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PubMed1999

[Pasteurella spp: a new microorganism to the cause of acute suppurative thyroiditis].

Acute suppurative thyroiditis is an uncommon disease due to local resistance of the gland to infection. Preexisting gland pathology and local anatomic abnormalities are predisposing factors. We present the first case described in the medical literature caused by Pasteurella spp after upper respiratory infection with insidious manifestations resembling subacute thyroiditis. The course was benign after surgical drainage.

Acute Disease↗
PubMed2000

Comparison of ofloxacin otic solution with oral amoxycillin plus chloramphenicol ear drop in treatment of chronic suppurative otitis media with acute exacerbation.

The efficacy and safety of 0.3 per cent Ofloxacin otic solution (OFLX) 6 drops twice daily was compared with those of oral Amoxycillin 500 mg three times daily plus 1 per cent Chloramphenicol ear drop at 3 drops three times daily (AMOX + CRP) in a two-week treatment of chronic suppurative otitis media (CSOM) with acute exacerbation. 80 adult patients were enrolled in a prospective, randomized, investigator-blind study at the outpatient ENT service of Chulalongkorn University Hospital. The most common pathogens isolated at the pretreatment visit were Staphylococcus aureus (30.3%) and Pseudomonas aeruginosa (24.7%). The susceptibility of all the pathogenic isolates to ofloxacin, amoxycillin and chloramphenicol were 96.4, 57.1 and 51.8 per cent respectively. The overall response expressed as an improvement or cure of otalgia, otorrhea and middle ear mucosal inflammation was recorded. It revealed that the improvement rate of the OFLX-treated patients was better than that of AMOX + CRP-treated, but was not statistically significant. However, the cure rate was significantly better in OFLX-treated than in AMOX + CRP-treated groups in terms of painless (p = 0.05) and dry (p < 0.001) ears. Ototoxicity was assessed by an elevation in bone conduction threshold (BC) and/or speech reception threshold (SRT) of greater than 5 dB or a presence of high tone hearing loss resulting from treatments. A significant decrease in BC and SRT was revealed in OFLX-treated ears (p < 0.0001; p = 0.002 respectively) but a significant elevation of BC was found in AMOX + CRP-treated ears (p = 0.007). The ototoxic rate was significantly higher in AMOX + CRP-treated than in OFLX-treated ears whether assessed by BC (p < 0.001) or SRT (p = 0.03). In conclusion, OFLX was more effective and safer than AMOX + CRP in the treatment of CSOM with acute exacerbation.

Administration, Oral↗
PubMed1999

Suppurative granulomatous eosinophilic panniculitis: case report.

A case of 12 year-old Nigerian male is presented. He had an unusual variant of Weber-Christian disease and manifested massive subcutaneous indurations and nodules limited to the cheeks, lips, left pectoral, infraclavicular and supraclavicular areas. A wedge biopsy revealed suppurative granulomatous eosinophilic panniculitis. Despite exhaustive investigations, no obvious trigger of the panniculitis could be identified. Response to corticosteroids and to empirical trials with other drugs was poor, and the outcome was fatal. We believe this is the first report from Nigeria of this rare variant of Weber-Christian panniculitis in the paediatric age, and draw attention to the life-threatening nature of this disorder.

Anti-Inflammatory Agents↗
PubMed2000

Clinicomicrobiologic evaluation of active tubotympanic type chronic suppurative otitis media.

