Otomastoiditis por Scedosporium apiospermum. Alucinaciones como efecto adverso del voriconazol / Otomastoiditis due to Scedosporium apiospermum. Hallucinations as an adverse reaction to voriconazol

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Rare case of otomastoiditis due to Coxiella burnetii chronic infection.

Q fever is a zoonotic disease caused by Coxiella burnetii that usually presents with non-specific or benign constitutional symptoms. Diagnosis is often challenging and, after acute Q fever, 1%-5% of patients can develop chronic disease. We present an 80-year-old male patient who was admitted due to a 3 months history of fever, productive cough, myalgia, weight loss, headache and hearing loss. Chronic Q fever was confirmed by positive antiphase I immunoglobulin G. Frequent locations of chronic infection was discarded, and ear CT revealed a right mastoid infection. He was treated with doxycycline and hydroxychloroquine for 18 months with significant improvement. This is a rare case of chronic Q fever presenting with otomastoiditis that has never been described.

Otomastoiditis caused by Candida auris: Case report and literature review.

Fungal otomastoiditis is a rare disease, but can be fatal for immunocompromised patients. Recently, there have been increasing cases of otologic infection caused by Candida auris. Candida auris can be easily misdiagnosed for other species and treatment is difficult due to multidrug resistance. Clinician should be aware of this rare pathogen, and it should be treated with appropriate antifungal agent with surgical debridement.

Laser spectroscopy applied to environmental, ecological, food safety, and biomedical research.

Laser spectroscopy provides many possibilities for multi-disciplinary applications in environmental monitoring, in the ecological field, for food safety investigations, and in biomedicine. The paper gives several examples of the power of multi-disciplinary applications of laser spectroscopy as pursued in our research group. The studies utilize mostly similar and widely applicable spectroscopic approaches. Air pollution and vegetation monitoring by lidar techniques, as well as agricultural pest insect monitoring and classification by elastic scattering and fluorescence spectroscopy are described. Biomedical aspects include food safety applications and medical diagnostics of sinusitis and otitis, with strong connection to the abatement of antibiotics resistance development.

Virtual endoscopy of the nasopharynx in the evaluation of its normal anatomy and alterations due to lymphoid hyperplasia: preliminary report.

The purpose of this study was to evaluate the diagnostic usefulness of virtual endoscopy in establishing the anatomic appearance of nasopharynx, both normal and affected by lymphoid hyperplasia. Thirty-seven patients affected by chronic rhinosinusal and otomastoid pathology, all studied by rhinoscopy, were examined with multislice computed tomography (CT) and virtual endoscopy of the nasopharynx. Rhinoscopy showed a completely normal nasopharynx in 15 cases and a variable grade of lymphoid hypertrophy in 22 patients. A general agreement was observed between traditional and virtual endoscopy findings in both subgroups. The tasca of Luschka was detected in 13/15 of normal subjects and only in 3/22 patients. The Rosenmuller fossae appeared deeper in normal subjects and their symmetry could be considered an important criterion of normality. In all cases, a good evaluation of the tubaric ostium was obtained. Differentiation between hyperplasic lymphoid tissue and neoplasms is possible only in lymphoid hyperplasia characterized by median crest-like swelling with a narrow base. In most cases, differential diagnosis cannot be based only on morphological criteria of virtual endoscopy, but it should be evaluated considering the overall CT findings and clinical presentation.

[Contribution of magnetic resonance imaging in the evaluation of chronic otitis]. / Apport de l'imagerie par résonance magnétique dans le bilan des otites chroniques.

Thirty four patients with a chronic otitis were evaluated prospectively by magnetic resonance imaging (MRI) to delineate its contribution in the diagnosis of middle ear masses. The results were correlated to the CT and the surgical and pathological findings. MRI permitted to differentiate the inflammatory tissues from either cholesteatoma, cholesterol granuloma and cerebromeningeal hernia.

Conductive hearing loss with normal tympanic membrane: fibrous change of long process of the incus.

This is a case of conductive hearing loss with the normal tympanic membrane due to fibrosis caused by potential inflammation of the long process of the incus. High resolution CT was a useful tool for the detection of ossicular disorder.

[Intracranial complications of otitis: the present-day situation]. / Complicaciones intracraneales de las otitis: situación actual.

The increasing number of intracranial complications of otic origin seen by the AA. in the previous 6 years, prompted them to make a survey of the respective files. In all, 9 patients were included in the group, with ages ranging from 18 to 72 years. Everyone showed marginal tympanic perforations with cholesteatoma. At their first visit to the office neurologic symptoms were present (mean time from beginning was 12 days) as an aftermath of chronic otitis. Meningitis, brain (temporo-parietal, temporal) and cerebellar abscesses of the implicated side were the diagnosis. Decisive for diagnosis was the CAT examination, being much better than the NMR (done once). Cases were managed in cooperation with the neurosurgical team. The mean time of hospitalization was 1 month. Eight cases did well (2 with neurologic sequels); the follow-up of the ninth patient is unknown.

X-ray diffraction analysis of the auditory ossicles in chronic otitis.

An X-ray diffraction analysis was carried out on 10 healthy mallei and incudes which were taken from cadavers and on 50 diseased mallei and incudes taken peroperatively from patients with atticoantral otitis. X-ray powder diagrams of normal ossicles were shown as a granular hydroxyapatite. In diseased ossicles, changes were found in the crystallinity of hydroxyapatite which can be divided into four groups: (i) with characteristics of a diagram of normal bones giving peaks of maximum intensity of a granular hydroxyapatite; (ii) with less hydroxyapatite crystallinity; (iii) characterized by the occurrence of an amorphous phase of bone; (iv) characterized by the absence of all types of crystallization. The occurrence of different phases of crystalline hydroxyapatite in various forms of atticoantral otitis does not depend on the type of pathological process, i.e., with or without cholesteatoma.

[Current strategy for the radiological exploration of the ear]. / Stratégie actuelle de l'exploration radiologique de l'oreille.

CAT scan by thin slices offers the possibility of evaluation of the bone structures of the ear and their contents. The progressively increasing availability of the scanner should make access much more routine for study of the ear, with a concomitant reduction in tomographies, inadequate in a large number of circumstances. The 4 main indications are chronic otitis with cholesteatoma, trauma, acoustic neuromas and malformations. The respective performances of tomography and CAT scan in each of these situations are discussed and an investigation strategy is suggested.

Changing concepts in the management of otitic intracranial infection: use of computerized axial tomography in early detection and monitoring of cerebritis.

The pathogenesis and course of intracranial inflammatory disorders of otitic origin have been studied extensively in the past by clinical, surgical, and morbid means. The recent contribution by CT scanning cannot be overestimated as a modality for identification of the pathologic process. Its use for early detection and monitoring of a clinically suspected intracranial complication of otitic suppurative disease is documented for the first time in this report. Cerebritis or encephalitis as the early manifestation of impending brain dissolution can be identified and followed during specific antibiotic therapy. The proper timing for surgery to remove the otitic focus is enhanced. A review of the literature and a case report illustrate this contribution.

Sinogenic and otogenic brain abscesses--a review of 63 cases occurring at Toronto General Hospital, 1956-75.

Sixty-three cases of brain abscess resulting from ear and paranasal sinus infections were reviewed. These patients were seen at the Toronto General Hospital from 1956-1965 and from 1969-1975. Comparisons are made relating to site, age and sex incidence, mortality rates, bacteriology, and rate of associated meningitis. Modern diagnostic methods are reviewed with particular emphasis on the use of the C.T. scanner.