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Sample records for acute external otitis

  1. External Otitis (Swimmer's Ear)

    Science.gov (United States)

    ... to Pneumococcal Vaccine Additional Content Medical News External Otitis (Swimmer's Ear) By Bradley W. Kesser, MD, Associate ... the Outer Ear Ear Blockages Ear Tumors External Otitis (Swimmer's Ear) Malignant External Otitis Perichondritis External otitis ...

  2. Acute otitis externa

    OpenAIRE

    Hui, Charles PS

    2013-01-01

    Acute otitis externa, also known as ‘swimmer’s ear’, is a common disease of children, adolescents and adults. While chronic suppurative otitis media or acute otitis media with tympanostomy tubes or a perforation can cause acute otitis externa, both the infecting organisms and management protocol are different. This practice point focuses solely on managing acute otitis externa, without acute otitis media, tympanostomy tubes or a perforation being present.

  3. Acute otitis externa.

    Science.gov (United States)

    Hui, Charles Ps

    2013-02-01

    Acute otitis externa, also known as 'swimmer's ear', is a common disease of children, adolescents and adults. While chronic suppurative otitis media or acute otitis media with tympanostomy tubes or a perforation can cause acute otitis externa, both the infecting organisms and management protocol are different. This practice point focuses solely on managing acute otitis externa, without acute otitis media, tympanostomy tubes or a perforation being present.

  4. Acute otitis externa

    OpenAIRE

    2013-01-01

    Acute otitis externa, also known as ‘swimmer’s ear’, is a common disease of children, adolescents and adults. While chronic suppurative otitis media or acute otitis media with tympanostomy tubes or a perforation can cause acute otitis externa, both the infecting organisms and management protocol are different. This practice point focuses solely on managing acute otitis externa, without acute otitis media, tympanostomy tubes or a perforation being present.

  5. MALIGNANT EXTERNAL OTITIS

    OpenAIRE

    Massoud Moghaddam

    1993-01-01

    Two case reports of malignant external otitis in the elderly diabetics and their complications and management with regard to our experience at Amir Alam Hospital, Department of ENT will be discussed here.

  6. Acute otitis media in adults: many unknowns.

    Science.gov (United States)

    2003-06-01

    (1) Acute otitis media is likely in adults with recent-onset otalgia, fever, and a bulging eardrum on otoscopy. Management is similar to that in children: no antibiotics in the first instance, then amoxicillin later if antibiotic therapy is needed. (2) Otitis media with a perforated eardrum, and evidence of pus must be distinguished from external otitis. In patients with otitis media and a perforated eardrum, the commonest bacterial isolates are staphylococci, pseudomonas and pneumococci. (3) If antibiotics are prescribed the choice of agent is based on individual clinical findings and underlying health status.

  7. Acute otitis media.

    Science.gov (United States)

    Dickson, Gretchen

    2014-03-01

    One in 4 children will have at least 1 episode of acute otitis media (AOM) by age 10 years. AOM results from infection of fluid that has become trapped in the middle ear. The bacteria that most often cause AOM are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Differentiating AOM from otitis media with effusion (OME) is a critical skill for physicians, as accurate diagnosis will guide appropriate treatment of these conditions. Although fluid is present in the middle ear in both conditions, the fluid is not infected in OME as is seen in AOM patients.

  8. Acute otitis media in children

    Directory of Open Access Journals (Sweden)

    Cherpillod J

    2011-06-01

    Full Text Available Jacques CherpillodEar, Nose and Throat Department, Childrens’ University Hospital, Lausanne, SwitzerlandDate of preparation: 6th March 2011Conflict of interest: None declaredClinical question: What is the best treatment for acute otitis media in children?Results: Watchful waiting, followed by amoxicillin treatment, if necessary, is the best first-line treatment for acute otitis media in children aged six months or older.Keywords: acute otitis media, antibiotics, watchful waitin

  9. External Otitis: An Unusual Presentation in Neonates

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    Peymaneh Alizadeh Taheri

    2016-01-01

    Full Text Available Acute otitis externa (AOE is an infection of the external auditory canal, the auricle, and the outer surface of the tympanic membrane. Although AOE is one of the most common otologic conditions encountered in pediatric population, it is known to primarily affect children older than 2 years. We report a case of AOE caused by Staphylococcus aureus in a 23-day-old neonate. A 23-day-old female infant presented to our neonatology clinic with irritability and discharge from the right ear. There were yellow otorrhea, mild erythema, and edema of right external ear canal. There was no sign of otitis media on otoscopy. The results of laboratory tests were insignificant. The discharge culture grew colonies of methicillin-sensitive Staphylococcus aureus. After 48 hours of treatment with intravenous cloxacillin, significant improvement was observed. The present case highlights an unusual presentation of staphylococcal infection in a neonate. This is the first case of methicillin-sensitive Staphylococcus aureus otitis externa in an immunocompetent newborn.

  10. Otite externa difusa aguda: um estudo prospectivo no verão do Rio de Janeiro Acute diffuse external otitis: a prospective study in Rio de Janeiro's summer

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    Ricardo R. Figueiredo

    2004-04-01

    Full Text Available A Otite Externa Aguda é uma doença extremamente comum em países tropicais, especialmente no verão. Vários fatores predisponentes são identificáveis e o quadro clínico pode ser bastante variado, principalmente com relação à intensidade da otalgia. OBJETIVO: Avaliar, através de um estudo prospectivo no maior hospital de Emergências do Rio de Janeiro, a incidência e as características da otite externa no período de verão. FORMA DE ESTUDO: Estudo clínico com coorte transversal. MATERIAL E MÉTODO: 391 pacientes com otite externa atendidos no Serviço de ORL do Hospital Souza Aguiar foram avaliados em uma série de parâmetros clínicos e de tratamento, incluindo análise de possíveis fatores predisponentes. RESULTADOS: Os principais sintomas referidos foram otalgia, otorréia discreta e plenitude auricular. Os principais fatores predisponentes foram banho de mar e piscina e uso de cotonetes. CONCLUSÃO: A otite externa aguda é uma doença extremamente comum em países tropicais, especialmente no verão. A possível contaminação da água de praias e piscinas, embora descartada por vários autores como fatores predisponentes, pode ter alguma influência na sua patogênese.The acute external otitis is a very common disease in tropical countries, especially in summer. There are many predisposing factors and clinical features may vary, particularly the pain's severity. AIM: Evaluate, with a prospective study in Rio de Janeiro's largest Urgencies Hospital, the incidence and characteristics of the acute external otitis in summer. STUDY DESIGN: Clinical study with transversal cohort. MATERIAL AND METH: 391 patients with acute external otitis in Souza Aguiar Hospital were evaluated in several clinical and treatment parameters, including predisposing factors analysis. RESULTS Pain, moderate ear discharge and sensation of "full ear" were the most common complaints. Sea and pool baths and the use of ear sticks were the most common

  11. [Acute otitis media in children].

    Science.gov (United States)

    Grzegorowski, Michał; Szydłowski, Jarosław

    2005-09-01

    Acute otitis media (A.O.M.) occurs mainly in children. The first peak of this disease appears between 6-18 month of life, and the second between 4-7 year of age. The younger age at which the first A.O.M. incidence is noted, the higher probability of its recurrence. In Poland 65% of children up to the 2 year of age suffer from otitis media once, and 30% more than three times. The portal of infection in a.o.m. comprises: (1) Eustachian tube (2) Blood vessels (3) External auditory meatus with perforated tympanic membrane. In ca. 30% of a.o.m. the causative agents are viruses, while in 70% the disease is due to bacteria (Streptococcus pneumoniae in 30-40%, Haemophilus influenzae ca. 20%, Moraxella catarrhalis 10-15%). A.O.M. is diagnosed basing on history, but mainly using otoscopic examination. Regarding different ear anatomy in infants, otoscopic examination may cause many difficulties. In A.O.M. due to possible dehiscence in tegmen tympani or antri may occur meningismus, and dehiscence in the facial nerve canal can occur facial nerve paresis. The treatment of choice is tympanocentesis and administration of amoxycillin in the dose of 40 mg/kg b.w. daily. After recovery, the examination of upper respiratory tract patency should be performed and following that the evaluation of the ear should be continued.

  12. Epidemiology of acute otitis in pediatric patients

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    Maddalena Perotti

    2011-03-01

    Full Text Available Introduction. Acute otitis is one of the most common pediatric infectious diseases that requires an accurate diagnosis in order to direct appropriate therapy to reduce the risk of complications. In this study pathogens collected from pediatric patients and their antibiotic susceptibility patterns were evaluated. Methods. Between May 2009 and May 2010, 739 samples (swabs taken from nasopharynx in case of acute otitis media and/or from ears in case of acute external otitis, collected from 680 patients, suffering of otalgia, admitted to the emergency department of our Hospital were studied.The specimens were submitted for routine bacterial cultures and the susceptibility tests were performed according to Clinical Laboratory Standards. Nitrocefin was used to detect ß-lactamase activity. Results. 316 samples (42.8% of 739 were negative, 102 (13.8% were positive for Streptococcus pneumoniae, 97 (13.1% for Moraxella catarrhalis, 68 (9.2% for Haemophilus influenzae, 62 (8.4% for Pseudomonas aeruginosa, 49 (6.6% for Staphylococcus aureus, 36 (4.9% for Streptococcus pyogenes, 5 (0.7% for Gram negative and 4 (0.5% for Candida spp. Antibiotic susceptibility tests showed that amikacin, ceftazidime, ciprofloxacin, imipenem, meropenem and piperacillin/tazobactam were active against all Gram negative strains isolated.We found one strain of MRSA. Of 102 Streptococcus pneumoniae, 5 (4.9% were penicillin resistant and 25 (24.5% were erythromycin resistant, showing the prevalence of constitutive phenotype (80%. All M. catarrhalis strains were ß-lactamase producers while all H. influenzae were ß-lactamase negatives. Conclusions. The prevalent etiological agents in pediatric acute otitis are S. pneumoniae, M. catharralis, and H. influenzae, as reported in literature. In external acute otitis P. aeruginosa prevails in particular in summer.

