Acute otitis medium complicated by mastoiditis in a child after a possible new coronoviral infection: a clinical case

Author(s):  
О.А. Егорова ◽  
В.Г. Тихонов ◽  
Е.И. Каманин ◽  
А.А. Тарасов

В статье описан клинический случай острого среднего отита у ребенка 8 лет, осложненного мастоидитом, в крови ребенка выявлены антитела к коронавирусу SARS-CoV-2, IgG. Имеющиеся на сегодня данные свидетельствуют о том, что дети составляют до 10% в структуре инфицированных SARS-CoV-2 и до 2% в структуре пациентов с диагностированными клиническими случаями COVID-19. В Российской Федерации дети составляют 6-7% зарегистрированных случаев COVID-19. В начале пандемии было выявлено, что у детей имеет место более легкое течение заболевания и значительно реже встречаются осложнения и неблагоприятные исходы. Однако в последующие месяцы клиницисты стали отмечать многократный рост частоты госпитализации детей по поводу COVID-19. Описанный случай показывает молниеносное развитие острого мастоидита с деструкцией наружной пластинки височной кости у ребенка как осложнение острого среднего отита после перенесенной новой коронавирусной инфекции. Представлены сведения об актуальности эпидемиологии, клинической картины, диагностики и лечения острого среднего отита, осложненного мастоидитом, у детей. Следует подчеркнуть, что для достижения наиболее эффективной тактики ведения пациентов необходимо тесное сотрудничество врачей узких специальностей с педиатрами, массовое тестирование детского населения, дальнейшие исследования для получения достоверных данных о влиянии новой коронавирусной инфекции на организм ребенка. В настоящее время в доступной литературе недостаточно данных по влиянию COVID-19 на ЛОР-органы у детей. В связи с этим необходимы дальнейшие исследования по ЛОР-заболеваниям у данной категории пациентов на фоне или после перенесенной инфекции COVID-19. The article describes a clinical case of acute otitis media in an 8-year-old child complicated by mastoiditis, antibodies to SARS-CoV-2 and IgG coronovirus were detected in the child's blood. The data available today indicate that children make up up to 10% in the structure of infected SARS-CoV-2 and up to 2% in the structure of patients with diagnosed clinical cases of COVID-19. In the Russian Federation, children account for 6-7% of the registered cases of COVID-19. At the beginning of the pandemic, it was revealed that children have a lighter course of the disease and complications and unfavorable outcomes are much less common. However, in the following months, clinicians began to note a multiple increase in the frequency of hospitalization of children for COVID-19. The described case shows the rapid development of acute mastoiditis with the destruction of the outer plate of the temporal bone in a child, as a complication of acute otitis media, after a new coronavirus infection. The article presents information on the relevance of epidemiology, clinical picture, diagnosis and treatment of acute otitis media complicated by mastoiditis in children. It should be emphasized that in order to achieve the most effective tactics of introducing patients, close cooperation of doctors of narrow specialties with pediatricians is necessary, mass testing of the child population, further research to obtain reliable data on the impact of a new coronavirus infection on the child's body. Currently, there is insufficient data in the available literature on the effect of COVID-19 on ENT organs in children. In this regard, further studies on ENT diseases in this category of patients are needed on the background of or after a COVID-19 infection.

JAMIA Open ◽  
2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Jana L Anderson ◽  
e Silva Lucas Oliveira J ◽  
Juan P Brito ◽  
Ian G Hargraves ◽  
Erik P Hess

