27 patients with OE for culture and 22 microorganisms were isolate to evaluate sensitivity. In vitro susceptibility tests were performed by agar diffusion disk and results were interpreted according to Clinical Laboratory Standards. RESULTS: 10 Ear cultures were positive for S. aureus , 8 for P. aeruginosa, 5 for P. aeruginosa and S. aureus and 4 for fungal organisms (Candida albicans e C. Krusei). Gentamicin and quinolones were active against all bacteria tested and significant resistance to amoxicillin/clavulanate was observed. The tested species of Candida had been sensitive to amphothericin B, nystatin, fluconazole and clotrimazole and resistant to miconazole. CONCLUSION: Acute external otitis is a polymicrobial infection and proper knowledge regarding microorganism etiology and susceptibility will contribute to rational antibiotic usage and treatment success.

Atividade antimicrobiana in vitro de produtos vegetais em otite externa aguda / In vitro antimicrobial activity of plants in Acute Otitis Externa

Otite externa aguda é a inflamação do conduto auditivo externo, e plantas medicinais podem ser utilizadas, na cultura popular, para seu tratamento. OBJETIVO: Avaliar atividade antimicrobiana in vitro de Aleolanthus suaveolens, Caryophyllus aromaticus, Cymbopogon citratus, Matricaria chamomila, Pithecellobium avaremotemo, Plectranthus amboinicus e Ruta graveolens sobre agentes etiológicos de otite externa. CASUÍSTICA E MÉTODOS: A concentração inibitória mínima de extratos e óleos destas plantas foi obtida em amostras de otite externa. RESULTADOS: Staphylococcus aureus em 10 culturas, Pseudomonas aeruginosa em 8, Pseudomonas aeruginosa e Staphylococcus aureus, em associação, em 5 culturas e Candida albicans e Candida krusei em 4 culturas. P. aeruginosa foi resistente a todos os extratos e óleos essenciais testados; os extratos de A. suaveolens, P. avaremotemo e de R. graveolens foram inativos, o óleo essencial de C. aromaticus e M. chamomila foram ativos contra 3 cepas de S. aureus e as cepas de Candida; Sete das cepas de S. aureus foram sensíveis ao extrato de P. amboinicus, mas o óleo não mostrou atividade, 4 cepas de S.aureus e as cepas de Candida foram sensíveis ao óleo essencial de R. graveolens. CONCLUSÃO: Algumas plantas apresentaram resultados satisfatórios, dependendo do agente etiológico, porém se faz necessário estudos mais detalhados, para melhorar o aproveitamento destas plantas.

Acute Otitis Externa is an inflammation of the outer auditory meatus, and according to popular saying, medicinal plant extracts can be used in its treatment. AIM: to assess the in vitro antimicrobial activity of the following plants: Aleolanthus suaveolens; Caryophyllus aromaticus; Cymbopogon citratus; Matricaria chamomila; Pithecellobium avaremotemo; Plectranthus amboinicus and Ruta graveolens on the germs that cause otitis externa. MATERIALS AND METHODS: the minimum inhibitory concentration of extracts and oils from these plants was obtained from otitis externa samples. RESULTS: Staphylococcus aureus in 10 cultures, Pseudomonas aeruginosa in 8, Pseudomonas aeruginosa and Staphylococcus aureus together in 5 cultures and Candida albicans and Candida krusei in 4 cultures. P. aeruginosa was resistant to all oils and extracts tested; extracts from A. suaveolens, P. avaremotemo and R. graveolens were inactive; the essential oil from C. aromaticus and M. chamomila were active against 3 strains of S. aureus and the Candida strains; seven of the S. aureus strains were sensitive to the P. amboinicus extract; however, the oil was inactive against 4 S. aureus strains and the Candida strains were sensitive to the R. graveolens essential oil. CONCLUSION: depending on the etiological agent, some plants presented satisfactory results, however we still need more detailed studies in order to better use these plants.

Microflora and antibiograms of discharging ears in a cross - section of population in Quetta, Balochistan

To study the micro flora and the antibiograms of patients with discharging ears due to Otitis externa / Otitis media in Quetta, Balochistan and to analyse and compare the results with other domestic and international studies. Prospective, descriptive study. Department of ENT, Combined Military Hospital, FC Hospital, Saleem Medical Complex and Mideast Hospital Quetta, from January 2003 to June 2005. The ear swabs of 1105 patients with otorrhoea were prospectively analyzed. Antibiotic testing was done using modified Kirby Bauer disc diffusion method. In addition to the usual antibiotics, the two most common topically available antibiotics [gentamicin and Ofloxacin] were also tested. There were 1057 positive cultures for organisms from the 1105 patients with 1125 isolates. The most common causal organisms isolated were staphylococcus aureus [40%] with 10.29% Methicillin resistant staphylococcus aureus [MRSA] positive followed by pseudomonas aeruginosa [38.4%]. Fungi accounted for 3.7% of isolates. Out of the two antibiotics commonly available as topical eardrops, Ofloxacin has a very high overall susceptibility rate [97.3%] to all organisms cultured. Staphylococcus aureus is the commonest organism, replacing pseudomonas aeruginosa in discharging ears. All the isolates cultured were highly sensitive to Ofloxacin / Ciprofloxacin. Thus apart from fungal infection of the ear Ofloxacin eardrops should be the mainstay of treatment

Necrotizing (malignant) otitis externa: an unusual localization of mucormycosis.