  13. Acute otitis externa: an update.

    Science.gov (United States)

    Schaefer, Paul; Baugh, Reginald F

    2012-12-01

    Acute otitis externa is a common condition involving inflammation of the ear canal. The acute form is caused primarily by bacterial infection, with Pseudomonas aeruginosa and Staphylococcus aureus the most common pathogens. Acute otitis externa presents with the rapid onset of ear canal inflammation, resulting in otalgia, itching, canal edema, canal erythema, and otorrhea, and often occurs following swimming or minor trauma from inappropriate cleaning. Tenderness with movement of the tragus or pinna is a classic finding. Topical antimicrobials or antibiotics such as acetic acid, aminoglycosides, polymyxin B, and quinolones are the treatment of choice in uncomplicated cases. These agents come in preparations with or without topical corticosteroids; the addition of corticosteroids may help resolve symptoms more quickly. However, there is no good evidence that any one antimicrobial or antibiotic preparation is clinically superior to another. The choice of treatment is based on a number of factors, including tympanic membrane status, adverse effect profiles, adherence issues, and cost. Neomycin/polymyxin B/hydrocortisone preparations are a reasonable first-line therapy when the tympanic membrane is intact. Oral antibiotics are reserved for cases in which the infection has spread beyond the ear canal or in patients at risk of a rapidly progressing infection. Chronic otitis externa is often caused by allergies or underlying inflammatory dermatologic conditions, and is treated by addressing the underlying causes.

  14. Malignant external otitis: early scintigraphic detection

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    Strashun, A.M.; Nejatheim, M.; Goldsmith, S.J.

    1984-02-01

    Pseudomonas otitis externa in elderly diabetics may extend aggressively to adjacent bone, cranial nerves, meninges, and vessels, leading to a clinical diagnosis of ''malignant'' external otitis. Early diagnosis is necessary for successful treatment. This study compares the findings of initial radiographs, thin-section tomography of temporal bone, CT scans of head and neck, technetium-99m methylene diphosphonate (MDP) and gallium-67 citrate scintigraphy, and single-photon emission computed tomography (SPECT) for detection of temporal bone osteomylitis in ten patients fulfilling the clinical diagnostic criteria of malignant external otitis. Skull radiographs were negative in all of the eight patients studied. Thin-section tomography was positive in one of the seven patients studied using this modality. CT scanning suggested osteomyelitis in three of nine patients. Both Tc-99m and Ga-67 citrate scintigraphy were positive in 10 of 10 patients. These results suggest that technetium and gallium scintigraphy are more sensitive than radiographs and CT scans for early detection of malignant external otitis.

  15. Acute otitis media and acute bacterial sinusitis.

    Science.gov (United States)

    Wald, Ellen R

    2011-05-01

    Acute otitis media and acute bacterial sinusitis are 2 of the most common indications for antimicrobial agents in children. Together, they are responsible for billions of dollars of health care expenditures. The pathogenesis of the 2 conditions is identical. In the majority of children with each condition, a preceding viral upper respiratory tract infection predisposes to the development of the acute bacterial complication. It has been shown that viral upper respiratory tract infection predisposes to the development of acute otitis media in 37% of cases. Currently, precise microbiologic diagnosis of acute otitis media and acute bacterial sinusitis requires performance of tympanocentesis in the former and sinus aspiration in the latter. The identification of a virus from the nasopharynx in either case does not obviate the need for antimicrobial therapy. Furthermore, nasal and nasopharyngeal swabs are not useful in predicting the results of culture of the middle ear or paranasal sinus. However, it is possible that a combination of information regarding nasopharyngeal colonization with bacteria and infection with specific viruses may inform treatment decisions in the future.

  16. Identificação e susceptibilidade antimicrobiana de microrganismos obtidos de otite externa aguda Identification and antimicrobial susceptibility of acute external otitis microorganisms

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    Janaina Cândida Rodrigues Nogueira

    2008-08-01

    Full Text Available Otite externa aguda é a infecção do conduto auditivo externo, geralmente causada por flora polimicrobiana. OBJETIVO: Isolar, identificar e determinar a susceptibilidade antimicrobiana dos organismos causadores da otite externa (OE. MÉTODO: 27 swabs foram obtidos de 27 orelhas de pacientes portadores de OE para cultura e 22 microrganismos foram isolados para avaliação de susceptibilidade. A susceptibilidade in vitro foi obtida através do método de ágar difusão em disco e os resultados, interpretados de acordo com critérios clínico-laboratoriais padrão. RESULTADOS: 10 culturas positivas para S. aureus, 8 culturas para P.aeruginosa, 5 para P.aeruginosa e S.aureus e 4 para fungos (Candida albicans e C. krusei. Gentamicina e as quinolonas foram ativas contra todas as cepas testadas, havendo resistência significativa contra amoxicilina/clavulanato. As espécies de Candida testadas foram sensíveis à Anfotericina B, nistatina, fluconazol e clotrimazol e resistentes à miconazol. CONCLUSÃO: A otite externa aguda é uma infecção polimicrobiana, e o conhecimento apropriado da etiologia e susceptibilidade dos microrganismos irá contribuir para o uso racional de antibióticos e o sucesso do tratamento.Acute external otitis is a polymicrobial infectious disease. AIM: The purpose of this study was to isolate, identify and determine the Antimicrobial susceptibility of organisms causing otitis externa (OE. METHODS: twenty-seven swabs were taken from the ears of 27 patients with OE for culture and 22 microorganisms were isolate to evaluate sensitivity. In vitro susceptibility tests were performed by agar diffusion disk and results were interpreted according to Clinical Laboratory Standards. RESULTS: 10 Ear cultures were positive for S. aureus , 8 for P. aeruginosa, 5 for P. aeruginosa and S. aureus and 4 for fungal organisms (Candida albicans e C. Krusei. Gentamicin and quinolones were active against all bacteria tested and significant

  17. Importance of viruses in acute otitis media.

    Science.gov (United States)

    Nokso-Koivisto, Johanna; Marom, Tal; Chonmaitree, Tasnee

    2015-02-01

    Acute otitis media occurs as a complication of viral upper respiratory tract infection. Bacterial otopathogens and respiratory viruses interact and play important roles in acute otitis media development. A better understanding of viral and bacterial interactions may lead to innovative ways to lessen the burden of this common childhood disease. There has been increasing evidence that acute otitis media occurs during upper respiratory infection, even in the absence of nasopharyngeal bacterial colonization. Among the types of viruses associated with acute otitis media, respiratory syncytial virus continues to be the most commonly detected. It is still unclear whether viral load plays an important role in acute otitis media development, but symptomatic upper respiratory tract infection (as opposed to asymptomatic viral infection) is crucial. Widespread use of bacterial and viral vaccines in young children, including pneumococcal conjugate and influenza vaccines, has led to the reduction in otitis media-related healthcare use between 2001 and 2011. There has been no new vaccine against respiratory viruses other than influenza. Progress has been made toward the reduction of the burden of acute otitis media in the last decade. Success in reducing acute otitis media incidence will rely mainly on prevention of nasopharyngeal otopathogen colonization, as well as reduction in the incidence of viral upper respiratory tract infection.

  18. Differentiating Acute Otitis Media and Acute Mastoiditis in Hospitalized Children.

    Science.gov (United States)

    Laulajainen-Hongisto, Anu; Aarnisalo, Antti A; Jero, Jussi

    2016-10-01

    Acute otitis media is a common infection in children. Most acute otitis media episodes can be treated at an outpatient setting with antimicrobials, or only expectant observation. Hospital treatment with parenteral medication, and myringotomy or tympanostomy, may be needed to treat those with severe, prolonged symptoms, or with complications. The most common intratemporal complication of acute otitis media is acute mastoiditis. If a child with acute mastoiditis does not respond to this treatment, or if complications develop, further examinations and other surgical procedures, including mastoidectomy, are considered. Since the treatment of complicated acute otitis media and complicated acute mastoiditis differs, it is important to differentiate these two conditions. This article focuses on the differential diagnostics of acute otitis media and acute mastoiditis in children.

  19. Innovative technologies in diagnosing acute otitis media.

    Science.gov (United States)

    Shand, Kate D; Campe, Kristin

    2016-01-01

    New guidelines for managing acute otitis media include stricter criteria for properly diagnosing the condition and ensuring an accurate diagnosis before clinicians make treatment decisions. This is key because of the increase in antibiotic-resistant pathogens. This article focuses on how clinicians can use ancillary techniques and technologies to improve diagnostic accuracy for acute otitis media. Techniques include proper cerumen removal, visualizing the tympanic membrane with the correct otoscope, pneumatic otoscopy, using a spectral gradient acoustic reflectometer, and tympanometry.

  20. Acute otitis media and respiratory virus infections.

    Science.gov (United States)

    Ruuskanen, O; Arola, M; Putto-Laurila, A; Mertsola, J; Meurman, O; Viljanen, M K; Halonen, P

    1989-02-01

    We studied the association of acute otitis media with different respiratory virus infections in a pediatric department on the basis of epidemics between 1980 and 1985. Altogether 4524 cases of acute otitis media were diagnosed. The diagnosis was confirmed by tympanocentesis in 3332 ears. Respiratory virus infection was diagnosed during the same period in 989 patients by detecting viral antigen in nasopharyngeal mucus. There was a significant correlation between acute otitis media and respiratory virus epidemics, especially respiratory syncytial virus epidemics. There was no significant correlation between outbreaks of other respiratory viruses and acute otitis media. Acute otitis media was diagnosed in 57% of respiratory syncytial virus, 35% of influenza A virus, 33% of parainfluenza type 3 virus, 30% of adenovirus, 28% of parainfluenza type 1 virus, 18% of influenza B virus and 10% of parainfluenza type 2 virus infections. These observations show a clear association of respiratory virus infections with acute otitis media. In this study on hospitalized children Haemophilus influenzae strains were the most common bacteriologic pathogens in middle ear fluid, occurring in 19% of cases. Streptococcus pneumoniae was present in 16% and Branhamella catarrhalis in 7% of cases. There was no association between specific viruses and bacteria observed in this study.

