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At least 811 records · Page 45Linked to original sources

Unusual infections in diabetes.

Infection with rare organisms or at unusual sites occur more frequently in people with diabetes. If not recognised and treated promptly, morbidity and mortality are high in such cases. Here we report cases of necrotising fascitis, malignant otitis externa, Fournier's gangrene and psoas abscess occurring in diabetics that needed intensive treatment with antibiotics, surgical debridement and insulin. Literature reviews suggest that cellular defence mechanisms may be impaired in people with diabetes.

Adult↗

Endoscopic photographic comparison of drug delivery by ear-drops and by aerosol spray.

The Otomize (Stafford-Miller Ltd) aerosol spray is a new device for delivering topical ear medication in otitis externa. Both the manufacturers and a recent study have claimed that the spray produces better coverage of the external ear canal than do traditional ear-drops. We performed an endoscopic photographic comparison study to investigate this claim. The are of tympanic membrane and ear canal covered with medication was greater in those ears treated with the aerosol (P less than 0.001, paired t-test). The ability of the aerosol to deliver drug to the level of the tympanic membrane suggests a possible role for this device in the treatment of chronic otitis media. The technique of endoscopic photography provides an objective and reproducible means of investigating drug delivery systems for otological conditions.

Administration, Topical↗

Comparison of bacterial organisms and their susceptibility patterns from otic exudate and ear tissue from the vertical ear canal of dogs undergoing a total ear canal ablation.

The purpose of this prospective study was to compare bacterial organisms and their susceptibility patterns from otic exudate and ear tissue from the vertical ear canal of six dogs with end-stage otitis undergoing a total ear canal ablation. Twenty-six organisms, 13 from the exudate and 13 from the tissue, were morphologically and biochemically similar, and their susceptibility patterns were compared. There were discrepancies for only 5 antibiotics for 4 organisms from 3 dogs. Culture of otic exudate from the vertical ear canal of dogs with chronic end-stage otitis externa provides an accurate reflection of the bacterial species present and the antimicrobial susceptibility patterns of these infections.

Administration, Oral↗

[Antibiotic-induced prolonged cholestasis: suspected induction by ceftibuten].

We report on a 43-year-old female diabetic patient who was treated with ceftibuten because of Pseudomonas aeruginosa induced otitis externa. Thereafter she developed a prolonged seven-months-persisting irreversible cholestasis. Liver puncutre revealed a canalicular and hepatocellular cholestasis without liver cell necrosis or bile duct injury. After seven-months the patient died because of antibiotic-resistant Pseudomonas-septicemia.

Adult↗

Pseudomonas dermatitis/folliculitis associated with pools and hot tubs--Colorado and Maine, 1999-2000.

During 1999-2000, outbreaks of Pseudomonas aeruginosa dermatitis and otitis externa associated with swimming pool and hot tub use occurred in Colorado and Maine. This report summarizes these outbreaks and provides recommendations for swimming pool and hot tub operation and maintenance, particularly when using offsite monitoring of water disinfectant and pH levels or when cyanuric acid is added to pools as a chlorine stabilizer.

Colorado↗

Pseudomonas folliculitis: an outbreak and review.

In November 1980, an outbreak of folliculitis due to Pseudomonas aeruginosa occurred in members of a health spa in Tennessee. The source of infection was traced to the health spa swimming pool, which had not been chlorinated for two days due to equipment malfunction. Thirty-seven (62%) of 60 members who used the swimming pool on these two days developed a papulopustular rash within eight hours to five days after swimming in the pool. The rash had a characteristic distribution, predominantly involving the buttocks, hips, and axillae. Other manifestations of infection included otitis externa (49%) and mastitis (11%). P. aeruginosa serogroup 0-11 was isolated from pustules of six people. A swab from the edge of the swimming pool also grew P. aeruginosa serogroup 0-11. With the rising popularity of home whirlpools and hot tubs, physicians may expect to encounter this disease with increasing frequency.

Disease Outbreaks↗

A unique isolate of Malassezia from a cat.

An isolate of Malassezia from a cat with otitis externa was examined mycologically as well as molecularly. The isolate was similar to M. sympodialis in morphological and biochemical characteristics. In molecular analysis, however, it differed from the 7 species of Malassezia previously reported. Therefore, this clinical isolate from a cat might be a new species of Malassezia.

Animals↗

Canalplasty for severe external auditory meatus exostoses.

Exostoses of the external auditory meatus is a well known condition which infrequently requires surgical correction. However, the stenosis caused by severe exostosis can affect quality of life considerably and may require surgical intervention. Canalplasty, in such a situation, is a valid and effective management option. In our series the commonest indication for surgery was recurrent otitis externa. The detailed surgical technique is described and a retrospective analysis of 65 such procedures is presented. There were only two significant complications, both post-operative stenosis, requiring further corrective surgery. In conclusion, canalplasty for the exostosis of the external auditory meatus is a safe surgical option.

Adolescent↗

High tech home care: a look at a success story.

The expansion of technology has allowed patients to receive intravenous therapy at home. This case study discusses the problems of a patient with diabetes mellitus and malignant otitis externa. This patient received intravenous therapy for the last 3 years of his life. In spite of several hospitalizations, he was able to return and remain home until his death. Management of the patient's discharge and home care seemed to be a major factor in his ability to remain in the community.

