[Necrotizing otitis externa: report of 36 cases]. / L'otite externe necrosante progressive: a propos de 36 cas.

BACKGROUND: Necrotizing otitis externa is a potentially lethal form of otitis externa which occurs mainly in elderly diabetic. AIM: To study the clinical, diagnostic and therapeutic aspects of necrotizing otitis externa and to describe the outcomes of this disease. METHODS: We report in this retrospective study, a series of 36 patients treated in our department for necrotizing otitis externa over a period of 9 years. RESULTS: Our series consisted of 34 diabetics. The average age of our patients was 62 years. The diagnosis was based on clinical, biological and bacteriological data and on imaging findings. A medical treatment based on a systemic antibiotic therapy combining a third generation cephalosporin to a fluoroquinolone was prescribed in 24 cases and to an aminoglycoside in 12 cases. In addition, a local treatment was performed daily and included meticulous cleaning of the external auditory canal and topical application of antimicrobial agents. Surgical debridement of infected soft tissues and bone sequestra was indicated in 8 cases because of the lack of improvement with medical treatment. Only one patient underwent hyperbaric oxygen therapy. The cure rate was estimated at 86%. Only one death was noted. CONCLUSION: Necrotizing otitis externa is a severe infection. Its prognosis has improved markedly since the advent of antibiotics effective on Pseudomonas aeruginosa. Its management must be started without delay and its treatment must be prolonged.

[Cervical-facial skin tuberculosis. Three case reports]. / La tuberculose cutanée cervico-faciale. A propos de trois cas.

The cervical-face skin tuberculosis is fairly uncommon pathology, it is caused by the Tuberculosis mycobacterium (or Bacille de Koch). With human or bovine origin this pathology is actually increased as like as AIDS in countries where it was eradicated. Skin lesion may be primitive or secondary to another pre-existing tuberculosis lesions, it may be have many clinical appearance with the same characteristics, as knew as, long evolution and anesthetics sequels. We report in this paper three cases of cervical-face tuberculosis with different age, the diagnosis was given by biology and histology and treated medically.