  1. Acute otitis media in neonatal life: a review.

    Science.gov (United States)

    Syggelou, A; Fanos, V; Iacovidou, N

    2011-06-01

    Acute otitis media is frequently encountered by general practitioners and pediatricians. In the neonatal period acute otitis media may present as an isolated local infection or as part of septicemia. Diagnosis of the condition by otoscopy is difficult. Considering the wide spectrum of middle ear disorders (acute otitis media, otitis media with effusion, chronic suppurative otitis media) one can appreciate why opinions on the management of the condition are diverse. This is a review of the literature on clinical presentation, etiology, risk factors, treatment and prevention of acute otitis media in neonatal life.

  2. Acute otitis media guidelines: review and update.

    Science.gov (United States)

    Lieberthal, Allan S

    2006-07-01

    In 2004, the Subcommittee on Management of Acute Otitis Media of the American Academy of Pediatrics and American Academy of Family Physicians published evidence-based clinical practice guidelines on the "Diagnosis and Management of Acute Otitis Media." The guidelines included a definition of acute otitis media (AOM) that included three components: 1) a history of acute onset of signs and symptoms; 2) the presence of middle-ear effusion; and 3) signs and symptoms of middle-ear inflammation. An option to observe selected children with AOM for 48 to 72 hours without initial antibiotic therapy was proposed. This option was based on age, severity of illness, and certainty of diagnosis. Despite the changing prevalence of bacterial pathogens and increasing resistance of Streptococcus pneumoniae, amoxicillin remains the first-line antibiotic for initial antibacterial treatment of AOM. The guideline also addresses the management of otalgia, choice of antibiotics after initial treatment failure, and methods for preventing AOM.

  3. Antibiotics for acute otitis media in children.

    Science.gov (United States)

    Nitsche, María Pía; Carreño, Monica

    2015-10-29

    Acute otitis media is one of the most common infectious diseases diagnosed in children. Antibiotic treatment use remains controversial. This summary aims to evaluate the effectiveness and safety of antibiotics in children with acute otitis media. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified six systematic reviews including 18 randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded antibiotics reduce pain at 48-72 hours and reduce the risk of tympanic perforations in children with acute otitis media, but they do not reduce late recurrences and increase the risk of side effects (rash, vomiting and diarrhea).

  4. [Bacterial flora in children with recurrent acute otitis media].

    Science.gov (United States)

    Zielnik-Jurkiewicz, Beata; Kolczyńska, Magdalena

    2005-02-01

    The aim of the study was to identify microorganisms and antimicrobial susceptibilities of pathogens from middle ear in children with recurrent acute otitis media and acute otitis media. The study comprised 83 children--42 with recurrent acute otitis media and 41 with acute otitis emdia classified for paracentesis. Agar, chocolate, blood and Chapman plates were inoculated for isolation of bacteria. The plates were incubated at 37 degrees C and examined at 24 hours. The susceptibility of bacteria was determined by disk diffusion technique containing concentration gradients for following antibiotics: penicillin, amoxicillin/clavulanate, ampicillin/sulbactam, cefaclor, cefprozil, cefuroxime, erythromycin, azithromycin, clinadamycin and trimethoprim/sulfamethoxazole. 217 organisms from middle ear in children with recurrent acute otitis media and 131 organisms from middle ear in children with acute otitis media were isolated. Most frequent cultured bacteria were: Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis--71.4% in recurrent acute otitis media and 47.3% in acute otitis media. We observed statistically significant (p acute otitis media older than 2 years. The best susceptibility was observed to amoxicillin/clavulanate (79.7% of bacteria in children with recurrent acute otitis media and 83.2% of bacteria in children with acute otitis media). The most of organisms presented resistance to trimethoprim/sulfamethoxazole--65.9% of bacteria in children with recurrent acute otitis media and 62.6% of bacteria in children with acute otitis media. Our investigation showed that resistance to bacteria increase in children with recurrent acute otitis media, most frequent appear in children older than 2 years and depend on number of episodes of acute otitis media and day care.

  5. Antibiotics for acute otitis media in children

    NARCIS (Netherlands)

    Venekamp, Roderick P.; Sanders, Sharon L.; Glasziou, Paul P.; Del Mar, Chris B.; Rovers, Maroeska M.

    2015-01-01

    BACKGROUND: Acute otitis media (AOM) is one of the most common diseases in early infancy and childhood. Antibiotic use for AOM varies from 56% in the Netherlands to 95% in the USA, Canada and Australia. This is an update of a Cochrane review first published in The Cochrane Library in Issue 1, 1997 a

  6. [The current views of the treatment of diffuse external otitis].

    Science.gov (United States)

    Fedorova, O V; Shadrin, G B

    2016-01-01

    The objective of the present study was to evaluate the clinical effectiveness and safety of the local application of triderm for the treatment of diffuse external otitis. The study included 68 patients presenting with bacterial and fungal diffuse external otitis. The treatment in the form of local empiric therapy was continued till the results of microbiological treatment became apparent. The beneficial outcome achieved in 91.2% of the patients was clinically manifest as the regression of the inflammatory process in the external auditory meatus. No complications, such as ototoxic events, either local or systemic allergic reactions, were documented. The authors substantiate the possibility of the application of the medication under consideration for the treatment of diffuse external otitis based on the knowledge of the mechanism of the actin of its constituent components, viz. betamethasone, dipropionate, gentamicin sulfate, and clotrimazole, taking into account the occurrence of the most common causative agents of diffuse external otitis. It is concluded that triderm is a safe medication for the local application and, probably, for the initial empiric therapy of diffuse external otitis to be continued till the results of the microbiological treatment become apparent.

  7. Quantitative bone and 67Ga scintigraphy in the differentiation of necrotizing external otitis from severe external otitis

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    Uri, N.; Gips, S.; Front, A.; Meyer, S.W.; Hardoff, R. (Department of Otolaryngology, Lady Davis Carmel Hospital, Haifa (Israel))

    1991-06-01

    Qualitative technetium Tc 99m bone scintigraphy using phosphate compounds and gallium 67 scintigraphy were described as a helpful means in diagnosing necrotizing external otitis (NEO). They were, however, claimed to be nonspecific. Quantitative Tc 99m methylene diphosphonate bone scintigraphy and gallium 67 scintigraphy were performed in eight patients with NEO and in 20 patients with severe external otitis, in order to prove usefulness of scintigraphy in the diagnosis of NEO. Ratios of lesion to nonlesion for bone scintigraphy were 1.67 {plus minus} 0.16 in patients with NEO and 1.08 {plus minus} 0.09 in patients with severe external otitis, and for gallium 67 scintigraphy they were 1.35 {plus minus} 0.24 in NEO patients and 1.05 {plus minus} 0.03 in patients with severe external otitis. There was no difference in uptake between diabetic patients with severe external otitis and nondiabetic patients. The scintigraphic studies were also evaluated using a qualitative scoring method (scores 0 to +4), according to the intensity of the radiopharmaceutical uptake. This method was found to be inferior in the diagnosis of NEO compared with the quantitative method. We conclude that lesion-to-nonlesion ratios greater than 1.5 and 1.3 on bone and gallium 67 scintigraphy, respectively, are indicative of NEO. Quantitative bone scintigraphy, which is quicker to perform, may be used as a single imaging modality for the diagnosis of NEO.

  8. Preliminary results on scintigraphic evaluation of malignant external otitis

    Energy Technology Data Exchange (ETDEWEB)

    Malamitsi, J.; Maragoudakis, P. (Hippocrateion Hospital, Athens (Greece). Dept. of Nuclear Medicine); Papafragou, K.; Koukouliou, V. (Athens Univ. (Greece). Dept. of Medical Physics); Kalatzis, Y.; Adamopoulos, G.; Proukakis, C. (Hippocrateion Hospital, Athens (Greece). ORL Univ. Clinic)

    1993-06-01

    Malignant external otitis (MEO) is a potentially fatal otitis occurring in diabetic and immunosuppressed patients, which may cause cranial nerve palsies and massive thrombophlebitis of the brain. We studied five diabetic patients with the clinical diagnosis of external otitis who were suspected of having MEO and one diabetic patient presumed cured from MEO. All of them underwent methylene diphosphonate, nanocolloid and gallium single-photon emission tomography studies with quantitative analysis on the basis of regions of interest and count profile curves. This combined assessment helped us to diagnose and follow-up soft tissue and temporal bone infection, especially in the case of transsphenoidal extension of the disease, since conventional radiology and computed tomography were of no particular help. On the basis of these results, we consider scintigraphic demonstration of skull base infection as a fourth criterion of MEO given that the classical Chandler's triad (diabetes, granuloma, and Pseudomonas aeruginosa) is not always present. (orig.).

  9. Observation option toolkit for acute otitis media.

    Science.gov (United States)

    Rosenfeld, R M

    2001-04-01

    The observation option for acute otitis media (AOM) refers to deferring antibiotic treatment of selected children for up to 3 days, during which time management is limited to analgesics and symptomatic relief. With appropriate follow-up complications are not increased, and clinical outcomes compare favorably with routine initial antibiotic therapy. Although used commonly in the Netherlands and certain Scandinavian countries, this approach has not gained wide acceptance in Europe and the United States. This article describes an evidence-based toolkit developed by the New York Region Otitis Project for judicious use of the observation option. The toolkit is not intended to endorse the observation option as a preferred method of management, nor is it intended as a rigid practice guideline to supplant clinician judgement. Rather, it presents busy clinicians with the tools needed to implement the observation option in everyday patient care should they so desire.

