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PubMed2001

Chronic otitis externa/media with total ear canal ablation and bulla curettage in a North American bison (Bison bison).

An adult female North American bison (Bison bison) with a chronic otitis externa/media of the right ear was examined because of a 4-mo history of intermittent anorexia, apparent painful behavior, and auricular discharge from the right ear. Computerized tomography (CT) demonstrated osteolysis of the tympanic, petrous, and squamous aspects of the temporal bone with soft tissue replacement and sclerosis of the right bulla. A total ear canal ablation with bulla curettage was performed, and cefazolin-impregnated polymethacrylate beads were left within the right bulla and the remnant temporal bone. Six months after the surgery, the bison had no clinical signs of otitis media.

Animals↗
PubMedDate not supplied

Outcomes of pituitary tumor irradiation in cats.

BACKGROUND: Information on tumor control and normal tissue effects of radiotherapy to treat pituitary tumors in cats is limited. HYPOTHESIS: Radiation therapy is effective in controlling the clinical signs associated with pituitary tumors in cats, with a low incidence of adverse effects. ANIMALS: Eight cats were irradiated at Colorado State University between 1991 and 2002 for spontaneous pituitary tumors. METHODS: A retrospective review of records was made to assess tumor control and incidence of radiation-induced adverse effects. RESULTS: Pituitary carcinoma was diagnosed in 2 cats and pituitary adenoma in 6 cats. Total radiation dosage ranged from 4,500 to 5,400 cGy administered Monday through Friday in 270 or 300 cGy fractions. Acute effects were limited to epilation and mild otitis externa. Focal brain necrosis adjacent to regrowth of a pituitary carcinoma and a second tumor in the radiation field were reported as possible late effects. Median survival, regardless of cause of death of the 8 cats, was 17.4 months (range, 8.4 to 63.1 months). Median survival could not be determined if cats were censored for non-tumor-related causes of death. Six cats were alive at 1 year, and 3 cats were alive at 2 years after treatment. Tumor recurrence was seen in 1 cat with a pituitary carcinoma. Neurologic signs improved within 2 months in all 5 cats that presented with abnormal neurologic signs. Clinical signs caused by a concurrent endocrine disorder began to improve within 1-5 months in the 7 cats with hyperadrenocorticism or acromegaly. CONCLUSIONS AND CLINICAL RELEVANCE: Radiation therapy is an effective primary treatment modality for cats presenting with neurologic signs associated with a pituitary mass and can improve clinical signs associated with concurrent hyperadrenocorticism or acromegaly in cats with no neurologic abnormalities.

Adenoma↗
PubMed1990

Common cutaneous disorders in athletes.

Athletic activity may cause or aggravate skin disorders, which in turn may diminish athletic performance. Since many sporting activities necessitate prolonged exposure to the sun, athletes must avoid painful sunburn which will adversely affect their performance. Drugs and chemicals also may cause photoallergic and/or phototoxic reactions, including polymorphous light eruption and athletes should thus avoid photosensitising drugs and chemicals. The effects of chronic ultraviolet exposure include ageing, pigmentation and skin cancers. The most effective protection against excessive exposure to sunlight is the use of sunscreens, although inadequate application and poor protection in the UVA spectrum may diminish their effectiveness and contact allergies may create other problems. Viral, bacterial and fungal infections are common in athletes due to heat, friction and contact with others. Herpes simplex may be treated with any drying agents (e.g. alcohol) as they are as effective as more expensive topical agents such as acyclovir. Molluscum contagiosum may be spread by close contact or water contact and is treated by superficial incision, cryotherapy or standard wart varnishes. Plantar wart infection is transmitted by swimming pool decks, changing rooms and hand-to-hand from weights in gymnasiums. Plantar warts presenting with pain may be aggressively treated, by blunt dissection, but painless ones are best treated conservatively. Impetigo and folliculitis often develop after trauma. Antibiotics are effective against mild infections while abrasions and lacerations should be cleansed and dressed with occlusive dressings. Diphtheroid bacteria in moist footwear may produce pitted keratolysis and erythrasma. Tinea pedis is common in athletes and probably originates in swimming pools, gymnasium floors and locker rooms. Interdigital, dry-moccasin and pustular-midsole forms can be distinguished. The latter two forms respond to topical antifungal agents, while the interdigital form, a mixed fungal/bacterial infection, is treated with debridement, antibiotics and drying routine similar to the therapy of otitis externa. Nail infections by a variety of organisms may appear as onycholysis with or without paronychia and should be treated with the appropriate antibiotics. Tinea versicolor occurs in heat and humidity. Since Pityrosporum orbiculare is part of the normal flora it often recurs, necessitating regular treatment. Acute trauma injuries include contusions, black heel or petichiae of the heel, black toe (bleeding under the nail), 'jogger's nipple' caused by chafing, and foot blisters. Chronic trauma may result in calluses, corns and paronychia. Plantar corns can be disabling and may be caused by overly tight shoes or abnormalities in biomechanics; treatment includes restoring normal foot function and minimal surgical procedures. Paronychia is treated best by wedge resection.(ABSTRACT TRUNCATED AT 400 WORDS)

Humans↗
PubMed2003

Langerhans' cell histiocytosis in the paediatric population: presentation and treatment of head and neck manifestations.

