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Biomedical subjects

P Marsella

Publications and source records attributed to P Marsella.

12 recordsLinked to original sources

[Otomastoiditis caused by Mycobacterium avium: a case report].

Non tuberculous Mycobacterial (NTM) Infections mainly affect immunocompromised patients, appearing as disseminated or pulmonary disease. In immunocompetent children the most common form of infection with NTM is cervical adenitis. Ear infection seems to be a rare disease. We present a case of otomastoiditis caused by Mycobacterium avium in a 15 months old child, immunologically normal. Patient was referred for persistent right otitis unresponsive to routine medical therapy. TC scan of the ear and temporal bones revealed: soft tissue in external auditory canal, Eustachian canal, and middle ear overlying ossicles with erosion of tegmen tympani. Tuberculin skin test was positive with 5 units PPD and culture yielded M. avium. The patient undergo timpanomastoidectomy and medical therapy with antituberculous drugs and Steroids, subsequently he was given Clarithromycin and Rifabutin. M. avium is an ubiquitous low grade pathogen found in soil, water, dust and food. There is no evidence of direct transmission. Only a few cases of otomastoiditis due to M. avium have previously been reported. The case presented underlines the importance of microbiological investigations. When a NTM infection is suspected surgeons and infectious diseases specialists should cooperate to find an optimal treatment regimen of this unusual disease.

English Abstract↗

Cervical chordoma in childhood: clinical statistical contribution.

Parapharyngeal neoplasias are rarely noticed in childhood, since they have their peak incidence between the 2nd and 4th decade of life. The authors report a case of a 4-year-old patient presenting with a retrostyloid mass, accompanied by nasal obstruction and some difficulty in swallowing at 12 months of age. CT scanning well ascertained the delimitation of the tumor, but it was of no help in the differential diagnosis. In fact, after surgical excision, the histological examination of the specimen revealed a chordoma. This result was unexpected because of the region concerned and the lack of a CT demonstration of the cervical boney involvement. A cervical vertebral localization of a chordoma is rare in all age groups and it is of particular clinical and statistical interest in infancy.

Child, Preschool↗

The pathogenesis of chronic recurrent parotitis in infants: a study of 93 cases including an analysis of the vascular and glandular changes before and after parasympathectomy.

Ninety-three cases of infantile chronic recurrent parotitis are recorded. Fifty-three cases were treated with parasympathectomy which was carried out at 2 levels. Good results were achieved in 79.1% of patients. The paper describes the use of the Doppler examination to study the effects of operation on the physiology of the parotid.

Child↗

Unilateral sensorineural hearing loss in children.

The authors present a report of 280 cases of unilateral sensorineural hearing loss (U.H.L.) in children, observed from 1979 to 1986 in the Bambino Gesu' Hospital in Rome. Only 23.2% of these hearing impairments were due to a known etiology (mainly mumps infection). In the majority of the cases (79.3%) the hearing loss was profound. The authors discuss the methods for the etiological diagnosis and the possibility of prophylaxis both of U.H.L. and of communication difficulties.

Child↗

Dysontogenetic neoplasms of the thyroid gland in infancy: two case reports.

Two rare cases of benign dysontogenetic neoplasms of the thyroid gland in pediatric age are presented, which were observed at the E.N.T. department of the Bambino Gesù Hospital of Rome, and successfully operated. The first case turned out to be a dysembryoma, classified as monodermic because of its origin from derivatives of only one germinal layer, the entoderm. The second case, a teratoma, presented a high seric concentration of AFP as the consequence of the synthetic activity of the share of embryonal epatic tissue present in the neoformation. Criteria to distinguish thyroid from cervical teratomata and to classify the different types of dysontogenetic neoplasms are discussed. The usual clinical and pathological manifestations of teratomas of the neck in infancy are mentioned. The necessity of a prompt surgical removal and of pre- and postoperative thyroid function studies is mentioned.

Child↗

Sudden deafness in children.

The authors present a report of 38 cases of sudden deafness (SD), observed in the Bambino Gesù Hospital in Rome. Twenty-six cases were due to infective causes, such as mumps, meningitis, measles, varicella or to physical trauma. The other 12 cases were defined as idiopathic (ISD) on the basis of their anamnestic and clinical findings. The etiological, prognostic and therapeutic aspects are discussed.

Child↗

[Monostotic fibrous dysplasia of the temporal bone: description of a case and review of the literature].

Only a few cases of fibrous dysplasia of the temporal bone (monostotic form) have been described in the literature. The recent observation of a 15-year-old child presenting this pathology led the authors to review the literature available and to analyze the most common aspects of this disease. The clinical and radiological aspects, the differential diagnosis, histopathological features and therapeutical approaches are discussed.

Adolescent↗

[A rare case of endotympanic hemangioma].

Hemangiomas affectioning the external ear canal or the tympanic membrane have rarely been described. Only a very few cases are reported in world literature conarn these vascular tumors involving the middle ear space. The Authors report a rare case of a right endotympanic hemangioma associated with ossicular dysmorphism, resulting in conductive unilateral hearing loss, in a 9 year-old girl with cutaneous hemangiomas of the face. The Authors review Literature and discuss the possible pathogenetic implications of the intraoperatory findings.

Child↗

[Bronchoalveolar lavage (BAL) in the diagnosis of pulmonary infections in immunocompromised children].

The authors report their personal case records of broncho-alveolar lavage in immuno-compromised children. 22 children were observed from 1991 to 1992 at the E.N.T. Department of the Bambino Gesù Hospital, National Research Institute, in Rome. Flexible bronchoscopy is used under both local and general anesthesia without muscle relaxants. The epithelial lining fluid collection is greater than that obtained when muscle relaxation is used. For each patient 3 specimens are collected: for virological, bacteriological, mycological and immunological analysis. In 90% of the cases a correct etiological diagnosis of the pulmonary disease was possible. In 14 cases the diagnosis was possible even after a week from the beginning of the antibiotic therapy.

AIDS-Related Opportunistic Infections↗