  10. Treatment of acute otitis media in general practice

    DEFF Research Database (Denmark)

    Plejdrup Hansen, Malene; Jarbol, Dorte Ejg; Gahrn-Hansen, Bente;

    2012-01-01

    Recommendations for antibiotic treatment of acute otitis media (AOM) have changed over the years, and today many experts recommend initial observation. However, antibiotic prescribing should be considered in children aged......Recommendations for antibiotic treatment of acute otitis media (AOM) have changed over the years, and today many experts recommend initial observation. However, antibiotic prescribing should be considered in children aged...

  11. 康复新液治疗急性弥漫性外耳道炎的效疗观察%Clinical Analysis of Acute Diffuse External Otitis with Kangfuxin Liquid

    Institute of Scientific and Technical Information of China (English)

    段中宁; 张书嘉; 关瑞; 李利; 韩加辉; 邹经纬

    2016-01-01

    目的探讨康复新液治疗急性弥漫性外耳道炎的临床效疗。方法选取2014年1月~2016年1月于我科门诊就诊并诊断为急性弥漫性外耳道炎的286例患者为研究对象,按初诊顺序将患者随机分成两组,治疗组146例,用康复新液治疗,对照组140例,用硼酸酒精治疗。治疗1 w后,统计分析两组患者治疗效果。结果治疗组总有效率为86.3%,而对照组为67.9%,两组的总有效率具有统计学差异(<0.05)。结论康复新液治疗急性弥漫性外耳道炎的临床疗效显著。%Objective The study of Kangfuxin Liquid in treatment of acute diffuse external otitis clinical curative effect.Methods January 2014 to 2016 January in our outpatient clinic and diagnosis for acute diffuse otitis externa 286 cases of patients as the research object,according to the order of newly diagnosed,the patients were randomly divided into 2 groups,146 cases of the treatment group,with Kangfuxin Liquid in treatment,140 cases in the control group,with boric acid alcohol treatment.After 1 week of treatment,statistical analysis of two groups of patients with curative effect.Results In the treatment group total effective rate was 86.3%,while the control group was 67.9%,two groups of the total efficiency and the difference is statistically significant(<5).Conclusion The clinical curative effect of Kangfuxin Liquid in treatment of acute diffuse external otitis is significant.

  12. Gradenigo’s syndrome and thrombosis of the cavernous sinus secundary to acute otitis media

    Directory of Open Access Journals (Sweden)

    Hellín-Meseguer D

    2012-05-01

    Full Text Available Gradenigo’s syndrome is characterized by facial pain in the area supplied by the trigeminal nerve and a unilateral external ophthalmoplegia (paralysis of VI cranial nerve secondary to acute apical petrositis for evolutionary complication of otitis media. This is a serious complication that requires immediate treatment to prevent permanent damage and may be associated with other intracranial complications such as thrombosis of the cavernous sinus. We report a 4 year old male who complains of fever, headache and external ocular paralysis in the course of acute otitis media.

  13. [Impact of vaccination on acute otitis media].

    Science.gov (United States)

    Blanchard-Rohner, Geraldine; Gervaix, Alain

    2016-02-17

    Acute otitis media (AOM) is an important reason for medical visits and antibiotic use in children, with possible complications. Pneumococcal conjugate vaccines (PCV) have been developed from 2000, with first the apparition of the 7-valent PCV (PCV7), and from 2013, of the 13-valent PCV (PCV13). First developed to prevent invasive pneumococcal infections, they have been shown to reduce the number of AOM as well. PC13 has allowed to reduce the nasopharyngeal carriage of the majority of pneumococcal serotypes found in AOM, with a reduction of 77% of pneumococcal AOM, according to one study.

  14. A Rare Complication of Acute Otitis Media: Otitic Hydrocephalus

    Directory of Open Access Journals (Sweden)

    Ahmet Mutlu

    2013-06-01

    Full Text Available Acute otitis media is very common disorder in childhood. In this article we present a 6-years old boy who applied with diplopia, dysfunction of lateral eye movements on left eye, nausea, at 10th day of acute otitis media treatment. After the radiological images case was described as an otitic hydrocephalus clinic. Patient underwent medical treatment, lomboperitoneal shunt operation and simple mastoidectomy. We wanted to share the evaluation and the management steps of this very rare complication of acute otitis media.

  15. An evidence-based approach to managing acute otitis media.

    Science.gov (United States)

    Nesbit, Chadd E; Powers, Margaret C

    2013-04-01

    Acute otitis media is one of the most common pediatric illnesses; however, there is considerable controversy in its management. While most cases are treated with antibiotics, there is a growing concern regarding antibiotic overuse and subsequent drug resistance. Researchers in the Netherlands have developed a "watchful waiting" (ie, an observation approach) that has been successful in treating acute otitis media, although it has not gained widespread popularity in the United States. This review will summarize the latest research on diagnosing acute otitis media as well as different treatment regimens, including the efficacy of the watchful-waiting approach.

  16. ADULT ONSET ACUTE OTITIS MEDIA - A PRELIMINARY REPORT

    Directory of Open Access Journals (Sweden)

    Mukta

    2014-05-01

    Full Text Available Acute otitis media is a common disease of children with typical symptomatology & is not infrequent in adults. Literature available on adult acute otitis media is limited. This study has been carried out to assess the presentation, progression & outcome of disease in adults. 90 patients presenting with signs & symptoms consistent with acute otitis media were examined, evaluated & followed up. Earache was the commonest symptom present in 65 patients. Spontaneous perforation was present in 37 patients. Earache, ear discharge & hearing loss are the commonest symptoms in adults & rate of spontaneous perforation is higher compared to children.

  17. Importance of respiratory viruses in acute otitis media.

    Science.gov (United States)

    Heikkinen, Terho; Chonmaitree, Tasnee

    2003-04-01

    Acute otitis media is usually considered a simple bacterial infection that is treated with antibiotics. However, ample evidence derived from studies ranging from animal experiments to extensive clinical trials supports a crucial role for respiratory viruses in the etiology and pathogenesis of acute otitis media. Viral infection of the upper respiratory mucosa initiates the whole cascade of events that finally leads to the development of acute otitis media as a complication. The pathogenesis of acute otitis media involves a complex interplay between viruses, bacteria, and the host's inflammatory response. In a substantial number of children, viruses can be found in the middle-ear fluid either alone or together with bacteria, and recent studies indicate that at least some viruses actively invade the middle ear. Viruses appear to enhance the inflammatory process in the middle ear, and they may significantly impair the resolution of otitis media. Prevention of the predisposing viral infection by vaccination against the major viruses would probably be the most effective way to prevent acute otitis media. Alternatively, early treatment of the viral infection with specific antiviral agents would also be effective in reducing the occurrence of acute otitis media.

  18. Microbial profiling does not differentiate between childhood recurrent acute otitis media and chronic otitis media with effusion

    NARCIS (Netherlands)

    Stol, K.; Verhaegh, S.J.; Graamans, K.; Engel, J.A.M.; Sturm, P.D.J.; Melchers, W.J.G.; Meis, J.F.; Warris, A.; Hays, J.P.; Hermans, P.W.M.

    2013-01-01

    OBJECTIVES: Otitis media (OM) is one of the most frequent diseases of childhood, with a minority of children suffering from recurrent acute otitis media (rAOM) or chronic otitis media with effusion (COME), both of which are associated with significant morbidity. We investigated whether the microbiol

  19. Tympanic membrane changes in experimental acute otitis media and myringotomy

    DEFF Research Database (Denmark)

    Alzbutiene, G.; Hermansson, A.; Caye-Thomasen, P.

    2008-01-01

    OBJECTIVE: The present experimental study explored pathomorphological changes and calcium depositions in the tympanic membrane during experimental acute otitis media caused by nontypeable Haemophilus influenzae in myringotomized and nonmyringotomized ears. MATERIAL AND METHODS: A rat model of exp...

  20. Tympanic membrane changes in experimental acute otitis media and myringotomy

    DEFF Research Database (Denmark)

    Alzbutiene, G.; Hermansson, A.; Caye-Thomasen, P.

    2008-01-01

    OBJECTIVE: The present experimental study explored pathomorphological changes and calcium depositions in the tympanic membrane during experimental acute otitis media caused by nontypeable Haemophilus influenzae in myringotomized and nonmyringotomized ears. MATERIAL AND METHODS: A rat model of exp...

