scholarly journals 651. Comparative Analysis Between Bacterial And Fungal Malignant Otitis Externa

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S383-S384
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Amal Chakroun ◽  
Fatma Smaoui ◽  
Khaoula Rekik ◽  
...  
Keyword(s):  
Otitis Externa ◽  
Clinical Presentation ◽  
The Elderly ◽  
Causative Organism ◽  
Diabetic Patients ◽  
Duration Of Treatment ◽  
Evolutionary Features ◽  
Significant Difference ◽  
Malignant Otitis Externa ◽  
History Of

Abstract Background Malignant otitis externa is a fatal infection of the external ear and temporal bone. Pseudomonas aeruginosa is the most common causative organism, while fungi are a rare cause of malignant otitis externa. We aimed to compare the clinical, therapeutic and evolutionary features between bacterial and fungal malignant otitis externa. Methods We conducted a retrospective study including all patients hospitalized for malignant otitis externa in the infectious diseases department between 2000 and 2018. Results Overall, we encountered 82 cases of malignant otitis externa, among which there were 54 cases (65.9%) of bacterial malignant otitis externa (BMO) and 28 cases (34.1%) of fungal malignant otitis externa (FMO). The males were predominant among BMO cases (57.4% vs 50%; p=0.5). Patients with FMO were significantly older (70±9 years vs 61±10 years; p< 0.001) and had medical history of diabetes mellitus more frequently (96.4% vs 77.8%; p=0.03). The use of topical corticosteroids was significantly more reported among FMO cases (28.6% vs 5.6%; p=0.006). Otalgia (96.4% vs 81.5%), otorrhea (75% vs 66.7%) and cephalalgia (46.4% vs 42.6%) were the revealing symptoms among FMO and BMO, respectively, with no significant difference. Tenderness to palpation of the mastoid bone (64.3% vs 38.9%; p=0.02) and stenosis of the external auditory canal (92.9% vs 72.2%; p=0.02) were significantly more frequent among FMO cases. Complications were significantly more frequent among FMO cases (42.9% vs 9.3%; p< 0.001). Treatment duration was significantly longer among FMO cases (70[40-90] days vs 45[34-75] days; p=0.03). Conclusion Our study showed that FMO affected more frequently the elderly and diabetic patients, when compared with BMO. Regardless of the causative agent, the clinical presentation was similar. However, the outcome was poor among FMO cases with the occurrence of complications, requiring a longer duration of treatment. Disclosures All Authors: No reported disclosures

Hot Bathtub, Cold Consequences—Misleading Wounds After Scald Injuries: A Retrospective Analysis

2020 ◽  
Author(s):  
Alperen S Bingoel ◽  
Nicco Krezdorn ◽  
Andreas Jokuszies ◽  
Khaled Dastagir ◽  
Peter Maria Vogt ◽  
...  
Keyword(s):  
Surface Area ◽  
Clinical Presentation ◽  
Previous History ◽  
The Elderly ◽  
Initial Assessment ◽  
P Value ◽  
Significant Difference ◽  
History Of ◽  
Erythematous Skin ◽  
The Mean

Abstract Scalds in the elderly are frequently associated with the use of a bathtub and a disturbed consciousness. Therefore, the total burn surface area is often high. The initial clinical presentation displays a stark erythema of the skin, which frequently does not represent the true depth. The aim of this study was to characterize and assess medical features and outcome of scalds sustained in the bathtub. We conducted a retrospective study at a burn intensive care unit (BICU) between 2011 and 2018. Medical features as well as the treatment in these patients were statistically analyzed. We identified 16 patients and divided them into two groups regarding survival and lethality. The mean total burn surface area was 37.50 ± 19.47%. In 81.25% of the patients, we found a previous history of neurological or psychiatric disorders. Dementia and alcohol abuse were the most common triggers for the trauma. The statistical analysis showed a significant difference for the ABSI-score and the presence of multi organ failure (P-value .0462, respectively, .0004). Erythematous skin areas tended to progress into full thickness burns. We, therefore, coined the term “lobster redness” for these regions. Scalds sustained in the bathtub are devastating injuries. Initial assessment can be misleading and might delay early necrectomy. The wounds request even more attention, if the injuries occurred due to unconsciousness because of the longer exposure to heat. Early necrectomy should be considered. A biopsy with histological workup can be useful. Furthermore, we recommend special safety precautions for neurologically and psychiatrically affected patients.