Abstract Objective The overuse of antibiotics for acute otitis media (AOM) in children is a healthcare quality issue in part arising from conflicting parent and physician understanding of the risks and benefits of antibiotics for AOM. Our objective was to develop a conversation aid that supports shared decision making (SDM) with parents of children who are diagnosed with non-severe AOM in the acute care setting. Materials and Methods We developed a web-based encounter tool following a human-centered design approach that includes active collaboration with parents, clinicians, and designers using literature review, observations of clinical encounters, parental and clinician surveys, and interviews. Insights from these processes informed the iterative creation of prototypes that were reviewed and field-tested in patient encounters. Results The ear pain conversation aid includes five sections: (1) A home page that opens the discussion on the etiologies of AOM; (2) the various options available for AOM management; (3) a pictograph of the impact of antibiotic therapy on pain control; (4) a pictograph of complication rates with and without antibiotics; and (5) a summary page on management choices. This open-access, web-based tool is located at www.earpaindecisionaid.org. Conclusions We collaboratively developed an evidence-based conversation aid to facilitate SDM for AOM. This decision aid has the potential to improve parental medical knowledge of AOM, physician/parent communication, and possibly decrease the overuse of antibiotics for this condition.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T A Agishina ◽  
V A Kontsevaya ◽  
M G Gambaryan

Abstract Background Smoking increases the risk of developing many diseases, both non-infectious and infectious. On February 23, 2013, the Russian Federation adopted an anti-smoking law, which provided for a two-stage ban on smoking in public places. Since June 1, 2013, smoking has been banned in schools, hospitals, public transport, railway stations, workplaces, and since June 1, 2014 - in trains, hotels, bars, restaurants. Purpose To study the dynamics of monthly hospitalization rates for respiratory diseases and acute otitis media in three regions of the Russian Federation (Chuvash Republic, Samara and Arkhangelsk regions). Methods A retrospective analysis of the monthly hospital incidence of pneumonia of various etiologies (ICD-10 J12-J18), other acute lower respiratory infections (J20-J22), asthma (J45), status asthmaticus (J46) and acute otitis media (H65.0, H65.1, H66.0) from 2012 to 2017. The data were analyzed by the method of interrupted time series. The information was provided by the regional Fund of Medical Insurance. Results Two control points were identified - June 2013 and June 2014. We demonstrated the reduction of hospitalization rates for acute lower respiratory infections and pneumonia immediately after each of the two stages of the anti-smoking policy implementation in all regions studied. In the Arkhangelsk region, the decrease was 19% in 2013 and 22% in 2014, in the Samara region - 20% and 23%, and in the Chuvash Republic - 31% and 39%. The reduction of hospitalization for asthma, status asthmaticus and acute otitis media was observed only in Chuvash Republic: the decrease in the number of hospitalizations for asthma and status asthmaticus was 11% in 2013 and 12% in 2014, and for acute otitis media - 25% and 35%. In other regions the decline was non-significant. Conclusions Anti-tobacco legislation leads to an immediate and significant reduction in the number of hospitalizations for lower respiratory tract infections. Key messages The ban on smoking in public places reduces infections of the lower respiratory tract and acute otitis media. Anti-tobacco legislation has a positive impact on public health.


Lex Russica ◽  
2021 ◽  
Vol 74 (2) ◽  
pp. 64-79
Author(s):  
R. V. Tkachenko

The paper is devoted to the examination of issues related to the increasing importance of budgetary regulation for the proper functioning of a modern innovative society. The key role of the budgetary regulation in the financial process of the State is particularly acute in the context of systemic crises that include socio-economic consequences caused by the spread of a new coronavirus infection (COVID-19) in Russia. In the course of the study, the features of changes in the state financial policy caused by the above-mentioned crisis phenomena are highlighted. The paper describes various approaches to the interpretation of the budgetary regulation as a category of financial law, explores various types and legal forms of methods of the budgetary regulation, analyses mechanisms and the impact of the State on the budget system through the existing legal structure of the budgetary regulation. It is determined that the rules of financial law governing the whole complex of public relations concerning the distribution and redistribution of the national product between the levels of the budget system of the Russian Federation constitute the institution of financial law, namely: the budgetary regulation. The author concludes that the approach based on the concentration of basic powers in the financial field at the federal level significantly slows down the dynamics of development of economic activity in the majority of regions of Russia, while the need for breakthrough innovative development of Russian society determinates the expansion of long-term tax sources of income for regional budgets. In this regard, it is proposed to consolidate additional regulation for revenues gained by regional and local budgets in the form of targeted deductions from federal taxes on a long-term basis.