Malignant otitis externa (MOE) is a severe infection of external auditory canal and skull base. A 17-year-old diabetic girl was admitted with diabetic ketoacidosis. Cellulitis of her right ear occurred on the second day of hospitalization and a black necrotic scar in the same region appeared on the next day. The lesion rapidly invaded to right side of neck and surrounding tissue of the patient. Therefore, antimycotic therapy was started. Unfortunately the patient died on seventh day of hospitalization because of probably extensive fungal invasion. Physicians should suspect MOE connected to mucormycosis especially in patients with cutaneous lesions of ear unresponsive to antibiotic therapy.

Susceptibilidade a antimicrobianos de bactérias isoladas de otite externa em cães / Antimicrobial sensitivity of bacteria from otitis externa in dogs

The occurrence of canine externa otitis in Fortaleza-Ceará is reported. About 91.5 percent of the animals with clinical signs were positive to bacterial culture. Among all infections, 49.5 percent were mixed infections and the most common pathogens were Staphylococcus spp coagulase negative or positive and Pseudomonas aeruginosa. The most effective antimicrobials for Staphylococcus coagulase negative were: the quinolones, the aminoglicoside netilmycin and the beta-lactams, excepted ampicillin, penicillin and oxacilin; for Staphylococcus coagulase positive were: cefotoxin, amoxicillin + clavulanic acid, imipenem, netilmycin and cephatoxin; for Pseudomonas aeruginosa were: ciprofloxacin, tobramycin and imipenem.

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

Malassezia pachydermatis e outros agentes infecciosos nas otites externas e dermatites em cäes / Malassezia pachydermatis and other infectious agents in external otitis and dermatitis in dogs

Malassezia pachydermatis (Pityrosporum canis) faz parte da microbiota da pele e quando ocorrem alteraçöes no microambiente local como aumento da umidade, da temperatura e do substrato, determinando uma elevaçäo do número de células, ocorre a transiçäo da forma comensal para o parasitismo. O objetivo deste trabalho foi determinar a prevalência da infecçäo por M. pachydermatis e outros agentes infecciosos nas otites externas e dermatites de cäes. Foram analisadas 78 amostras de cäes com otite, 36 amostras de cäes com o conduto auditivo normal e 24 com dermatite. Todas as amostras foram submetidas ao exame direto, cultivo em ágar sangue e ágar Sabouraud dextrose, acrescido de cloranfenicol e cicloheximida. Ao exame direto, 50 porcento das amostras de otite e 16,6 porcento das amostras de dermatite apresentaram numerosas células semelhante a M. pachydermatis, enquanto 83,3 porcento das amostras de ouvidos saudáveis apresentaram ausência de células com esta morfologia. M. pachydermatis foi isolada em 25 porcento das amostras do conduto auditivo normal, em 80,7 porcento das amostras de otite e em 37,5 porcento das amostras de dermatite. Foram também isolados das amostras de otite Staphylococcus intermedius, S. aureus, S. epidermidis, Pseudomonas aeruginosa, Proteus sp, Actinomyces sp, Streptococcus sp e Otodectes cynotis e das de dermatite Staphylococcus intermedius, S. aureus, S. epidermis, Microsporum canis, M. gypseum, Trychophyton sp e Demodex canis. M. pachydermatis foi o agente com maior prevalência nas otites externas e dermatites, sendo um agente oportunista que causa otite e dermatite quando há uma alteraçäo do microambiente.

Malignant otitis externa

Malignant external otitis is a serious pseudomonas infection of the external ear which when untreated may extend towards the base of the skull. To find out the results of conservative treatment and compare it with previous studies. To diagnose this condition at its earlier stage to improve the prognosis. Design: Case study. Setting: ENT Department Punjab Medical College Hospital Faisalabad. Period: Mar 86 to March 1996. Subjects: Fifteen patients, 9 females, 6 males between the ages of 20-26 years, all diabetics presented during the period Mar 86 to Mar 1996. Diagnosis was based upon clinical findings and positive pseudomonas aeruginosa in culture of ear swab. Local debridement, cleansing local drops and systemic use of aminoglycoside with third generation cephalosporin in resistent case used for treatment. 9 Females and 6 Males all between 20-26 years of age presented with pain, discharge, edema, granulations and fever. All were confirmed diabetics and ear swab revealed pseudomonas aeruginosa. Local cleansing with local and systemic aminoglycoside was sufficient in 10 cases but in 5 cases Ceftazidime was also added. Antibiotics were continued 4 weeks after control of symptoms. 13 patients [86.6%] cured without any long term complications, 2 patients [13.3%] died due to MEO. Malignant otitis externa through a dangerous infection can be cured on conservative treatment if diagnosed early