scholarly journals Prevalence of self probing, clinical presentation and the causative organism among the patients presented with otitis externa in a tertiary care hospital

2018 ◽  
Vol 4 (4) ◽  
pp. 1057
Author(s):  
Edakkattil Rameshkumar ◽  
Salini Ajitha
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Otitis Externa ◽  
Clinical Presentation ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Causative Organism ◽  
Care Hospital ◽  
Age Group ◽  
History Of ◽  
The Common

<p class="abstract"><strong>Background:</strong> Otitis externa, an inflammatory condition commonly reported in almost all age groups. But the prevalence and etiology are varying on different region. This study was aimed to find out the prevalence of self probing, clinical presentation and the causative organism among the patients presented with otitis externa in a tertiary care hospital.</p><p class="abstract"><strong>Methods:</strong> All the patients presented with otitis externa in the outpatient department of ENT were included in the retrospective study. The history of self probing was identified using a questionnaire. The clinical presentation was noticed and organism was isolated from the swab taken from the external ear canal. The non-parametric data was expressed in numbers and percentage.  </p><p class="abstract"><strong>Results:</strong> Total 49 patients were included in the study. The average age of patient was 39.5±14.3 years with 24 males and remaining females. Among them, 85.7% (42/49) had a history of self probing (p&lt;0.05). The most prevalent age group for the self probing associated otitis externa was 31 to 40 years. The discharge was the major clinical presentation (40/49) and the common organism isolated was <em>Pseudomonas aeruginosa</em> in 38% of incidence.</p><p><strong>Conclusions:</strong> Self probing was major etiological factor for otitis externa in the age group of 31-40 years. Discharge was the major clinical presentation and the common organism isolated was <em>Pseudomonas aeruginosa</em>. This emphasized the need for a proper awareness programme in the society against self probing to reduce the incidence.</p>

scholarly journals Necrotizing Otitis Externa: A Disease Barely Known to Neurosurgeons

2016 ◽  
Vol 38 (03) ◽  
pp. 239-245
Author(s):  
Sérgio Augusto Vieira Cançado ◽  
Lucídio Duarte de Souza ◽  
Rodrigo Moreira Faleiro ◽  
José Maurício Siqueira
Keyword(s):  
Early Diagnosis ◽  
Skull Base ◽  
Otitis Externa ◽  
Clinical Presentation ◽  
Neurological Impairment ◽  
Diabetic Patients ◽  
Necrotizing Otitis Externa ◽  
Clinical Presentations ◽  
Malignant Otitis Externa ◽  
High Index Of Suspicion

AbstractNecrotizing otitis externa (NOE), also known as malignant otitis externa (MOE), is a severe and rare infectious disease of the external auditory canal (EAC). Without treatment, it may progress to skull base involvement. The bacteria Pseudomonas aeruginosa is the most common causative agent (∼ 90% of the cases), and affects immunocompromised subjects, particularly diabetic patients. Severe chronic otalgia, otorrhea, and cranial nerve palsy are the most common clinical presentations. Patients with NOE are frequently referred to neurosurgery because of the neurological impairment and skull base compromise. The definitive diagnosis is frequently elusive, requiring a high index of suspicion. Several laboratorial tests, imaging modalities, and the histologic exclusion of malignancy may be required. An early diagnosis and aggressive treatment reduce morbidity and mortality. We present four NOE cases to illustrate the spectrum of clinical presentation and complementary exams. According to the literature, more effort for early diagnosis and treatment is required, and neurosurgeons play an important role in this task.