  1. Acute otitis media and respiratory viruses.

    Science.gov (United States)

    Bulut, Yunus; Güven, Mehmet; Otlu, Bariş; Yenişehirli, Gülgün; Aladağ, Ibrahim; Eyibilen, Ahmet; Doğru, Salim

    2007-03-01

    The present study was performed to elucidate the clinical outcome, and etiology of acute otitis media (AOM) in children based on virologic and bacteriologic tests. The study group consisted of 120 children aged 6 to 144 months with AOM. Middle ear fluid (MEF) was tested for viral pathogens by reverse transcriptase polymerase chain reaction (RT-PCR) and for bacteria by gram-staining and culture. Clinical response was assessed on day 2 to 4, 11 to 13, 26 to 28. Respiratory viruses were isolated in 39 patients (32.5%). Respiratory syncytial virus (RSV) (46.5%) was the most common virus identified in MEF samples, followed by human rhinovirus (HRV) (25.6%), human coronavirus (HCV) (11.6%), influenza (IV) type A (9.3%), adenovirus type sub type A (AV) (4%), and parainfluenza (PIV) type -3 (2%) by RT-PCR. In total 69 bacterial species were isolated from 65 (54.8%) of 120 patients. Streptococcus pneumoniae (S. pneumoniae) was the most frequently isolated bacteria. Viral RNA was detected in 31 (56.3%) of 55 bacteria-negative specimens and in 8 (12.3%) of 65 bacteria-positive MEF samples. No significant differences were found between children representing viral infection alone, combined viral and bacterial infection, bacterial infection alone, and neither viral nor bacterial infection, regarding clinical cure, relapse and reinfection rates. A significantly higher rate of secretory otitis media (SOM) was observed in alone or combined RSV infection with S. pneumonia or Haemophilus influenzae (H. influenzae) than in other viruses infection. Conclusion. This study provides information about etiologic agents and diagnosis of AOM in Turkish children. The findings highlight the importance of common respiratory viruses and bacterial pathogens, particularly RSV, HRV, S. pneumoniae and H. influenzae, in predisposing to and causing AOM in children.

  2. Mucormycosis Presenting as Acute Otitis Media

    Directory of Open Access Journals (Sweden)

    M. Mamani

    2013-04-01

    Full Text Available Introduction: Mucormycosis is a rare, fatal infection which mainly affects the patients with diabetes or immunodeficiency. Various clinical forms of the disease include rhinocerebral, pulmonary, cutaneous, gastrointestinal, and disseminated infection. The aim of this study was to report a rare case of mucormycosis involving middle ear. Case Report: A 22-year-old female patient with a history of type 1 diabetes mellitus and end stage of renal disease who were under treatment with insulin and twice a week hemodialysis refered to hospital because of abrupt onset of severe left ear pain, and received oral antibiot-ics. Her symptoms worsened and left facial palsy developed the day after. Myringotomy was done and administration of parenteral antibiotics were begun. Subsequently, she developed left fifth and sixth cranial nerve palsies, followed by fever, unconsciousness, left hemi-facial edema, and serosanguinous discharge from eye and nose. In spite of parenteral antibacterial and antifungal therapy, she developed refractory septic shock and died. Conclusion: Acute otitis media in diabetic patients may be due to mucormycosis. Considering the rapid progression of necrosis and fatality, prompt diagnosis and therapy for mucormycosis is mandatory. (Sci J Hamadan Univ Med Sci 2013; 20 (1:86-90

  3. 77 FR 60126 - Guidance for Industry on Acute Bacterial Otitis Media: Developing Drugs for Treatment; Availability

    Science.gov (United States)

    2012-10-02

    ...; Formerly 2008N-0004] Guidance for Industry on Acute Bacterial Otitis Media: Developing Drugs for Treatment... Administration (FDA) is announcing the availability of a guidance for industry entitled ``Acute Bacterial Otitis... treatment of acute bacterial otitis media (ABOM). This guidance finalizes the revised draft guidance of the...

  4. Children hospitalized due to acute otitis media: how does this condition differ from acute mastoiditis?

    Science.gov (United States)

    Laulajainen-Hongisto, Anu; Saat, Riste; Lempinen, Laura; Aarnisalo, Antti A; Jero, Jussi

    2015-09-01

    To evaluate the clinical picture and microbiological findings of children hospitalized due to acute otitis media and to analyze how it differs from acute mastoiditis. A retrospective review of the medical records of all children (0-16 years) hospitalized due to acute otitis media in the Department of Otorhinolaryngology at the Helsinki University Hospital, between 2003 and 2012. Comparison with previously published data of children with acute mastoiditis (n=56) from the same institute and period of time. The most common pathogens in the children hospitalized due to acute otitis media (n=44) were Streptococcus pneumoniae (18%), Pseudomonas aeruginosa (16%), Streptococcus pyogenes (14%), and Staphylococcus aureus (14%). One of the most common pathogens of out-patient acute otitis media, Haemophilus influenzae, was absent. Otorrhea was common in infections caused by S. pyogenes and otorrhea via tympanostomy tube in infections caused by P. aeruginosa. In children under 2 years-of-age, the most common pathogens were S. pneumoniae (43%), Moraxella catarrhalis (14%), and S. aureus (7%). S. pyogenes and P. aeruginosa were only found in children over 2 years-of-age. Previous health problems, bilateral infections, and facial nerve paresis were more common in children hospitalized due to acute otitis media, compared with acute mastoiditis, but they also demonstrated lower CRP values and shorter duration of hospital stay. The number of performed tympanostomies and mastoidectomies was also comparatively smaller in the children hospitalized due to acute otitis media. S. aureus was more common and S. pneumoniae, especially its resistant strains, was less common in the children hospitalized due to acute otitis media than acute mastoiditis. Acute otitis media requiring hospitalization and acute mastoiditis compose a continuum of complicated acute otitis media that differs from common out-patient acute otitis media. The bacteriology of children hospitalized due to acute otitis media

  5. The transcriptome of a complete episode of acute otitis media.

    Science.gov (United States)

    Hernandez, Michelle; Leichtle, Anke; Pak, Kwang; Webster, Nicholas J; Wasserman, Stephen I; Ryan, Allen F

    2015-04-03

    Otitis media is the most common disease of childhood, and represents an important health challenge to the 10-15% of children who experience chronic/recurrent middle ear infections. The middle ear undergoes extensive modifications during otitis media, potentially involving changes in the expression of many genes. Expression profiling offers an opportunity to discover novel genes and pathways involved in this common childhood disease. The middle ears of 320 WBxB6 F1 hybrid mice were inoculated with non-typeable Haemophilus influenzae (NTHi) or PBS (sham control). Two independent samples were generated for each time point and condition, from initiation of infection to resolution. RNA was profiled on Affymetrix mouse 430 2.0 whole-genome microarrays. Approximately 8% of the sampled transcripts defined the signature of acute NTHi-induced otitis media across time. Hierarchical clustering of signal intensities revealed several temporal gene clusters. Network and pathway enrichment analysis of these clusters identified sets of genes involved in activation of the innate immune response, negative regulation of immune response, changes in epithelial and stromal cell markers, and the recruitment/function of neutrophils and macrophages. We also identified key transcriptional regulators related to events in otitis media, which likely determine the expression of these gene clusters. A list of otitis media susceptibility genes, derived from genome-wide association and candidate gene studies, was significantly enriched during the early induction phase and the middle re-modeling phase of otitis but not in the resolution phase. Our results further indicate that positive versus negative regulation of inflammatory processes occur with highly similar kinetics during otitis media, underscoring the importance of anti-inflammatory responses in controlling pathogenesis. The results characterize the global gene response during otitis media and identify key signaling and transcription factor

  6. Serum Antibody Response to Five Streptococcus pneumoniae Proteins during Acute Otitis Media in Otitis Prone and Non-Otitis Prone Children

    Science.gov (United States)

    Kaur, Ravinder; Casey, Janet R.; Pichichero, Michael E.

    2011-01-01

    Background Streptococcus pneumoniae (Spn) is one of the common bacteria responsible for episodic acute otitis media (AOM; non-otitis prone), recurrent AOM (otitis-prone) and AOM treatment failure (AOMTF) in children. Objective From a population of 268 children we sought to compare the serum IgG antibody titers to five different Spn proteins (PhtD, LytB, PcpA, PhtE and Ply) that are vaccine candidates in children with episodic AOM (n=34), who were otitis prone (n=35), and who had AOMTF (n=25) caused by Spn. Methods Antibody was quantitated by ELISA. Results At their acute AOM visit, anti-PhtD, -LytB, -PhtE and −Ply IgG antibody titers in otitis-prone children were significantly lower compared to non-otitis prone children (p otitis-prone, AOMTF and non-otitis prone children had no significant change in geometric mean IgG antibody titers against the five proteins (except for PhtE in children with AOMTF), but detailed analysis showed that about one-third of the children in each cohort had a 2-fold rise in antibody to the studied antigens. While non-otitis prone children had significant increases (p otitis-prone children either failed to show rises or the rises were significantly less than the non-otitis prone children. Conclusion Otitis-prone and AOMTF children mount less of an IgG serum antibody response than non-otitis prone children to Spn proteins following AOM and nasopharyngeal colonization. PMID:21487325

  7. Clinical practice guideline: acute otitis externa executive summary.

    Science.gov (United States)

    Rosenfeld, Richard M; Schwartz, Seth R; Cannon, C Ron; Roland, Peter S; Simon, Geoffrey R; Kumar, Kaparaboyna Ashok; Huang, William W; Haskell, Helen W; Robertson, Peter J

    2014-02-01

    The American Academy of Otolaryngology--Head and Neck Surgery Foundation (AAO-HNSF) has published a supplement to this issue featuring the updated Clinical Practice Guideline: Acute Otitis Externa, as a supplement to Otolaryngology-Head and Neck Surgery. To assist in implementing the guideline recommendations, this article summarizes the rationale, purpose, and key action statements. The 8 recommendations developed address appropriate diagnosis of acute otitis externa (AOE) and the use of oral and topical antimicrobials and highlight the need for adequate pain relief. An updated guideline is needed due to new clinical trials, new systematic reviews, and the lack of consumer participation in the initial guideline development group.

  8. Variation in Rates of Diagnosis of Acute Otitis Media.

    Science.gov (United States)

    Berwick, Donald M.; Thibodeau, Lawrence A.

    1980-01-01

    Over 13 weeks during two periods in 1978 the diagnostic rate for acute otitis media was monitored among febrile children in the emergency room of a large children's hospital. Temporal variation in diagnostic rates by physicians was largely attributable to differences among individual providers and independent of level of training. (Author/MLW)

  9. Burden and outcome of acute otitis media in rural Bangladesh

    African Journals Online (AJOL)

    changes in the doses of various antibiotic regimens as strategies ... To report on the burden and outcome of episodes of acute otitis media (AOM) based on awareness of AOM and ... AOM is a disease of public health importance in rural children aged under 2 in Bangladesh. ..... of development of antimicrobial resistance.