OBJECTIVES: This prospective study was conducted to determine the spectrum of micro-organisms encountered in patients with active-stage chronic suppurative otitis media (CSOM) (tubotympanic type) and to see whether prescribing an antibiotic after culture sensitivity was more beneficial as compared to initial treatment without cultures. DESIGN: Prospective randomized study of 110 patients of active CSOM (tubotympanic type) divided into two groups of 55 cases each. SETTING: Departments of Ear, Nose and Throat and Microbiology of a tertiary care hospital. METHODS: The patients in group A were prescribed an antibiotic according to the culture and sensitivity, whereas in group B, culture was not done at the first visit, and a broad-spectrum antimicrobial, namely, co-trimoxazole, was prescribed blindly for a maximum period of 2 weeks. The cases that still had ear discharge were then subjected to culture and sensitivity and the antibiotic was prescribed accordingly. MAIN OUTCOME MEASURES: All patients in group A were subjected to bacterial culture and sensitivity and fungal culture. Only failed cases in group B were subjected to the same. RESULTS: In group A, 47 patients (85.50%) had positive bacterial culture and 20 patients had positive fungal culture. Pseudomonas aeruginosa was the most common bacterial isolate. All of these 47 patients had a dry ear with a maximum 2 weeks of antibiotic therapy. Among the remaining 8 patients who had negative bacterial culture, 5 patients (9.0%) showed fungal isolates on culture and responded to topical antifungal treatment. The remaining 3 failed cases (5.5%) responded to daily dry mopping alone. In group B, 41 patients (74.54%) attained a dry ear. Bacterial culture and sensitivity were done in the remaining 14 (25.46%) failed cases. The culture was positive in 11 patients (20.0%) and sterile in 3 patients (5.5%). In the latter group, only 1 patient had fungus on culture and the remaining 2 patients responded to daily dry mopping alone, which was done at a maximum for a week only. The most common fungal pathogen isolated was Aspergillus flavus. CONCLUSIONS: Pseudomonas aeruginosa was the most common bacteria and Aspergillus flavus the most common fungus isolated in this study. In group A patients, the failed cases were less as compared to the control group B, but the p value was .2. Hence, there is no definite role of culture and sensitivity in the initial management plan of all cases of CSOM. Ideally, every such case should be prescribed a broad-spectrum antibiotic and only in failed cases should culture and sensitivity be done.

Adolescent↗
PubMed2000

[Removable draining aponeurotic and muscular-aponeurotic sutures in the prevention of suppuration of laparotomy wounds].

Clinico-instrumental investigations and experimental studying of the regeneration of laparotomy wounds sutured by removable draining aponeurotic and muscular-aponeurotic sutures have shown less pronounced course of aseptic inflammation in the wounds. It has been established that the removable aponeurotic sutures substantially decrease the frequency of postoperative suppurations of laparotomy wounds in patients operated on the colon mainly for colorectal carcinoma. The original authors' sutures provide the formation of a cicatrix of the laparotomy wound by the 20th day of the postoperative period and completely prevent the appearance of ligature fistulas.

Aged↗
PubMedDate not supplied

[Chronic suppurative otitis media. Experience with 140 cases at the Hotel-Dieu of France].

OBJECTIVES: Chronic suppurative otitis media (CSOM) is a common disease especially in developing countries. In Lebanon, CSOM is a frequent complaint. This retrospective study is an objective evaluation of the cases we operated in HDF. METHODS: One hundred and forty cases of CSOM were collected between 1993 and 1997: 88/140 cases were simple CSOM and the others 52/140 cases had cholesteatomas. RESULTS: There were no immediate postoperative complications reported (< 6 weeks). Beyond 6 weeks, with a mean follow-up of 20 months, 15% of the patients were lost for follow-up and we had 93.4% of success rate in CSOM and 88% in cholesteatomas. The recurrence rate of cholesteatoma was 14%. Children's cholesteatoma (below 15 years of age) were more aggressive than adult's cholesteatomas. In CSOM without cholesteatoma, the hearing gain was 5 dB. In CSOM with cholesteatoma the mean hearing gain was 4 dB. In conclusion the study revealed the importance of this pathology in our country with the relative high incidence of cholesteatoma compared to simple CSOM, this could be explained by the chronicity of the disease and the lack of preventive measures.

Adolescent↗
PubMed2001

Treatment of chronic suppurative otitis media with Broncasma Berna.