scholarly journals 990. Fungal Malignant Otitis Externa: Clinical and Therapeutic Features

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S585-S586
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Amal Chakroun ◽  
Khaoula Rekik ◽  
Chakib Marrakchi ◽  
...  
Keyword(s):  
Granulation Tissue ◽  
Otitis Externa ◽  
Fungal Species ◽  
Duration Of Treatment ◽  
Positive Serology ◽  
Serological Tests ◽  
Disease Evolution ◽  
Evolutionary Features ◽  
Malignant Otitis Externa ◽  
Empirical Antibiotics

Abstract Background Fungal malignant otitis externa is a rare, but a serious infection that might lead to death if not promptly diagnosed and treated. We aimed to study the clinical, therapeutic and evolutionary features of fungal malignant otitis externa. Methods We conducted a retrospective study including all cases of fungal malignant otitis externa hospitalized in the infectious diseases department between 2003 and 2020. Results We included 35 patients with a mean age of 68±11 years. There were 18 males (51.4%). All patients were diabetics, and 7 patients had a previous medical history of otitis externa (20%). The use of topical corticosteroids was noted in 10 cases (28.5%). The revealing symptoms were otalgia (97.1%), otorrhea (82.9%) and cephalalgia (54.3%). Physical examination revealed tenderness to palpation of the mastoid bone in 21 cases (60%) and the temporomandibular joint in 16 cases (45.7%). Facial paralysis was noted in 14.3% of the cases. Otoscopic examination revealed stenosis of the external auditory canal (94.3%), granulation tissue (34.3%) and a polyp (31.4%). Candida species were isolated in 22 cases (62.8%) represented by Candida parapsilosis in 15 cases (42.8%) and Candida albicans in 5 cases (14.2%). Serological tests detecting Candida were positive in 12 cases (34.2%). Aspergillus species were isolated in 13 cases (37.1%) represented mainly by Aspergillus flavus in 7 cases (20%). Positive serology results for Aspergillus were noted in 8 cases (22.8%). A polyp or granulation tissue biopsy, performed in 12 cases (34.2%), revealed non-specific inflammatory reaction (28.5%) and the presence of fungal hyphae and spores (5.7%). After empirical antibiotics treatment, patients received fluconazole in 18 cases (51.4%) and voriconazole in 17 cases (48.6%). The median duration of treatment was 3 [1.5-12] months. Both surgery and hyperbaric oxygen therapy were indicated in one case (2.8%). Complications including the onset of contralateral otitis (14.3%) and endocranial extension (8.6%) were noted. The disease evolution was favorable in 65.7% of the cases. Four patients were dead (11.4%). Conclusion Involvement of fungal species in malignant otitis externa should be considered in front of the absence of improvement with antibiotic. Prompt treatment might prevent complications. Disclosures All Authors: No reported disclosures

scholarly journals 1641. A Comparative Analysis Of Lymph Node Tuberculosis Between Children And Adults

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S810-S810
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Amal Chakroun ◽  
Khaoula Rekik ◽  
Fatma Smaoui ◽  
...  
Keyword(s):  
Lymph Node ◽  
Family History ◽  
Extrapulmonary Tuberculosis ◽  
Diagnostic Delay ◽  
Disease Evolution ◽  
Evolutionary Features ◽  
Significant Difference ◽  
History Of ◽  
Adults And Children ◽  
Lymph Node Tuberculosis