Adult↗

[Ototoxicity of locally applied amino-glycosides (author's transl)].

Medical literature contains numerous references to the ototoxic effects of amino-glycosides if locally applied. In the present study patients who had fallen ill with otitis externa with concomitant myringitis, whose eardrum however, was intact, were treated with Neomycin and Polymyxin B containing ear-drops (Otosporin) and supervised audiometrically. There were no references to any ototoxic damage to the inner ear as a consequence of the treatment. Theoretical considerations and reports in the literature on the subject give advice to caution in the case of eardrum perforations and surgical caverns.

Aminoglycosides↗

When not to syringe an ear.

This article reviews the potential hazards of ear syringing and the Accident Compensation Corporation Medical Misadventure Unit's experience of alleged iatrogenic injury over a 17-month period. Syringing claims account for about 25% of the total claims received by the ACC ENT Medical Misadventure Committee. Forty-seven claims were accepted as either mishap or error, and 63 claims were declined. Perforation of the drum was by far the commonest injury resulting in significant disability. Severe iatrogenic otitis externa accounted for most of the remainder. Practice nurses had syringed the ears of approximately two-thirds of the claimants with significant disability. The contraindications to ear syringing are listed and discussed. The correct technique, with a few "do and don't" pointers, is briefly reviewed. Management of the unintentional injury is discussed.

Adult↗

Infections of the external ear.

Otitis externa is one of the most common conditions seen in the otolaryngology practice. It encompasses a wide range of conditions, from those that cause mild inflammation and discomfort to those that are life-threatening. The management of these conditions requires a clear understanding of the anatomy and physiology of the ear canal, the microbiology of pathogens and familiarity with the clinical presentation.

Acute Disease↗

Isolation of Cryptococcus neoformans var. neoformans from canine otitis.

Cryptococcus neoformans was demonstrated in the clinical material of a 15-year-old male dog with a history of chronic otitis externa by employing Helianthus annuus seed agar as a selective medium. The examination of the isolate for sexual compatibility on modified Helianthus annuus seed medium revealed that it belonged to Filobasidiella neoformans var. neoformans 'alpha' mating type. In the authors' view, this appears to be the first report of isolation of Cr. neoformans var. neoformans from diseased ear of a dog.

Animals↗

Clinical efficacy of cefoxitin in the treatment of head and neck infections.

Cefoxitin sodium, a new cephamycin antibiotic, is active against many aerobic and anaerobic bacteria. Four patients with infections of the head and neck (otitis externa with cellulitis, parotiditis, tracheitis, and facial cellulitis), who had failed to respond to initial antibiotic regimens, responded satisfactorily to cefoxitin therapy. No adverse effects were noted in any of these patients. Results of this report suggest cefoxitin is a safe and well-tolerated antibiotic that is efficacious in the treatment of head and neck bacterial infections that are sensitive to this drug.

Adult↗

Marine-acquired infections. Hazards of the ocean environment.

Numerous pathogenic bacteria are found in seawater. They can cause several environmental infections, such as conjunctivitis, otitis externa, wound infections, pneumonia, and gastrointestinal illness. The incidence of some of these infections could be lowered if people took care to avoid eating undercooked seafood, swimming in brackish water, or sustaining lacerations in a marine environment. However, such infections will probably increase in frequency as more people visit ocean resorts. Prompt elimination of the infective agent, adequate wound care, and avoidance of reexposure can minimize the severity of the condition.

Bacterial Infections↗

Otomycosis in Burma, and its treatment.

Otomycosis of the auditory canal is common in Burma. Of 346 cases of otitis externa seen in a hospital outpatient clinic during two consecutive rainy seasons, 189 were due to fungus infection. Aspergillus species were the fungi isolated most frequently. Infection was most commonly due to self-manipulation. Itching and tinnitus were common complaints. Treatment by local cleansing and application of antifungal agents was effective, 10% 5-fluorocytosine ointment being most successful.

Adolescent↗

How we do it: a new 'one stop' ear wick.

In some practices, otitis externa is treated with ear wick and patient is asked to remove it independently without re-attending clinic. * Although this method reduces workload on aural care services, it can be unhygienic and difficult to perform. * We propose a new design whereby the wick is tied to a string to facilitate its later removal. * Out of 18 patients treated with this method, only 4 opted to re-attend for further aural care.

Device Removal↗

Canine atopic dermatitis: a retrospective study of 266 cases examined at the University of California, Davis, 1992-1998. Part I. Clinical features and allergy testing results.

The medical records of 266 dogs diagnosed as having atopic dermatitis were reviewed. Statistical data were evaluated referable to breed predilections, clinical signs and positive reactions to allergens. Positive reactions were most common to house dust mites (more common with clinical signs in the fall) followed by moulds (more common with clinical signs in the fall and spring). Dogs with positive reactions to moulds, trees or cultivated plants were more likely to have skin and ear yeast infections. Dogs with positive reactions to cultivated plants were more likely to have otitis externa and pedal lesions. Positive reactions to house dust were more common in dogs with early onset of signs and in those tested early in the disease. Dogs had more positive reactions to weeds when allergy tests were performed in the summer and fall. Positive reactions to flea antigen were highly correlated with the clinical diagnosis of flea allergy dermatitis.

Animals↗