2003 ◽  
Vol 10 (4) ◽  
pp. 721-724 ◽  
Author(s):  
Gunter Scharer ◽  
Frank Zaldivar ◽  
Guillermo Gonzalez ◽  
Ofelia Vargas-Shiraishi ◽  
Jasjit Singh ◽  
...  

ABSTRACT This pilot study was designed to determine the serum cytokine profile of acute otitis media (AOM) due to Streptococcus pneumoniae and the impact of clarithromycin (Abbott Laboratories, Inc). Serum levels of interleukin-1β (IL-1β), tumor necrosis factor alpha (TNF-α), IL-6, and IL-8 were measured at diagnosis and 3 to 5 days after start of antibiotic treatment in 10 patients (mean age, 18.3 ± 13.9 months) who had middle ear fluid culture positive for S. pneumoniae. The mean concentrations of all cytokines were elevated at diagnosis of AOM compared to levels in healthy controls, yet only IL-6 reached statistical significance (P = 0.05). IL-6 showed a statistically significant decrease in mean serum concentration at visit 2 (P = 0.03). IL-8 displayed a similar pattern to IL-6, but the difference between samples from day 1 and day 2 did not reach statistical significance. The cytokines IL-1β and TNF-α appear to be elevated in the serum of patients with S. pneumoniae AOM, but there was no significant change between mean serum levels obtained pre- and postinitiation of antibiotic treatment in the time frame studied. The results suggest a systemic inflammatory response as evidenced by increased IL-6. A significant decrease of IL-6 and improvement of clinical symptoms were observed. Determining cytokine levels, especially IL-6, in AOM could offer a powerful tool for objective assessment of response to treatment, minimizing unnecessary treatment of asymptomatic children who may still have some otoscopic findings suggestive of AOM at follow-up visits.


2007 ◽  
Vol 18 (2) ◽  
pp. 121-127 ◽  
Author(s):  
Adrienne Morrow ◽  
Philippe De Wals ◽  
Geneviève Petit ◽  
Maryse Guay ◽  
Lonny James Erickson

BACKGROUND: In the United States, implementation of the seven-valent conjugate vaccine into childhood immunization schedules has had an effect on the burden of pneumococcal disease in all ages of the population. To evaluate the impact in Canada, it is essential to have an estimate of the burden of pneumococcal disease before routine use of the vaccine.METHODS: The incidence and costs of pneumococcal disease in the Canadian population in 2001 were estimated from various sources, including published studies, provincial databases and expert opinion.RESULTS: In 2001, there were 565,000 cases of pneumococcal disease in the Canadian population, with invasive infections representing 0.7%, pneumonia 7.5% and acute otitis media 91.8% of cases. There were a total of 3000 deaths, mainly as a result of pneumonia and largely attributable to the population aged 65 years or older. There were 54,330 life-years lost due to pneumococcal disease, and 37,430 quality-adjusted life-years lost due to acute disease, long-term sequelae and deaths. Societal costs were estimated to be $193 million (range $155 to $295 million), with 82% borne by the health system and 18% borne by families. Invasive pneumococcal infections represented 17% of the costs and noninvasive infections represented 83%, with approximately one-half of this proportion attributable to acute otitis media and myringotomy.CONCLUSIONS: The burden of pneumococcal disease before routine use of the pneumococcal conjugate vaccine was substantial in all age groups of the Canadian population. This estimate provides a baseline for further analysis of the direct and indirect impacts of the vaccine.