Langerhans' cell histiocytosis (LCH) is a rare paediatric disease of unknown etiology affecting 1 to 5 children per 1 million each year. It is characterized by the idiopathic proliferation of Langerhans' cells. The clinical spectrum of disease is quite varied, ranging from a solitary eosinophilic granuloma to diffuse multisystem involvement. The head and neck is the most common site of involvement, occurring in approximately 60% of LCH patients. Head and neck manifestations are diverse and include skull and temporal bone lesions, cervical lymphadenopathy, and skin rash. Diagnosis can be difficult as these lesions mimic other common conditions seen by the otolaryngologist, including otitis externa, acute mastoiditis, and gingivitis. A retrospective study was carried out to study our centre's experience with LCH over the last 10 years. Twenty-one patients were diagnosed between January 1990 and December 1999. Patient's age at time of diagnosis ranged from 6 days to 14 years. Fifty-seven percent of patients had localized bony lesions; the remaining 43% had diffuse multisystem disease. The head and neck was also the most commonly involved site in our study, affecting 67% of our patients. Presentation and diagnosis of these lesions are discussed in detail. Treatment, complications, and patient outcomes will also be discussed.

Adolescent↗
PubMedDate not supplied

[Aetiology and antibiotic sensitivity of the most frequent outpatient infections, except those of the lower respiratory tract].

Reporting of antimicrobial susceptibility profiles is recommended in order to improve antibiotic prescribing policies and to avoid the emergence of bacterial resistance. During 2001, susceptibility data from bacterial isolates collected from urine, faeces and ear swabs and antimicrobial susceptibility for Streptococcus pyogenes during the first five months in 2002 were recorded in the Health Area of Pamplona (389,489 inhabitants) and compared against data for antibiotic prescriptions. More than 80% of bacteria from urine were susceptible to amoxicillin plus clavulanic acid, oral cephalosporins, fosfomycin and nitrofurantoin. Of the Salmonella Enteritidis isolates, 98.3% were susceptible to trimethroprim-sulfamethoxazole and 96.6% of Campylobacter jejuni to erythromycin. Amoxicillin remained susceptible for more than 95.5% of middle ear isolates. Gram-negative bacilli isolates from otitis externa swabs were susceptible to ciprofloxacin, gentamicin and polimyxin B in over 80% of cases. Of the Streptococcus pyogenes isolated, 22.5% were resistant to erythromycin. Antimicrobial consumption in defined daily doses per 1,000 inhabitants, day (DID) during 2001 was 14.8. Here, we highlight the over-prescription of some broad-spectrum antibiotics and macrolides for the empiric treatment of infectious diseases in our area. Knowledge of local susceptibility patterns is essential in order to inform empiric therapy.

English Abstract↗
PubMed2006

In vitro activity of an ear rinse containing tromethamine, EDTA, and benzyl alcohol on bacterial pathogens from dogs with otitis.

OBJECTIVE: To evaluate the in vitro activity of an ear rinse (ER) containing tromethamine, EDTA, and benzyl alcohol on bacterial pathogens from dogs with otitis. SAMPLE POPULATION: Organisms were collected from ear swab specimens from the external and middle ear and included Staphylococcus spp (n = 11; Staphylococcus intermedius [7] and Staphylococcus spp [4]), Pseudomonas aeruginosa (5), Proteus spp (5), beta-hemolytic streptococcus (11), and 1 control strain of each organism. PROCEDURES: 3 test solutions were evaluated including EDTA, tromethamine, and benzyl alcohol (ER); EDTA and tromethamine (ER without benzyl alcohol [ER - BA]); and purified water. Ten-milliliter aliquots of each test solution were transferred into 36 tubes and inoculated with one of the organisms. Samples were retrieved from each tube at 0, 15, 30, 45, and 60 minutes, transferred to Petri dishes, mixed with soybean-casein digest agar, and incubated. After incubation, plates were examined for growth, and the number of colonies was expressed as CFU per milliliter. RESULTS: ER significantly decreased bacterial growth in vitro of P aeruginosa and beta-hemolytic streptococcal organisms within 15 minutes, Proteus spp within 30 minutes, and Staphylococcus spp within 60 minutes. Comparatively, the presence of benzyl alcohol in ER significantly decreased bacterial growth of beta-hemolytic streptococcus and Proteus spp. CONCLUSIONS AND CLINICAL RELEVANCE: On the basis of results of this study, future studies should be performed to evaluate the in vivo efficacy of ER alone as a treatment for otic infections caused by beta-hemolytic streptococcus, P aeruginosa, and Proteus spp and of ER combined with an antimicrobial agent for otic infections caused by Staphylococcus spp.

