Mycoplasma Hominis: A Rare Case of Acute Otitis Media and Facial Nerve Paralysis.

Facial paralysis secondary to acute otitis media (AOM) is rare in the post-antibiotic era.1,2 In immunosuppressed patients, atypical bacteria are more commonly encountered as the cause. Mycoplasma hominis, normally found in the genitourinary tract, uncommonly causes extragenital infection.3 We report a case of AOM secondary to M. hominis, complicated by facial paralysis in an immunosuppressed patient. A 24-year-old male with multiple sclerosis, on rituximab, presented to the emergency department with otalgia and facial paralysis. He was diagnosed with Bell's palsy and subsequently referred to the otolaryngology service. Examination revealed right facial paralysis and purulent otorrhea. Computed tomography (CT) of the temporal bone showed right tympanic and mastoid opacification. The patient was admitted and started on IV ampicillin/sulbactam, IV dexamethasone, and ciprofloxacin/dexamethasone otic drops. Debridement and examination under anesthesia revealed a right tympanic membrane perforation and granulation tissue. Biopsy and cultures were obtained. Final cultures were positive for Mycoplasma hominis. Facial paralysis is an uncommon complication of AOM but typically resolves once appropriate antibiotic therapy is regimented. Because Mycoplasma can be missed on routine culture, clinicians should consider workup for atypical organisms in settings of immunosuppression so appropriate antibiotic therapy can be initiated.

Acute Calcific Tendinitis of the Longus Colli: Not All Retropharyngeal Fluid is an Abscess.

OBJECTIVE: This report aimed to present a case of acute calcific tendinitis of the longus colli muscle as an uncommon cause of neck pain and dysphagia and is often misdiagnosed as a retropharyngeal abscess. METHODS: Case report and literature review. RESULTS: Acute calcific tendinitis is often misdiagnosed as a retropharyngeal abscess; however, it is distinguished from the latter based on patient history and unique radiologic findings. History, examination, and laboratory findings do not suggest an infectious etiology, and radiographic findings include a non-rim-enhancing fluid collection with or without calcifications anterior to the upper cervical spine. CONCLUSION: Unlike retropharyngeal abscess, acute calcific tendinitis is managed conservatively. When consulted for a possible retropharyngeal abscess, the otolaryngologist should avoid anchoring bias by independently obtaining a detailed history and examination and personally reviewing radiologic images to avoid unnecessary intervention.

Improving protection from bioaerosol exposure during postoperative patient interaction in the COVID-19 era, a quality improvement study.

PURPOSE: During patient transport from operating room to post-operative recovery area, anesthesia staff are at increased risk of particle aerosolization from patients despite wearing face shields. Current single-use face shields do not provide anesthesia staff from adequate protection from bioaerosolized particles expired during a patient's cough, particularly during transfer from the operating room to the post-anesthesia recovery unit. In this study, we compare the efficacy of single-use face shield currently available at our institution to a newly designed face shield that provides better protection while still maintaining cost-effectiveness and the ease-of-use of a disposable device. MATERIALS AND METHODS: A patient actor, simulated movements from a patient post-procedure, during transport from operating room to postoperative recovery area. Patterns of exposure of bioaerosolized particles produced from a cough between different face shields was evaluated using fluorescein dye. MAIN RESULTS: More extensive coverage of the lower face, as provided by the Enhanced Protection Face Shield, offers improved droplet protection from bioaerosolized particles emitted from a cough. CONCLUSIONS: Transfer from the operating room to the post-operative recovery unit is a hands-on process and involves managing multiple aspects of patient care physically. Current single-use face shields are convenient and cost-effective, but do not provide adequate protection from droplet aerosolization by patients during transfer. Other masks that provide adequate coverage are costly and are not designed to be single-use. A single-use disposable face shield that offers improved coverage of the lower face provides improved protection for anesthesia staff while maintaining cost-effectiveness, ease-of-use, and infection control.