necrotising otitis media

Granulomatosis with polyangiitis (GPA) is an uncommon disorder that mainly involves the upper and lower respiratory tract and kidney, presenting as sinusitis, saddle nose, otitis media, pulmonary nodule and cavity, rapidly progressive glomerulonephritis. It also affects skin, eye, heart, joint and nervous system. Renal involvement in GPA is commonly manifested as necrotising glomerulonephritis, while renal mass is very rare. We herein present two hospitalised cases with fever, pulmonary cavity and renal mass...

BACKGROUND: Tuberculosis (TB) otitis media is an uncommon site of extrapulmonary TB and can primarily present as a complicated TB mastoiditis (TBM). This complication is rare in children, even in TB endemic areas but necessitates early identification as delays can lead to severe morbidities. We describe the clinical characteristics as a case series to raise awareness of the condition, and highlight fundamentals related to diagnosis and management. METHODS: A retrospective chart review of clinical and radiological information of five children with TBM seen at the Red Cross War Memorial Children's Hospital in Cape Town, South Africa, over the last 5 years...

Granulomatosis with polyangiitis (GPA) is a rare systemic disease of unknown aetiology, characterised by necrotising granuloma formation and diffuse vasculitis. It typically affects the upper and lower respiratory tract in addition to the kidneys. Without treatment, the 2-year mortality rate exceeds 90%. We describe a presentation of intractable serous otitis media, rhinosinusitis, fever and unilateral facial palsy in an 18-year-old man with learning difficulties, which highlights the need for a high index of suspicion in diagnosing and treating this enigmatic disease...

BACKGROUND: Interventions aimed at promoting breastfeeding rates are among the most effective possible health policies available, with an estimated return of US$35 per dollar invested. Indeed, some authors found that a 10% increase in exclusive breastfeeding rates in the first two years of life led to a reduction in treatment costs of US$312 million in the US, US$7.8 million in the UK, US$30 million in China, and US$1.8 million in Brazil. Among high-income countries, Spain stands out for its low breastfeeding rate...

BACKGROUND: Immunothrombosis is a physiological process based on the release of neutrophil extracellular traps (NETs) to immobilise, contain and kill bacteria. This is an innate immune response in which the local activation of blood coagulation exerts the critical protective function during microbial infection. In recent years, there has been much interest in the adult literature about the key role of immunothrombosis in pathologic states including thrombosis, cancer, sepsis and trauma...

OBJECTIVES: To estimate the cost savings and health benefits in the UK NHS that could be achieved if human milk usage in the NICU was increased. METHODS: A systematic review established the disease areas with the strong sources of evidence of the short, medium and long-term benefits of human milk for preterm infants as opposed to the use of formula milk. The analysis assessed the economic impact of reducing rates of necrotising enterocolitis, sepsis, sudden infant death syndrome, leukaemia, otitis media, obesity and neurodevelopmental impairment...

This review focuses key advances in different pediatric fields that were published in Italian Journal of Pediatrics and in international journals in 2015. Weaning studies continue to show promise for preventing food allergy. New diagnostic tools are available for identifying the allergic origin of allergic-like symptoms. Advances have been reported in obesity, short stature and autoimmune endocrine disorders. New molecules are offered to reduce weight gain and insulin-resistance in obese children. Regional investigations may provide suggestions for preventing short stature...

RATIONALE: Studies suggest that increased breastfeeding rates can provide substantial financial savings, but the scale of such savings in the UK is not known. OBJECTIVE: To calculate potential cost savings attributable to increases in breastfeeding rates from the National Health Service perspective. DESIGN AND SETTINGS: Cost savings focussed on where evidence of health benefit is strongest: reductions in gastrointestinal and lower respiratory tract infections, acute otitis media in infants, necrotising enterocolitis in preterm babies and breast cancer (BC) in women...

OBJECTIVE: To report a rare case of tuberculous otitis media, and to highlight barriers to clinical and microbiological diagnosis. METHOD: Case report and literature review. RESULTS: Tuberculous otitis media is a rare cause of chronic ear infection in the UK. Its symptoms may mimic a range of other otological conditions, including otitis media, chronic suppurative otitis media, cholesteatoma and necrotising otitis media. CONCLUSION: This case report highlights the challenges of obtaining a clinical diagnosis of tuberculous otitis media, and emphasises the fact that screening for acid-fast bacilli is not sufficient, in isolation, to rule out mycobacterial infection...

We present a case of cervical necrotising fasciitis in a 56 year old man, secondary to a rare mastoid infection. The patient had coexisting diabetes mellitus and hypertension. He was treated with early surgical debridement followed by neck and chest reconstruction and radical mastoidectomy. Aggressive antibiotic therapy and supportive care was given. He recovered well with minimal residual functional deficit.

OBJECTIVE: To estimate the attributable ACT hospital system costs of treating selected infant and childhood illnesses having known associations with early weaning from human milk. METHOD: We identified relative risks of infant and childhood morbidity associated with exposure to artificial feeding in the early months of life vs. breastfeeding from cohort studies cited by the American Academy of Pediatrics in 1997 as establishing the protective effect of breastfeeding...

Melioidosis is a potentially deadly infection that can affect any organ system. Reports of melioidosis of the ENT/head and neck region are relatively uncommon. Four cases are presented: (i) parotid abscess evolving into necrotising fasciitis, (ii) acute sinusitis and parapharyngeal cellulitis resulting in upper airway obstruction, (iii) acute suppurative lymphadenitis (iv) and chronic suppurative otitis media causing meningoencephalitis. Three of the four cases are believed to be unique, as a literature review of melioidosis in ENT/head and neck is also presented...

The authors report on 5 observations of necrotising angiitis with a specifically otological onset, namely 4 Wegener's syndromes and one periarteritis nodosa. In all 5 cases, the initial symptomatology consisted of otological signs in a feverish context, producing pictures of serous or sero-purulent otitis. Its resistance to usual forms of therapy led in 3 cases to the installation of transtympanic aerators, and in 2 cases to the performance of an antro-attico-mastoidectomy. One of the observations led to the discovery in the middle ear of a histological aspect specific to the disease, from which it can be considered that the otologic impairment could be a specific seat of the disease...

Anaerobic bacteria form the predominant flora of the oral cavity, outnumbering facultative organisms by 10-1,000: 1. The type of anaerobic bacteria and their concentration depend on the anatomical site and the degree of anaerobiosis in the different sites in the mouth. Three groups of anaerobic bacteria inhabit the oral cavity; the strict anaerobes, the moderate anaerobes, and the microaerophilic group of organisms. The majority of anaerobic bacterial infections occurring in the region of the mouth, head and neck are caused by the commensal flora...

Discharge from the ear can be the result of many disease processes. The ear may discharge blood, pus, cerebrospinal fluid (CSF) or wax. Keratosis obturans, stenosis of the external meatus and benign tumours of the external meatus all lead to wax build-up, which may cause recurrent attacks of otitis externa. Malignant tumours, such as basal cell carcinoma, squamous cell carcinoma and tumours of ceruminous gland origin may also present with discharge. Tumours should be excluded by submitting all material removed from the external canal for histological examination...