Animals↗
PubMed2005

Effect of tympanic cavity evacuation and flushing on microbial isolates during total ear canal ablation with lateral bulla osteotomy in dogs.

OBJECTIVE: To evaluate differences in bacterial numbers, identity, and susceptibility in samples obtained from the tympanic cavity on entry (preflush) and after evacuation and lavage (postflush) and assess perioperative and empiric antimicrobial selection in dogs that underwent total ear canal ablation (TECA) with lateral bulla osteotomy (LBO) or reoperation LBO. DESIGN: Prospective clinical study. ANIMALS: 34 dogs. PROCEDURE: TECA with LBO or reoperation LBO was performed on 47 ears. Pre- and postflush aerobic and anaerobic samples were obtained from the tympanic cavity. Isolates and antimicrobial susceptibility patterns were compared. RESULTS: Different isolates (31/44 [70%] ears) and susceptibility patterns of isolate pairs (6/44 [14%] ears) were detected in pre- and postflush samples from 84% of ears. Evacuation and lavage of the tympanic cavity decreased the number of bacterial isolates by 33%. In 26% of ears, bacteria were isolated from post-flush samples but not preflush samples. Only 26% of isolates tested were susceptible to cefazolin. At least 1 isolate from 53% of dogs that received empirically chosen antimicrobials postoperatively was resistant to the selected drugs. Anaerobic bacteria were recovered from 6 ears. CONCLUSIONS AND CLINICAL RELEVANCE: Accurate microbiologic assessment of the tympanic cavity should be the basis for selection of antimicrobials in dogs undergoing TECA with LBO. Bacteria remain in the tympanic cavity after evacuation and lavage. Cefazolin was a poor choice for dogs that underwent TECA with LBO, as judged on the basis of culture and susceptibility testing results.

Animals↗
PubMed2002

Molecular epidemiology of Pseudomonas aeruginosa.

Pseudomonas aeruginosa is a serious opportunistic pathogen in certain compromised hosts, such as those with cystic fibrosis, thermal burns and cancer. It also causes less severe noninvasive disease, such as otitis externa and hot tub folliculitis, in normal hosts. P. aeruginosa is phenotypically very unstable, particularly in patients with chronic infection. Phenotypic typing techniques are useful for understanding the epidemiology of acute infections, but they are limited by their discriminatory power and by their inability to group isolates that are phenotypically unrelated but genetically homologous. Molecular typing techniques, developed over the past decade, are highly discriminatory and are useful for typing strains from patients with chronic infection where the bacterial phenotype is unstable; this is particularly true in cystic fibrosis, where patients often are infected with the same strain for several decades, but the bacteria undergo phenotypic alteration. Molecular typing techniques, which have proven useful in typing P. aeruginosa for epidemiological purposes, include pulsed field gel electrophoresis, restriction fragment length polymorphic DNA analysis, random amplified polymorphic DNA analysis, repetitive extrapalindromic PCR analysis, and multilocus sequence typing. These methods are generally only available in specialized laboratories, but they should be used when data from phenotypic typing analysis are ambiguous or when phenotypic methods are unreliable, such as in cystic fibrosis.

Bacterial Typing Techniques↗
PubMedDate not supplied

Postinflammatory acquired atresia of the external auditory canal.

Seventeen cases of postinflammatory acquired artresia of the external auditory canal in 14 women are described and analysed. Fourteen of these cases were solid atresias in which the auditory canal was more or less filled with fibrous tissue. Three patients had partial membranous atresia. The aetiology was external otitis and/or chronic otitis media. The formation of atresia is usually by jerks, and its steps are as follows: External otitis with destruction of the epithelium, formation of granulations, fibrosing of the granulations, and lining with new meatal skin.

Adult↗
PubMed1987

Black fungi: a survey of dematiaceous hyphomycetes from clinical specimens identified over a five year period in a reference laboratory.