Broncasma Berna, an inactivated bacterial vaccine, has been safely used throughout the world for 30 years for the prevention or treatment of various infectious processes. Until now, there has been no published report regarding its use as a treatment for chronic suppurative otitis media. In this small study, five such patients (median age: 57 years) underwent a series of seven 0.05-ml injections of Broncasma Berna. In all cases, their otorrhea diminished markedly and their tympanic membranes were almost completely dry. The cost of treatment was extremely low.

Bacterial Vaccines↗
PubMed2002

Microbiology of chronic suppurative otitis media in Singapore.

The objective of the study was to study the microflora and the antibiograms of patients with chronic suppurative otitis media (CSOM) in Singapore. Ninety patients with CSOM were prospectively studied. They had chronic ear discharge and had not received antibiotics for the previous five days. Swabs were taken, and cultured for bacteria. Antibiotic testing was done using modified Kirby Bauer disk diffusion method. In addition to the usual antibiotics, the three most common topically available antibiotics (chloramphenicol, gentamicin and neomycin) were tested. There were 135 positive cultures for organisms from the 90 patients. The most common causal organisms isolated were Pseudomonas aeruginosa (33.3%) and Staphylococcus aureus (33.3%) followed by coagulase negative Staphylococcus (21.1%). Fungi accounted for 8.8% of isolates while 6.6% were anaerobes. Of the three antibiotics commonly available as topical eardrops, gentamicin has the highest susceptibility rate (82.6%), followed by neomycin (67.8%) and chloramphenicol (62.8%).

Adolescent↗
PubMed2000

[Observation of cell ultrastructuse in suppurative otitis media treated with bosneol and application].

OBJECTIVE: To explore the pharmacological action and optimal concentration of borneol in treating suppurative otitis media. METHOD: Aspergillus niger separated from the secretion in external auditory canal of the patient and the fungus strains kept in the laboratory were used to determine the minimum fungus inhibiting concentration (MIC) and minimum fungus killing concentration (MFC) of borne. The change of cell ultrastructure after borneol taking effect was observed under electron microscope. RESULT: Borneol MIC and MFC turned out to be 5% and 10% respectively. The cell wall of Aspergillus niger became thicker and blurred with vacuoles. In the cytoplasm various materials were found deep dyed and agglutinated with many fat drops. The electron density increased and the ridge arrangement was in disorder. Some organelles were destroyed, and many areas of electron blank appeared. Some cells became warped and deformed and lost their original structure. CONCLUSION: Borneol can destroy the structure of fungus cells, make fungus dissolve and dieout and thus features a fungus inhibiting and killing function. The optimal inhibiting concentration is 5% and killing concentration 10%.

Antifungal Agents↗
PubMed1999

[The selection of tympanoplastic type in treating chronic suppurative otitis media].

OBJECTIVE: To investigate the effect of different type of tympanoplasty on chronic suppurative otitis media (CSOM). METHOD: Myringoplasty, focuses clearance and myringoplasty, focuses clearance and ossiculoplasty and myringoplasty were performed in 189 cases of CSOM. RESULT: The cure rate of perforation of tympanic membrane with myringoplasty was above 99% accompanied by the varying improvement in acoustic sensibility. CONCLUSION: Different types of tympanoplasty should be used according to the CSOM. The slighter the pathological changes of CSOM, the more the hearing improve. The better effects was in tympanoplasty of simple type. The tympanic exploration is necessary to be included in tympanoplasty.

Adolescent↗
PubMed2000

[HSP70 expression of middle ear mucosa in acute suppurative otitis media].