  10. Detection of human metapneumovirus from children with acute otitis media.

    Science.gov (United States)

    Suzuki, Akira; Watanabe, Oshi; Okamoto, Michiko; Endo, Hiroko; Yano, Hisakazu; Suetake, Mitsuko; Nishimura, Hidekazu

    2005-07-01

    Nasal and middle ear specimens collected from children with acute otitis media were subjected to viral isolation and bacteria culture. All virus-negative specimens underwent reverse transcription polymerase chain reaction to detect human metapneumovirus. Three of 126 middle ear specimens were positive by this assay.

  11. Depletion of mucosal substance P in acute otitis media

    DEFF Research Database (Denmark)

    Cayé-Thomasen, Per; Schmidt, Peter Thelin; Hermansson, Ann

    2004-01-01

    OBJECTIVE: The neuropeptide substance P (SP) is an inducer of neurogenic inflammation and bone resorption in the middle ear. Resorption of the bone tissue structures surrounding the middle ear cavity is a distinct feature of the initial stage of acute otitis media (AOM), which may be due to nerve...

  12. Radionuclide evaluation in malignant external otitis; Avaliacao com radionuclideos da otite externa maligna

    Energy Technology Data Exchange (ETDEWEB)

    Wolosker, Sara; Penha Costa Marques, Marise da [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina; Fonseca, Lea Miriam Barbosa da [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina]|[Hospital Universitario Clementino Fraga Filho, Rio de Janeiro, RJ (Brazil). Servico de Medicina Nuclear

    1996-03-01

    Malignant external otitis (MEO) is a severe infection of the external auditory canal that can result in osteomyelitis of the skull base. Twenty-eight patients with MEO (19 diabetics, 8 with AIDS and 1 with acute mielogenous leukemia) were evaluated using {sup 99m} Tc-MDP bone scintigraphy. {sup 67} Ga citrate and computed tomography (CT) at the time of diagnosis for establishing the MEO extent. {sup 67} Ga scans were obtained periodically in order to assess the evolution of the treatment. {sup 99m} Tc scans had shown high sensitivity and specificity in assessing the bone disease. Serial {sup 67} Ga scans had shown to be valuable indicators of infection remission. CT scans provided poor diagnosis of early bone involvement. (author). 26 refs., 4 figs.

  13. Acute otitis media: characterization and risk factors

    Directory of Open Access Journals (Sweden)

    Amalia Nieves Álvarez

    2011-03-01

    Full Text Available La otitis media aguda es una de las infecciones respiratorias superiores más frecuentes en la infancia, fundamentalmente en niños menores de seis años. Su elevada incidencia y recidiva se deben a la interacción entre diferentes factores de riesgo. El signo más específico de presentación es la otalgia, acompañándose de fiebre, malestar y disminución de la audición.Por la frecuencia de niños con otitis media aguda en las consultas externas y de urgencia del hospital, nos planteamos conocer su comportamiento en el grupo estudiado. Se realizó un estudio descriptivo longitudinal retrospectivo a los pacientes que acudieron a consulta de Otorrinolaringología con otitis media aguda del Hospital Pediátrico Universitario Centro Habana, ubicado en La Habana, en el período comprendido entre enero de 2006 hasta diciembre de 2009. Se caracterizaron los pacientes en cuanto a edad, sexo, factores predisponentes, manifestaciones clínicas, etapa clínica de la otitis, recurrencia y tratamiento. Resultados: El sexo masculino y los menores de cinco años fueron los más afectados. Los factores de riesgo predominantes fueron el tabaquismo pasivo, asistencia a círculos infantiles y lactancia materna insuficiente. Las manifestaciones clínicas más frecuentes fueron los síntomas catarrales, otalgia y fiebre. La otitis media con trasudado fue la etapa clínica más observada. El grupo de edades que mayor recurrencia presentó fue el de uno a cuatro años y la terapia antimicrobiana con amoxicilina fue la más utilizada.

  14. Contemporary concepts in management of acute otitis media in children.

    Science.gov (United States)

    Rettig, Eleni; Tunkel, David E

    2014-10-01

    Acute otitis media (AOM) is a common disease of childhood. AOM is most appropriately diagnosed by careful otoscopy with an understanding of clinical signs and symptoms. The distinction between AOM and chronic otitis media with effusion should be emphasized. Treatment should include pain management, and initial antibiotic treatment should be given to those most likely to benefit, including young children, children with severe symptoms, and those with otorrhea and/or bilateral AOM. Tympanostomy tube placement may be helpful for those who experience frequent episodes of AOM or fail medical therapy. Recent practice guidelines may assist the clinician with such decisions.

  15. Vibrant Soundbridge surgery in patients with severe external otitis: complications of a transcanal approach

    NARCIS (Netherlands)

    Zwartenkot, J.W.; Mulder, J.J.S.; Snik, A.F.M.; Cremers, C.W.R.J.

    2011-01-01

    OBJECTIVE: To evaluate the transcanal surgical implantation of the semi-implantable Vibrant Soundbridge (VSB) device in patients with severe external otitis. STUDY DESIGN: Retrospective analysis. METHODS: Long-term postoperative complications and postoperative hearing thresholds were evaluated in 13

  16. Implementing guidelines for the treatment of acute otitis media.

    Science.gov (United States)

    Barenkamp, Stephen J

    2006-01-01

    The recently published Clinical Practice Guideline for the Diagnosis and Management of Acute Otitis Media represents a sincere effort by the AAP andthe AAFP to provide management guidelines for the practitioner based upon the best scientific evidence available. Despite many years of research and hundreds of clinical studies addressing various aspects of the epidemiology, clinical presentation, and treatment of acute otitis media, important questions remain unaddressed or have been addressed in a less than optimal fashion. These gaps in knowledge and deficiencies in several of the studies that formed the scientific basis for the proposed guidelines are the major reasons behind continued disagreement over certain recommendations. Until more comprehensive and careful analyses can be performed, disagreements are likely to persist. Even so, there is general agreement about most of the recommendations made in these guidelines, and these recommendations will provide a very valuable framework for the practicing physician as he or she cares for children with acute otitis media. To briefly review the major points, first is the critical importance of accurately diagnosing acute otitis media using a combination of clinical findings and observable abnormalities of the tympanic membrane and middle ear space. Particularly important is the differentiation of acute otitis media from otitis media with effusion. Second is the value of treating the pain associated with acute otitis media as a regular component of care, irrespective of any decision concerning antimicrobial treatment. Third is the option, for a select group of older patients with nonsevere disease, of withholding antimicrobial therapy for the first 48 to 72 hours, if close follow-up and active parental involvement can be guaranteed. Fourth is the recommendation that if an antimicrobial agent is used, high-dose amoxicillin (80 to 90 mg/kg/d) is the treatment of choice for most children at the time of initial presentation

  17. Antibiotics for acute otitis media in children

    Directory of Open Access Journals (Sweden)

    María Pía Nitsche

    2015-10-01

    Full Text Available La otitis media aguda es una de las enfermedades infecciosas más comunes diagnosticadas en niños. Con respecto a su tratamiento, el uso de antibióticos sigue siendo controvertido. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos seis revisiones sistemáticas que en conjunto incluyen 18 estudios clínicos aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que los antibióticos disminuyen el dolor a las 48-72 horas y reducen el riesgo de perforación timpánica en niños con otitis media aguda, sin embargo no disminuyen el riesgo de recurrencia tardía y aumentan el riesgo de efectos adversos (rash, vómitos y diarrea.

  18. Acute otitis media with spontaneous tympanic membrane perforation.

    Science.gov (United States)

    Principi, N; Marchisio, P; Rosazza, C; Sciarrabba, C S; Esposito, S

    2017-01-01

    The principal aim of this review is to present the current knowledge regarding acute otitis media (AOM) with spontaneous tympanic membrane perforation (STMP) and to address the question of whether AOM with STMP is a disease with specific characteristics or a severe case of AOM. PubMed was used to search for all studies published over the past 15 years using the key words "acute otitis media" and "othorrea" or "spontaneous tympanic membrane perforation". More than 250 articles were found, but only those published in English and providing data on aspects related to perforation of infectious origin were considered. Early Streptococcus pneumoniae infection due to invasive pneumococcal strains, in addition to coinfections and biofilm production due mainly to non-typeable Haemophilus influenzae, seem to be precursors of STMP. However, it is unclear why some children have several STMP episodes during the first years of life that resolve without complications in adulthood, whereas other children develop chronic suppurative otitis media. Although specific aetiological agents appear to be associated with an increased risk of AOM with STMP, further studies are needed to determine whether AOM with STMP is a distinct disease with specific aetiological, clinical and prognostic characteristics or a more severe case of AOM than the cases that occur without STMP. Finally, it is important to identify preventive methods that are useful not only in otitis-prone children with uncomplicated AOM, but also in children with recurrent AOM and those who experience several episodes with STMP.

  19. Malignant external otitis: long-term (months) antimicrobial therapy

    Energy Technology Data Exchange (ETDEWEB)

    Strauss, M.; Aber, R.C.; Conner, G.H.; Baum, S.