Five hundred and fifty six dematiaceous hyphomycetes, the great majority referred from other laboratories, were identified by us over a five year period. Of these, thirty five were regarded as being of probable pathogenetic significance. These included seven isolates associated with chromoblastomycosis, and seven isolates thought to be causing phaeohyphomycosis. There were six strains of Phaeoannellomyces werneckii and five strains of Sporothrix schenckii. Seven isolates, all strains of Aureobasidium pullulans, were associated with fungal peritonitis in patients on chronic ambulatory peritoneal dialysis. Two Bipolaris isolates were associated with paranasal sinus fungus ball, a condition in which no evidence of tissue invasion by fungi could be found, even though pressure necrosis of bone could lead to very serious consequences. A further seven dematiaceous hyphomycetes, isolated from cases of paranasal fungus ball, keratitis and otitis externa, were thought to be of possible pathogenetic significance. Of the remaining 514 isolates thought to be of no pathogenetic significance, two thirds were made up of strains of Aureobasidium pullulans, Alternaria alternata, Cladosporium cladosporioides, Epicoccum purpurascens and Phoma species. In many cases it was thought that the referring laboratories had allowed insufficient time for development of conidiogenesis in these strains, before sending them to our laboratory for identification.

Humans↗
PubMed2004

Management of the draining ear in children.

There are a variety of causes of otorrhea in children. The most important factor in reaching the proper diagnosis and providing relief of the problem is aural toilet. Once adequate debridement has been performed, the diagnosis is usually clearer, and treatment with ototopicals is significantly more effective. Most cases of otorrhea are due to infection or granulation tissue and can be managed initially with appropriately selected ototopical medication, thereby avoiding the risks and side effects of systemic therapy and the need for referral to a specialist. However, otorrhea in children that is refractory to medical therapy may be due to retained tympanostomy tubes or insidious pathology such as cholesteatoma or malignancy. In such cases, prompt referral to the otolaryngologist can facilitate accurate diagnosis and successful management.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Aetiology and antibiotic sensitivity of the most frequent outpatient infections].

The diffusion of the outlines of antibiotic sensitivity is a practice that is recommended for improving the prescription of antibiotics and for controlling the appearance and spread of resistances. During the years 2003 and 2004, data was gathered on the sensitivity to antibiotics of the main bacteria isolated in outpatient urine cultures, coprocultures, faringoamygdal and otic smears in the Pamplona health area, which attends to a population of approximately 400,000 inhabitants. Of the 9,495 uropathogens isolated, 90% were sensitive to amoxicillin-clavulanate, 96.4% to 2nd generation cephalosporins, 95.3% to phosphomycin and 97.7% to nitrofurantoin. One point eight percent (1.8%) of the strains of Escherichia coli isolated in urine were producers of extended spectrum b-lactamases, while 0.5% of the urinary isolations of Klebsiella pneumoniae were producers of this type of b-lactamases. Ninety-six point five percent of the 797 isolations of Salmonella serotipo Enteritidis were sensitive to cotrimoxazol, and 97.5% of the 1,057 isolations of Campylobacter jejuni were sensitive to eritromycine. Of the 319 bacteria isolated in otitis media, 96.5% were sensitive to amoxyline. The Gram negative bacillae producers of otitis externa showed a sensitivity above 90% to ciprofloxacin, gentamycin and polimixin B. Twenty-nine point seven percent of the isolations of Streptococcus pyogenes were resistant to eritromycine. Fourteen point three percent and 17.4% of the Staphylococcus aureus isolated in the years 2003 and 2004 respectively were resistant to methicillin. Knowledge of the map of antibiotic sensitivity of the microorganisms in circulation in each geographical area is information that is necessary for the empirical choice of antibiotic treatment.

Anti-Bacterial Agents↗
PubMedDate not supplied

Efficacy of hyposensitization in feline allergic diseases based upon results of in vitro testing for allergen-specific immunoglobulin E.

A survey was undertaken to evaluate the responses to hyposensitization in cats for which a diagnosis of allergic disease was made by assessment of clinical signs and evaluation of allergen-specific immunoglobulin E (IgE) using the radioallergosorbent test (RAST). Eighty-one cases were available for analysis. In 39 cases, a dietary change resulted in some subjective improvement, which usually was minimal; however, some cases had significant improvement. In 75.3% of cases, an improvement of at least 50% was noted and ascribed to a combination of immunotherapy and dietary change, when implemented. The response of the 42 cases in which immunotherapy alone was used or where there was no response to dietary change was broadly similar. Response of the specific dermatological conditions ranged from 93.6% in the case of linear granuloma to 60% in cases where self-induced hair loss was evident. Response also was good in cases of presumed allergic asthma (86.1% improvement) and suspected allergic otitis externa (62.6% improvement). In nine patients, the hyposensitization was discontinued due to lack of response. The results suggest that confirmation of a suspected diagnosis of allergic disease in cats by means of in vitro tests and subsequent therapy with hyposensitization should be a major consideration in feline practice.

Animals↗