Author(s):  
Railya V. Garipova ◽  
Leonid A. Strizhakov ◽  
Yuri Yu. Gorblyansky ◽  
Sergey A. Babanov

Introduction. The professional activity of medical workers (MW) is in close contact with daily contact with various factors of the production environment: physical, chemical, biological, and labor processes. Until 2020, tuberculosis and viral hepatitis prevailed in the structure of occupational diseases (OD) of the medical workers in the Russian Federation. According to the State report "On the state of sanitary and epidemiological welfare of the population in the Russian Federation in 2020," the first ranking the second place in the structure of occupational diseases, depending on the impact of harmful production factor took the illnesses associated with the action of biological factors - 20,19%, while the main reason for the growth in the incidence of healthcare workers in coronavirus infection COVID-19 (further COVID-19). The study aims were to identify problematic aspects in the establishment of the COVID-19 work from MW. Materials and methods. We have given descriptions of clinical cases, as well as a retrospective analysis of issues of OD according to the patient registers of the following medical institutions: the Center of Occupational Pathology of Sechenov University, the Republican Center of Occupational Pathology of the Ministry of Health, Republic of Tatarstan, the Regional Center of Occupational Pathology of the Samara Region. Results. In 2020, COVID-19 was the most common OD with fatal outcomes and complications in healthcare workers. Today, difficulties in determining the connection of COVID-19 with the profession arise when assessing the epidemiological history, the consequences after a coronavirus infection, and the formulation of the diagnosis. Conclusions. For a qualitative examination of the connection of COVID-19 with the profession, it is necessary to develop a list of clinical conditions with the definition of the timing of complications.


2020 ◽  
Vol 145 ◽  
pp. 106133 ◽  
Author(s):  
Jongmin Oh ◽  
Seulbi Lee ◽  
Min-ho Kim ◽  
Youngrin Kwag ◽  
Hae Soon Kim ◽  
...  

2015 ◽  
Vol 41 (1) ◽  
Author(s):  
Silvia Palma ◽  
Cristiano Rosafio ◽  
Cinzia Del Giovane ◽  
Viviana Dora Patianna ◽  
Laura Lucaccioni ◽  
...  

2018 ◽  
Vol 56 (12) ◽  
Author(s):  
Sigríður J. Quirk ◽  
Gunnsteinn Haraldsson ◽  
Helga Erlendsdóttir ◽  
Martha Á. Hjálmarsdóttir ◽  
Andries J. van Tonder ◽  
...  

ABSTRACTVaccination with pneumococcal conjugate vaccines (PCVs) disrupts the pneumococcal population. Our aim was to determine the impact of the 10-valent PCV on the serotypes, genetic lineages, and antimicrobial susceptibility of pneumococci isolated from children in Iceland. Pneumococci were collected between 2009 and 2017 from the nasopharynges of healthy children attending 15 day care centers and from the middle ears (MEs) of children with acute otitis media from the greater Reykjavik capital area. Isolates were serotyped and tested for antimicrobial susceptibility. Whole-genome sequencing (WGS) was performed on alternate isolates from 2009 to 2014, and serotypes and multilocus sequence types (STs) were extracted from the WGS data. Two study periods were defined: 2009 to 2011 (PreVac) and 2012 to 2017 (PostVac). The overall nasopharyngeal carriage rate was similar between the two periods (67.3% PreVac and 61.5% PostVac,P= 0.090). Vaccine-type (VT) pneumococci decreased and nonvaccine-type (NVT) pneumococci (serotypes 6C, 15A, 15B/C, 21, 22F, 23A, 23B, 35F, and 35B) significantly increased in different age strata post-PCV introduction. The total number of pneumococci recovered from ME samples significantly decreased as did the proportion that were VTs, although NVT pneumococci (6C, 15B/C, 23A, and 23B) increased significantly. Most serotype 6C pneumococci were multidrug resistant (MDR). Serotype 19F was the predominant serotype associated with MEs, and it significantly decreased post-PCV introduction: these isolates were predominantly MDR and of the Taiwan19F-14 PMEN lineage. Overall, the nasopharyngeal carriage rate remained constant and the number of ME-associated pneumococci decreased significantly post-PCV introduction; however, there was a concomitant and statistically significant shift from VTs to NVTs in both collections of pneumococci.


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