OBJECTIVE: To study HSP70 expression of middle ear mucosa in acute suppurative otitis media. METHOD: An animal model of acute middle ear infection was established by inoculating Klebsiella Pneumoniae into middle ear of guinea pigs. Animals were sacrificed 1, 3, 5 and 7 days after inoculation. The expression of Hsp70 epitope related proteins in middle ear mucosa were analysed by modified western blot test. RESULT: Very light 70 kD bands were recognized by anti Hsp70 monoclonal antibody in the unstressed group. However, middle ear mucosa of the stressed group not only showed relatively strong 70 kD bands, but also expressed more intensely 31 kD and 17 kD bands. The infected mucosa expressed one 70 kD band at 1st day, the strongest band at 3rd day, falling at 5th day; 31 kD was recognized two bands at 3rd day, the strongest bands at 5th day, falling at 7th day; two bands of 17 kD were detected in all days, with the strongest bands at 7th day. CONCLUSION: The results suggested that middle ear mucosa expressed Hsp70 and Hsp70 epitope related proteins like 31 kD and 17 kD in acute otitis media.

Animals↗
PubMed2001

[Two terms tympanoplasty in chronic suppurative otitis media].

OBJECTIVE: To explore the clinical manifestations and therapeutic effects of treating chronic suppurative otitis media with two terms tympanoplasty. METHOD: 36 patients were retrospectively analyzed. The criterions of success are air room in middle ear, intact eardrum and decrease of A-B gape in audiometry. RESULT: 32 cases of all patients got successful effects, 4 cases failed. The main cause of failure is to fail forming air room in middle ear. CONCLUSION: The two term's tympanoplasty can save the residual hearing in most patient. But it is difficult to get successful result if more mucous membrane in the middle ear disappeared.

Adolescent↗
PubMed2001

[Labyrinthine fistula caused by chronic suppurative otitis media].

OBJECTIVE: To study the clinical feature and surgical management of labyrinthine fistula caused by chronic suppurative otitis media (CSOM). METHOD: A retrospective study of 450 patients with CSOM who underwent radical mastoidectomy between the years 1992 to 1999 in Department of Otolaryngology, Xijing Hospital was conducted. RESULT: 20 patients (4.4%) with labyrinthine fistula caused by CSOM were found. The average history of ear drainage was 22 years, 18 patients (90%) had subjective hearing loss, and 13 patients (65%) had dizziness. The fistula test was positive in 9 patients (45%). 2 patients had anacusis in the affected ear. The preoperative pure tone average for bone conduction thresholds was less than 30 dB in 11 patients, between 31 and 50dB in 3 patients, and more than 51 dB in 4 patients. The ears with a positive fistula test had worse preoperative hearing than those with negative test (P < 0.01). The fistula was detected by CT in 2 of 9 patients. Cholesteatoma was present in 18 patients (90%) and granulation tissue was present in 2 patients (10%). The lateral semicircular canal was the site of labyrinthine fistula. The lesion at the site of fistula was completely removed in 17 patients and exteriorized in the remaining 3. CONCLUSION: There are no reliable methods at present for preoperative diagnosis of labyrinthine fistula, ultimately, the most reliable way to identify a fistula is during surgery. The method of manipulation of labyrinthine fistula is based on the concrete conditions of fistula and patient.

Adult↗
PubMed2003

[Endoscopic nasobiliary drainage for acute obstructive suppurative cholangitis with multiple organ failure: report of 25 cases].

OBJECTIVE: To explore the treatment of acute obstructive suppurative cholangitis (AOSC) with multiple organ failure (MOF). METHODS: Twenty-five patients with AOSC complicated by MOF underwent non-surgical comprehensive therapies, including endoscopic naso biliary drainage (ENBD), flushing and antibiotic perfusion through the naso biliary catheter. The alterations of the levels of serum total bilirubin and common bile duct diameter were measured both preoperatively and postoperatively, with retrospective analysis of the patients' clinical record. RESULTS: Of all the 25 patients, 23 underwent endoscopic retrograde cholangiopancreatography (ERCP) with successful placement of the nasobiliary catheters and bile drainage, and MOF was corrected. The cure rate of the this group of patients was 92.0%, with two cases being transferred for emergency surgical treatment. CONCLUSION: Comprehensive treatment consisting of ENBD, flushing and antibiotic perfusion through the naso biliary catheter and intravenous use of antibiotics is effective and safe for the treatment of AOSC complicated by MOF.