    1982-04-01

    Since Chandler's initial report in 1968 on malignant external otitis (MEO), this entity has been recognized in its earlier stages with increasing frequency. As a result of this, the availability of new antimicrobial agents, and the judicious use of surgery, there has been an improvement in the results of therapy. There remains, however, a subgroup of patients who continue to experience a significant mortality from this infection. A review and selected discussion of our experience with MEO from 1976 to 1979 is presented. Six patients have been diagnosed and successfully treated for MEO. They presented with problems ranging from severe otalgia to multiple cranial neuropathy. For the most part, therapy consisted of the now standard aminoglycoside and carbenicillin combination. Two of the patients were in the high mortality risk group. One of these patients developed an osteomyelitis which extended across the skull base resulting in bilateral cranial neuropathies. His therapy included surgery as well as long-term (months) outpatient treatment with tobramycin and carbenicillin with an excellent result. The second patient was treated similarly. The efficacy of this approach is discussed as well as the usefulness of radionuclide bone scanning in assessing the course and therapy of patients with MEO.

  20. Antibiotics for acute otitis media in children

    OpenAIRE

    María Pía Nitsche; Monica Carreño

    2015-01-01

    La otitis media aguda es una de las enfermedades infecciosas más comunes diagnosticadas en niños. Con respecto a su tratamiento, el uso de antibióticos sigue siendo controvertido. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos seis revisiones sistemáticas que en conjunto incluyen 18 estudios clínicos aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que l...

  1. Cat’s external otitis - diagnose and treatment

    Directory of Open Access Journals (Sweden)

    Degi, J.

    2008-06-01

    Full Text Available Otitis externa is a frequent finding in cats, with a prevalence rate of 2-10 % of all feline patients seen in general practice. Otodectes cyanotis, the ear mite, is responsible for approximately 50% of all feline otitis externa cases. However, other infectious and inflammatory conditions frequently either cause or predispose the cat to ear disease. In 20-30 % of chronic feline ear cases the initiating cause remains unknown.

  2. Acute otitis media | EU Clinical Trials Register [EU Clinical Trials Register

    Lifescience Database Archive (English)

    Full Text Available condition(s) being investigated Acute otitis media MedDRA Classification E.1.3Condition being studied is a ...mation not present in EudraCT E.3Principal inclusion criteria Acute Otitis Media ...jects incapable of giving consent Children age 12 months – 10 years clinically suspected Acute

  3. Serum Antibody Response to Three Non-typeable Haemophilus influenzae Outer Membrane Proteins During Acute Otitis Media and Nasopharyngeal Colonization in Otitis Prone and Non-Otitis Prone Children

    Science.gov (United States)

    Kaur, Ravinder; Casey, Janet R.; Pichichero, Michael E.

    2011-01-01

    Non-typeable Haemophilus influenzae (NTHi) is the most common bacteria responsible for episodic acute otitis media (AOM; non-otitis prone), recurrent AOM (rAOM; otitis prone) and AOM treatment failure (AOMTF) in children. In this 3.5 years of prospective study, we measured the serum antibody response to outer membrane proteins D, P6 and OMP26 of NTHi in children with AOM (n= 26), rAOM (n= 32), AOMTF (n=27). The geometric mean titers (GMTs) of IgG at their acute AOM visit against protein D in otitis prone children were significantly lower compared to AOMTF (p value otitis prone (p value otitis prone children had significantly lower IgG levels to P6 compared to AOMTF children (p value otitis prone children had significantly lower IgG levels to OMP26 compared to AOMTF children (p value otitis prone and AOMTF children had no significant change in total IgG against all the three proteins, while non-otitis prone children had significant increases to protein D. Anti-Protein D, P6 and OMP26 antibody levels measured longitudinally during NP colonization between age 6 and 24 months in 10 otitis prone children and 150 non-otitis prone children showed otitis prone children compared to > 4 fold increases in the non-otitis prone children (p value otitis prone children mount less of an IgG serum antibody response toward Protein D, P6 and OMP26 after AOM which may account for recurrent infections. The data on acute sera of otitis prone versus non-otitis prone children and the acute-to-convalescence response in non-otitis prone children point to a possible link of anti-PD to protection. Moreover, the data suggest that otitis prone children should be evaluated for their responses to Protein D, P6 and OMP26 vaccine antigens of NTHi. PMID:21129398

  4. Acute otitis media: a simple diagnosis, a simple treatment.

    Science.gov (United States)

    Chhetri, S S

    2014-09-01

    To assess the symptoms and signs of acute otitis media and efficiency of simple antibiotics like amoxicillin in its treatment in the primary health care setup. This is a prospective longitudinal study including 204 patients from different institutions. Patients were diagnosed as suffering from acute otitis media when presented with earache, fever, fullness and or otorrhea. Patients were divided into two equal groups on basis of the treatment they received, Group A received only symptomatic treatment while Group B were given Amoxicillin (40 mg/kg/day) for 7 days. Acute otitis media was common in children under 15 years (64.7%). Patients presented with earache (100%), aural fullness (90.68%), fever (76.47%) associated with recent onset of upper respiratory tract infections (88.23%). In group A, improvement was noticed in 28.43% in 3 days while 35.29% in 7 days. In group B, improvement was noticed in 48.03% in day 3 while 86.27% in day 7. In countries where medical care is scarce, patients lost to follow up, it is wise to treat with simple antibiotics like amoxicillin in adequate dose than to treat only symptomatically. It prevents chronicity, early hearing impairments and reduces antibiotic resistance.

  5. Viral-bacterial interactions and risk of acute otitis media complicating upper respiratory tract infection.

    Science.gov (United States)

    Pettigrew, Melinda M; Gent, Janneane F; Pyles, Richard B; Miller, Aaron L; Nokso-Koivisto, Johanna; Chonmaitree, Tasnee

    2011-11-01

    Acute otitis media (AOM) is a common complication of upper respiratory tract infection whose pathogenesis involves both viruses and bacteria. We examined risks of acute otitis media associated with specific combinations of respiratory viruses and acute otitis media bacterial pathogens. Data were from a prospective study of children ages 6 to 36 months and included viral and bacterial culture and quantitative PCR for respiratory syncytial virus (RSV), human bocavirus, and human metapneumovirus. Repeated-measure logistic regression was used to assess the relationship between specific viruses, bacteria, and the risk of acute otitis media complicating upper respiratory tract infection. In unadjusted analyses of data from 194 children, adenovirus, bocavirus, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis were significantly associated with AOM (P virus loads (≥3.16 × 10(7) copies/ml) experienced increased acute otitis media risk. Higher viral loads of bocavirus and metapneumovirus were not significantly associated with acute otitis media. In adjusted models controlling for the presence of key viruses, bacteria, and acute otitis media risk factors, acute otitis media risk was independently associated with high RSV viral load with Streptococcus pneumoniae (odds ratio [OR], 4.40; 95% confidence interval [CI], 1.90 and 10.19) and Haemophilus influenzae (OR, 2.04; 95% CI, 1.38 and 3.02). The risk was higher for the presence of bocavirus and H. influenzae together (OR, 3.61; 95% CI, 1.90 and 6.86). Acute otitis media risk differs by the specific viruses and bacteria involved. Acute otitis media prevention efforts should consider methods for reducing infections caused by respiratory syncytial virus, bocavirus, and adenovirus in addition to acute otitis media bacterial pathogens.

  6. Acute Otitis due to Vibrio fluvialis after Swimming

    Directory of Open Access Journals (Sweden)

    Ping-Jen Chen

    2012-01-01

    Full Text Available A 40-year-old female presented with purulent exudate through the left auditive duct and pain in the left ear region, which intensified during mastication. After collection of the pus from the left ear lesion, amoxicillin-clavulanic acid for seven days was prescribed for a presumed diagnosis of acute otitis. Four days later, the pus culture grew V. fluvialis which is further identified by API 20E identification system (bioMérieux. Following the successful completion of a course of antibiotics, the patient recovered completely and without complication. To the best of our knowledge, this is the first case of Vibrio fluvialis otitis after swimming in an immunocompetent patient.

  7. 76 FR 39883 - Design of Clinical Trials for Systemic Antibacterial Drugs for the Treatment of Acute Otitis...

    Science.gov (United States)

    2011-07-07

    ... for the Treatment of Acute Otitis Media; Public Workshop AGENCY: Food and Drug Administration, HHS... Acute Otitis Media. This public workshop is intended to provide information for and gain perspective... of clinical trials of antibacterial agents for the treatment of acute otitis media (middle ear...

  8. Recurrent acute otitis media detracts from health-related quality of life.

    Science.gov (United States)

    Kujala, T; Alho, O-P; Kristo, A; Uhari, M; Renko, M; Pokka, T; Koivunen, P

    2017-02-01

    Acute otitis media causes discomfort to children and inconvenience to their parents. This study evaluated the quality of life in children with recurrent acute otitis media aged less than 24 months. Quality of life was evaluated in 149 children aged 10 to 24 months who were referred to the Oulu University Hospital on account of recurrent acute otitis media. The children were treated with or without surgery. Age-matched controls were selected randomly from the general child population. Parents completed the Child Health Questionnaire. The children with recurrent acute otitis media had a significantly poorer quality of life than control children. The control children with a history of a few acute otitis media episodes had a significantly poorer quality of life than those without any such history. The quality of life of the children with recurrent acute otitis media improved during the one-year follow up, regardless of the treatment, but did not reach the same level as healthy children. Acute otitis media detracted from quality of life when a generic measure was used. The mode of treatment used to prevent further recurrences of acute otitis media did not influence quality of life improvement.

  9. Herniation of the temporomandibular joint into the external auditory meatus secondary to benign necrotising otitis externa.

    Science.gov (United States)

    Tan, Neil C-W; Wilson, Alan; Buckland, Jonathan

    2009-03-01

    The temporomandibular joint (TMJ) is intimately related to the external auditory meatus (EAM). Herniation of the joint into the EAM occurs secondary to neoplasia, trauma, inflammation and developmental problems [Conover GL, Crammond RJ. Tympanic plate fracture from mandibular trauma. J Oral Maxillofac Surg 1985;43:292-4; Ali TS, Rubinstein JT. Rheumatoid arthritis of the temporomandibular joint with herniation into the external auditory canal. Ann Otol Rhinol Laryngol 2000;109:177-9]. Benign necrotising otitis externa (BNOE) is an uncommon condition characterized by avascular necrosis of the tympanic plate that has been described as a sequela of simple otitis externa. [Wormald PJ. Surgical management of benign necrotizing otitis externa. J Laryngol Otol 1994;108:101-5.] We present a case of BNOE that resulted in a posterior herniation of the TMJ capsule into the EAM.