Abstract Background Lymph node tuberculosis (LNTB) represents the most common site of extrapulmonary tuberculosis. Among children, due to non-specific clinical features, the diagnosis is often delayed. We aimed to compare the clinical, therapeutic and evolutionary features of LNTB between adults and children. Methods We conducted a retrospective study including patients hospitalized for LNTB in the infectious diseases and pediatric department between 1993 and 2018. Children aged ≤18 years were included. Results Overall, we encountered 231 cases of LNTB. There were 40 children (17.3%) with a mean age of 11±4 years and 191 adults (82.7%) with a mean age of 42±16 years. As to gender, females were more affected (adults: 67% vs children: 70%), with no significant difference (p &gt;0.05). A family history of tuberculosis was significantly more frequent among children (20% vs 6.3%; p=0.01). Raw milk consumption (38.2% vs 30%; p &gt;0.05) and close contact with animals (29.8% vs 35%; p &gt;0.05) were noted among both adults and children. Fever (53.4% vs 32.5%; p=0.01), night sweats (35.8% vs 10%; p=0.001), loss of appetite (38.2% vs 17.5%; p=0.01) and weight loss (35.1% vs 15%; p=0.01) were significantly more frequent among adults. Tuberculin skin test was positive in 75.8% of the cases among adults and in 86.2% of the cases among children (p &gt;0.05). Multifocal tuberculosis was significantly more frequent among adults (23.8% vs 5.7%; p=0.01). Antitubercular therapy was prescribed for a mean duration of 10±4 months among adults and for 9±3 months among children, with no significant difference (p &gt;0.05). Side effects of antitubercular drugs were more frequent among adults (33% vs 10.3%), with a significant difference (p=0.004). Comparison of the disease evolution showed no significant difference between adults and children, regarding recovery (94.8% vs 90%), relapse (5.2% vs 5%) and death (0.5% vs 2.5%). Conclusion The clinical presentation of LNTB among children was less common and misleading. A family history of tuberculosis and a high index of suspicion might shorten the diagnostic delay. Disclosures All Authors: No reported disclosures

scholarly journals Structure of the clinical and geriatric depression: Similarities and differences

Psihologija ◽  
2006 ◽  
Vol 39 (4) ◽  
pp. 425-437 ◽  
Author(s):  
Zdenka Novovic ◽  
Petar Colovic ◽  
Maja Babic ◽  
Gordana Misic-Pavkov
Keyword(s):  
Depression Scale ◽  
The Elderly ◽  
Clinical Depression ◽  
Aged People ◽  
Method Of Maximum Likelihood ◽  
Significant Difference ◽  
Clinically Depressed ◽  
The Matrix ◽  
History Of ◽  
Negative Estimate

Studies demonstrating the uniqueness of depression in old age are numerous, but conclusions on the fact if the problems of the elderly people cause depression or if they are a part of depression are not unique. The aim of this paper is to compare the structure of depression of old people without the history of mental illness and middle-aged people treated for depression. The sample consists of 82 healthy inmates of different Homes for the Aged and 78 patients diagnosed with some sort of affective disorder. A depression has been assessed with the shorten version of the MMPI D-scale. The structure of the geriatric and clinical depression has been compared with the method of maximum likelihood, over the matrix of co-variances of answers on the items on the depression scale. The results point out to the statistically significant difference in the structure of depression of the old and clinically depressed individuals. However, half of the items of the D-scale have significant loadings on the factor of depression in both groups. The essence of the depression in both samples is made of cognitive subject matters, depressive affect, decline of motivation and a negative estimate of one's basic abilities. Symptoms concerning low self-esteem, experiencing cognitive deficit, energy and impaired physical health have been significant in describing the clinical depression, while a feeling of reduced positive stimulation and the affective liability is typical for the depression of geriatric sample. The conclusion is that, despite the differences, there is a common core of symptoms that makes the essence of depression, apart from the samples.