Acute Disease↗
PubMed1992

[Several components of plasma hemostasis in patients with suppurative processes in the abdominal cavity].

Blood and urine concentrations of antithrombin-III, plasminogen, alpha 2-macroglobulin, alpha 1-antitrypsin, degradation products of fibrinogen-fibrin were studied in patients with abdominal suppuration. Noticeable deviations from the normal values especially marked in the severe process indicated the development of DIC syndrome and renal failure. Heavy combined treatment promoted normalization of the hemostasis shifts and eliminated pyo-inflammatory processes in the abdominal cavity.

Abdomen↗
PubMed1992

The bacteriology of chronic suppurative otitis media.

Specimens obtained directly from the middle ear under direct vision from 40 patients with chronic suppurative otitis media (CSOM) were investigated quantitatively and qualitatively for aerobes and anaerobes. Twenty one of the 40 specimens yielded aerobes only, 17 yielded a mixed flora of anaerobes and aerobes while only one yielded anaerobes only and the remaining one was sterile. Bacteroides fragilis was the commonest anaerobe and the second single most common bacteria generally present in CSOM. Pseudomonas aeruginosa and Staphylococcus aureus were the dominant aerobic flora appearing in 17 and 14 out of 40 specimens respectively. All pathogens isolated were present in very high counts averaging 10(8) ml of the exudate. The use of systemic anti-anaerobic drug combined with an anti-aerobic drug is worthy of a clinical trial.

Adolescent↗
PubMed2003

Bacteriology of chronic suppurative otitis media in congolese children.

AIM: The study intended to identify bacteria active in the chronic suppurative otitis media and to determine their sensitivity to current antibiotics. METHODS: After clinical evaluation, middle-ear secretions were taken for bacteriological examination from 78 children meeting the inclusion criteria. All children with cholesteatoma and those with tumors occluding the ear canal were excluded. RESULTS: The most frequent isolated germs, in descending order frequency, were as follows: Proteus mirabilis (23%), Pseudomonas aeruginosa (22%), Citrobacter (20%) and Salmonella (5%). There were no cases of mixed flora. Ofloxacin was susceptible on all isolates. Neomycin, gentamicin and polymyxin B were susceptible on 96%, 83% and 67% of the isolates respectively. All isolates were resistant to amoxycillin. CONCLUSION: Peudomonas, Proteus and Citrobacter are the most common causes of chronic otitis media among children in our community of congolese children. Ofloxacin and neomycin are the most highly effective against most of the isolated germs, and are therefore recommended as the first line local treatment. Amoxycillin and chloramphenicol should be avoided.

Adolescent↗
PubMed2003

[Suppurative coxitis after a viper bite--case report].

A 46-year-old woman having sustained a rhinoceros viper bite to the left lower leg is presented. She was treated at Department of Infectious Diseases, Split University Hospital. After 20 days she left the hospital in good condition, with a small crust at the bite site. About ten days later suppurative secretion developed at the bite site and a few days later she felt pain in her right hip and leg, and turned febrile. She was treated at home with antibiotics and analgetics for nearly one month. Her condition was worsening, and she was referred to Department of Neurosurgery, for suspected lumboischialgia. Then, she was transferred to the Department of Orthopedics as suspected septic coxitis, where she was operated on. The disease was not recognized on time, appropriate treatment was introduced too late, and irreparable consequences developed in the right hip. To the best of our knowledge, this is the first reported case of coxitis, especially on the contralateral side to the snake bite. Infection from the site of snake bite on the left lower leg could have been transferred to the right hip exclusively by hematogenous way. Our objective is to warn of this rare snake bite complication, and to contribute to better diagnostic and therapeutic management in similar situations.

Animals↗