Febrile illness a major cause of profound childhood deafness in Nigeria.

A prospective study of 63 children with profound deafness seen personally at the E.N.T. Clinic, University of Nigeria Teaching Hospital, Enugu between January, 1984 and October, 1987 is the subject of this paper. There were 35 males and 28 females. Thirty-six (57.1%) were in the age group, 0-3 years, 17 (27%) in the age group 4-6 years, 7 (11.1%) in the age group 7-10, and 3 (4.8%) over 11 years. Febrile illness 41.3% was the most common cause followed by unknown with about 20.6%. The various causes were compared with causes from other parts of the world. The possible causes of the febrile illness with special emphasis on the role of viral infections and malaria are highlighted. Mention is made of possible preventive measures.

Anaerobes and fungi in chronic suppurative otitis media.

Microbiology of 102 ears with chronic suppurative otitis media was studied for aerobes, anaerobes, and fungi. Forty-four percent were pure cultures, 33.3% were mixed, and 18.6% had no growth. Seventy-four percent were aerobes, 25% fungi, and only 0.9% anaerobes. Pseudomonas aeruginosa (22.5%) was the most common isolate, followed by Staphylococcus aureus and the Aspergillus species. The possible reasons for low yield of anaerobes and the pathogenic roles of anaerobes and fungi in chronic suppurative otitis media are discussed. It is advocated that in investigating pathogenic organisms in chronic suppurative otitis media, requests should include anaerobes and fungi.

Diagnostic problems of tuberculous cervical adenitis (scrofula).

PURPOSE: This study was designed to review the diagnostic procedure for tuberculous cervical adenitis and propose a simple protocol for the work-up of patients with suspected tuberculous cervical adenitis. Moreover, it served to increase physician awareness of tuberculosis as possible cause of cervical mass. PATIENTS AND METHODS: We performed a retrospective study of 57 patients with tuberculous cervical adenitis who were treated at North West Armed Forces Hospital, Tabuk, Saudi Arabia between March 1989 and April 1993. The results of diagnostic procedures, chest x-ray, tuberculin test, fine-needle aspiration, microbiology culture, and histopathology were reviewed. RESULTS: Forteen percent showed changes in chest x-ray, 92% had positive tuberculin test, and 50% of the culture material grew Mycobacterium tuberculosis. All specimens for histopathology were suggestive of tuberculosis. CONCLUSION: A thorough history and physical examination, tuberculin test, and fine-needle aspiration will help arrive at an early diagnosis of tuberculous cervical adenitis and allow early commencement of treatment before final diagnosis can be made by incisional biopsy and culture. Tuberculosis should be included in the differential diagnosis of neck mass.

Immediate skin sensitivity test reactivity in Nigerians with allergic rhinitis.

A report of skin tests on 62 patients with allergic rhinitis is presented. Detailed allergy history was obtained using Bencard case history chart. Skin test using Bencard skin testing kit was done on each patient. Results showed house dust was most common agent with 74.19% and house dust mite next with 70.38%. Most of the patients fall within the age group 21-30 years. The need to obtain extracts for the skin test locally is stressed as that will make the result more meaningful.

Subperiosteal mastoid abscesses in chronic suppurative otitis media.

In Europe and America, acute mastoiditis usually appears as a complication of acute otitis media, and some patients develop subperiosteal mastoid abscesses. In Nigeria, however, most subperiosteal mastoid abscesses develop from chronic otitis media with cholesteatoma. Of the 16 patients with subperiosteal mastoid abscesses discussed, 11 (69%) had cholesteatoma and only five (31%) had granulation tissue in the mastoid cavity. The ideal treatment for these cases is modified radical mastoidectomy. Radiographic investigation of the mastoid can be useful in the diagnosis of cholesteatoma in the presence of a subperiosteal mastoid abscess.

Verrucous carcinoma of the larynx: problems of diagnosis and treatment.

The first report of a case of verrucous carcinoma from Africa is presented. Problems of diagnosis and treatment are highlighted and the need for co-operation between the clinician and the pathologist for an accurate diagnosis is emphasized.

Pathogenic organisms in chronic suppurative otitis media in Enugu, Nigeria.

Pathogenic organisms in chronic suppurative otitis media from 62 patients were identified. Pseudomonas aeruginosa was responsible in 46%, Staphylococcus aureus in 29%. Proteus mirabilis in 13%, Streptococcus pyogenes in 6%, Aspergillus niger in 5% and Mucor sp. in 2%. The most prevalent organism in children was Staphylococcus aureus. The role of fungi in chronic suppurative otitis media is discussed.