New-onset congestive heart failure (CHF) and cardiovascular disease (CVD) in older colorectal cancer (CRC) survivors: A population-based study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10011-10011
Author(s):  
Kelly Kenzik ◽  
Courtney Balentine ◽  
Smita Bhatia ◽  
Grant Richard Williams
Keyword(s):  
Cumulative Incidence ◽  
Cox Regression ◽  
The Elderly ◽  
Population Based ◽  
Diabetic Patients ◽  
Cumulative Incidence Functions ◽  
Increased Risk ◽  
History Of ◽  
Incidence Functions ◽  
New Onset

10011 Background: CRC is primarily a disease of the elderly. The high burden of pre-existing comorbidities alone or in concert with cancer treatment place the older patients with CRC at increased risk of new-onset morbidities, specifically, CVD and CHF. However, the magnitude of risk of new-onset morbidity, and its association with pre-existing comorbidities or treatment remain unknown. Methods: Using SEER-Medicare data, we evaluated individuals diagnosed with incident stage I-III CRC at age ≥66y between 1/1/2000 and 12/31/2011 who had survived ≥2y after diagnosis (n = 57,256; 77% with colon cancer). We compared these to an age, sex-, and race-frequency matched comparison group of non-cancer Medicare patients (n = 104,731). We evaluated new-onset CHF and CVD using competing risk cumulative incidence functions and multivariable Cox regression models. Results: The median age at diagnosis was 77y (66-106y); 45% males; and 85% non-Hispanic white. Median follow-up was 8y (2-14y) from diagnosis of CRC. Treatment included surgery for 99%, chemotherapy for 31%, and radiation for 12%. New-onset morbidity: The 10y cumulative incidence of new-onset CHF and CVD were 43.6% and 58.9%, respectively. After controlling for pre-cancer comorbidities, CRC survivors were at increased risk of new-onset CHF (HR 1.29) and CVD (HR 1.74) (all p < 0.001) compared to controls. Patients receiving radiation (HR 1.29) or 5-FU+oxaliplatin (HR 1.09) were at increased risk of CVD compared to those without those therapies (p < 0.001). Pre-existing diabetes (HR 1.16) and CHF (HR 1.21) independently increased the risk of CVD (p < 0.001). While 5FU+oxaliplatin did not increase the risk of CHF independently (HR 0.97), diabetic patients treated with 5-FU+oxaliplatin were at 1.71-fold increased risk of developing CHF (p < 0.001) when compared with those without pre-existing diabetes. Conclusions: Older CRC survivors are at increased of developing CHF and CVD. Monitoring survivors with a history of exposure to 5FU+oxaliplatin or radiation, and improving management of pre-existing comorbidities may reduce the burden of long-term morbidity for older CRC survivors.

scholarly journals Atypical presentations of malignant otitis externa

2010 ◽  
Vol 124 (11) ◽  
pp. 1205-1208 ◽  
Author(s):  
Z Vourexakis ◽  
M-I Kos ◽  
J-P Guyot
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Skull Base ◽  
Diagnostic Criteria ◽  
Otitis Externa ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Diabetic Patients ◽  
Malignant Otitis Externa ◽  
Life Threatening ◽  
Atypical Presentations

AbstractIntroduction:Malignant otitis externa is a life-threatening infection of the skull base. Its presentation is not always typical.Case reports:We report three cases of malignant otitis externa which illustrate the diversity of its clinical manifestations and the difficulties in its diagnosis.Discussion:The perception of malignant otitis externa as an infection caused by Pseudomonas aeruginosa in diabetic patients is not always correct. The adoption of diagnostic criteria could be helpful in identifying atypical cases.

scholarly journals Raised Arterial Pressure and Microalbuminuria in Type 2 Diabetic Subjects with Familial Hypertension

2016 ◽  
Vol 4 (1) ◽  
pp. 14-18
Author(s):  
Md Anisur Rahman ◽  
Md Mostarshid Billah ◽  
Palash Mitra ◽  
Md Emtiaz Hossan ◽  
Md Jakir Hossain ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Pressure ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Familial Predisposition ◽  
Significant Difference ◽  
History Of ◽  
Family History Of Hypertension ◽  
Type 2 Diabetic

Background and Aims : Microalbuminuria is claimed to be an early marker of nephropathy in type 2 diabetes.The raised arterial pressure is an important factor in the progression of diabetic nephropathy. There is a significant correlation between blood pressure and the progression of albuminuria in both type 1 and type 2 diabetes. This study in Bangladeshi type 2 diabetic patients was to evaluate whether microalbuminuria and raised arterial pressure are influenced by familial predisposition to hypertension.Methods : Sixty three newly diagnosed Bangladeshi type 2 diabetic patients were investigated. The diabetic subjects were divided into two groups as diabetes with family history of hypertension (n=37) and diabetes without family history of hypertension (n=26). Diabetic subjects were further divided into normotensive (n= 46) and hypertensive (n= 17); diabetic normoalbuminuric (n 44) and diabetic microalbuminuric (n 19) subgroups. Serum glucose was measured by glucose-oxidase; blood urea, serum creatinine and urinary creatinine by enzymatic-colorimetric method and urinary albumin by immunoturbidimetry method.Results : systolic blood pressure (SBP), diastolic blood pressure (DBP) and microalbuminuria were significantly elevated in diabetic subjects with familial predisposition to hypertension when compared to diabetic subjects without familial predisposition to hypertension [SBP (127±16 vs 110±14) mmHg P= 0.001; DBP (81±9 vs 72±11) mmHg P= 0.001; Microalbuminuria 2.23(0.28-9.43) vs 1.52(.29-3.91) mg/mmol p<0.03]. When diabetic normotensive subjects were compared with diabetic hypertensive subjects for microalbuminuria, no significant difference was found among themselves [median (range) 1.67(0.17-8.62) vs 1.70(.28-9.43) mg/mmol p = NS]. Comparison of blood pressure was found no significant difference between diabetic normoalbuminuric and diabetic microalbuminuric subjects [systolic blood pressure (117±17 vs 125±17) mmHg p= NS ; diastolic blood pressure (76±11 vs 82±10) mmHg p= NS ].Conclusion : Microalbuminuria, a marker of early diabetic nephropathy and raised arterial pressure, a progression factor of nephropathy are more influenced by familial predisposition to hypertension in diabetic population irrespective of presence or absence of microalbuminuria and hypertension.Bangladesh Crit Care J March 2016; 4 (1): 14-18

scholarly journals Diabetes a risk for antimicrobial resistance?

2017 ◽  
Vol 6 (12) ◽  
pp. 2811 ◽  
Author(s):  
Vasavi Gedela ◽  
Sree Lakshmi Gosala
Keyword(s):  
Antimicrobial Resistance ◽  
Diabetic Foot ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Resistance Pattern ◽  
Causative Organism ◽  
Diabetic Patients ◽  
Diabetic Foot Infections ◽  
Significant Difference ◽  
Resistance Rates

Background: Diabetic foot infections can cause substantial morbidity. The role of Diabetes mellitus in the antimicrobial resistance of pathogens in patients with foot infections is not well clarified. So, we compared the profile of antibiotic resistance in diabetic and non-diabetic foot ulcer infections. Objectives were to compare the antimicrobial resistance pattern in diabetic and non-diabetic lower limb infections.Methods: T Pus was isolated in 50 Diabetic and 50 non-diabetic foot ulcer infections. The organisms were isolated on specific media and antibiotic susceptibility was done by using Kirby-Bauer disc diffusion method.Results: The most frequent causative organism in diabetic and non-diabetics is Pseudomonas 27.5% vs 27.1%, Staphylococcus 24.1% vs 27.1%, Klebsiella 24.1% vs 22.03%, E. coli 10.3% vs 10.16%, Proteus 5.17% vs 5.08%. No significant differences in resistance rates to Amikacin, Penicillin, Ofloxacin, Vancomycin, Piperacillin + Tazobactum were observed between diabetic and non-diabetic patients. There is significant difference in resistance to Ampicillin (p=0.017).Conclusions: Diabetes per se does not seem to influence the susceptibility pattern to antimicrobials in our group of patients with foot ulcer infections.

Sign in / Sign up

Export Citation Format

Share Document