  10. Ossicular bone modeling in acute otitis media

    DEFF Research Database (Denmark)

    Salomonsen, Rasmus Lysholdt; Hermansson, Ann; Cayé-Thomasen, Per

    2010-01-01

    A number of middle ear diseases are associated with pathologic bone modeling, either formative or resorptive. As such, the pathogenesis of a sclerotic mastoid has been controversial for decades. Experimental studies on acute middle ear infection have shown progressive osteoneogenesis in the bone ...

  11. Ossicular bone modeling in acute otitis media

    DEFF Research Database (Denmark)

    Salomonsen, Rasmus Lysholdt; Hermansson, Ann; Cayé-Thomasen, Per

    2010-01-01

    A number of middle ear diseases are associated with pathologic bone modeling, either formative or resorptive. As such, the pathogenesis of a sclerotic mastoid has been controversial for decades. Experimental studies on acute middle ear infection have shown progressive osteoneogenesis in the bone ...

  12. SPECT imaging in evaluating extent of malignant external otitis: case report

    Energy Technology Data Exchange (ETDEWEB)

    English, R.J.; Tu' Meh, S.S.; Piwnica-Worms, D.; Holman, B.L.

    1987-03-01

    Otitis externa, a benign inflammatory process of the external auditory canal, is general responsive to local therapy. Some patients however, develop a less controllable disease leading to chondritis and osteomyelitis of the base of the skull. The direct invasive characteristic of the disease has led to the descriptive term malignant external otitis (MEO), more appropriately called necrotizing or invasive external otitis. Malignant external otitis is caused by an aggressive pseudomonas or proteus infection that almost exclusively occurs in elderly diabetic patients. The primary imaging modalities previously used in the diagnosis and evaluation of MEO were standard planar scintigraphic techniques with technetium-99M (/sup 99m/Tc) bone agents and gallium-67 (/sup 67/Ga), and pluridirectional tomography. The advent of high resolution computed tomography (CT) effectively allowed demonstration of the soft tissue extension and bone destruction associated with MEO, but still suffered from the low sensitivity constraints of all radiographic techniques in determining early inflammatory bone involvement. Recent work suggests that scintigraphic detection of MEO with /sup 99m/Tc-MDP and /sup 67/Ga, combined with the cross-sectional resolution of single photon emission computed tomography (SPECT) may be of value in planning treatment of this inflammatory condition.

  13. Identification of bacteria causing acute otitis media using Raman microspectroscopy

    Science.gov (United States)

    Ayala, Oscar D.; Wakeman, Catherine A.; Skaar, Eric P.; Mahadevan-Jansen, Anita

    2016-03-01

    Otitis media (OM) is the leading cause of acute physician visits and prescription of antibiotics for children. Current standard techniques to diagnose acute otitis media (AOM) are limited by their ability to probe only changes in symptoms of the bacterial infection that cause AOM. Furthermore, they are not able to detect the presence of or identify bacteria causing AOM, which is important for diagnosis and proper antibiotic treatment. Our goal is to detect the presence of and identify the pathogens involved in causing AOM based on their biochemical profile using Raman spectroscopy (RS). An inVia confocal Raman microscope (Renishaw) at 785 nm was used to detect bacteria causing AOM in vitro. The three main bacteria that cause AOM, Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae were cultured in chocolate agar and Mueller-Hinton agar to determine which agar type would minimize Raman signal from the growth agar. Preliminary results identified specific Raman spectral features characteristic of S. pneumoniae. RS has the potential to accurately diagnose AOM, which will help in identifying the antibiotic that will be most beneficial for the patient and ultimately decrease the course of infection.

  14. Serum antibody response to three non-typeable Haemophilus influenzae outer membrane proteins during acute otitis media and nasopharyngeal colonization in otitis prone and non-otitis prone children.

    Science.gov (United States)

    Kaur, Ravinder; Casey, Janet R; Pichichero, Michael E

    2011-01-29

    Non-typeable Haemophilus influenzae (NTHi) is the most common bacteria responsible for episodic acute otitis media (AOM; non-otitis prone), recurrent AOM (rAOM; otitis prone) and AOM treatment failure (AOMTF) in children. In this 3.5 years of prospective study, we measured the serum antibody response to outer membrane proteins D, P6 and OMP26 of NTHi in children with AOM (n=26), rAOM (n=32), AOMTF (n=27). The geometric mean titers (GMTs) of IgG at their acute AOM visit against Protein D in otitis prone children were significantly lower compared to AOMTF (p value4 fold increases in the non-otitis prone children (p value<0.001). We conclude that otitis prone children mount less of an IgG serum antibody response toward Protein D, P6 and OMP26 after AOM which may account for recurrent infections. The data on acute sera of otitis prone vs non-otitis prone children and the acute-to-convalescence response in non-otitis prone children point to a possible link of anti-PD to protection. Moreover, the data suggest that otitis prone children should be evaluated for their responses to Protein D, P6 and OMP26 vaccine antigens of NTHi.

  15. Rare but numerous serious complications of acute otitis media in a young child.

    Science.gov (United States)

    Van Munster, Mariëtte P E; Brus, Frank; Mul, Dick

    2013-03-12

    Acute otitis media is a very common disease in children. Most children recover with symptomatic therapy like potent analgesics, but occasionally serious complications occur. We present a 3-year-old girl who suffered from acute otitis media for already 2 weeks and presented with fever, abducens nerve palsy of her left eye and vomiting. She was finally diagnosed with an acute otitis media complicated by a mastoiditis, sinus thrombosis, meningitis and cerebellar empyema. Fusobacterium necrophorum was cultured from cerebrospinal fluid. The girl recovered following appropriate antibiotic and anticoagulation treatment.

  16. Nasal nitric oxide in children with recurrent acute otitis media.

    Science.gov (United States)

    Torretta, S; Marchisio, P; Capaccio, P; Pignataro, L

    2016-01-01

    Recently, reduced Nasal nitric oxide (nNO) nNO levels have been reported in children with adenoidal hypertrophy predisposing to chronic nasosinusal inflammation. Given the strict anatomic and physiopathologic link between the nasopharyngeal and middle ear compartments, and considering the high prevalence of otitis prone children among those affected with chronic adenoiditis, we designed a study aimed to test any possible difference in nNO levels between non-allergic children with and without recurrent acute otitis media (RAOM) associated with chronic adenoiditis. The study involved 54 children with RAOM (44.4% males; mean age= 7.5±3.5 years) and 51 children without RAOM (47.4% males; mean age= 7.0±3.8 years). nNO levels were significantly reduced in children with RAOM compared to children without RAOM (676.9±250.7 ppb vs 831.8±320.4 ppb, respectively; p= 0.02). Our results could be related to reduced NO production by the ciliated paranasal, nasopharyngeal and middle ear epithelium and the impaired sinusal ostial and Eustachian tube patency due to chronic inflammation, and seem to confirm the involvement of NO pathway in recurrent upper airway infections related to impaired ciliated respiratory mucosa.

  17. [Changing the therapeutic approach to acute otitis media in children].

    Science.gov (United States)

    Grossman, Zahi; Branski, David

    2004-04-01

    Acute Otitis Media (AOM) is the most common reason for pediatrician's visits and for antibiotic prescription in childhood. A significant rise in bacterial resistance to antibiotic treatment has been detected in recent years. Accordingly, the attitude towards antibiotic treatment for AOM has been re-evaluated. Due to various difficulties in ear examination, physicians overdiagnosis Otitis Media with Effusion (OME) as AOM, leading to unnecessary prescription of antibiotics. The natural history of AOM shows spontaneous improvement without complications. Studies that have examined antibiotic treatment versus placebo in AOM have shown only minimal advantage for the antibiotic therapy in symptom reduction. Critical appraisal of the literature according to Evidence-based Medicine (EBM) criteria has led to several meta-analyses that showed only a minor advantage for antibiotics over placebo in AOM. In the Netherlands, the approach to AOM is that of delayed prescribing: symptomatic therapy is given for the first 24-72 hours and an antibiotic drug is prescribed only if symptoms persist after this initial period. This review examines the difficulties in reaching an accurate diagnosis of AOM and describes the natural history of AOM and evaluates the studies and meta-analyses comparing antibiotics to placebo. The Dutch approach to AOM will be discussed as an option and a recommended basis for reduction in antibiotic prescriptions for AOM.

  18. Pediatric Acute Otitis Media in the Era of Pneumococcal Vaccination.

    Science.gov (United States)

    Tawfik, Kareem O; Ishman, Stacey L; Altaye, Mekibib; Meinzen-Derr, Jareen; Choo, Daniel I

    2017-05-01

    Objectives (1) Describe longitudinal trends in annual prevalence of hospital admission for pediatric acute otitis media (AOM) and complications of AOM (CAOM) since introduction of pneumococcal vaccination in 2000 and (2) describe the longitudinal trend of prevalence of hospital admission for pneumococcal meningitis in children with AOM-related diagnoses in the postvaccination era. Study Design Retrospective analysis of Kids' Inpatient Database from 2000 to 2012. Setting Community, nonrehabilitation hospitals. Subjects and Methods To determine annual prevalence of admission for AOM/CAOM, nationally weighted frequencies of children aged otitis media, acute mastoiditis, suppurative labyrinthitis, and/or acute petrositis were collected. The frequency of coexisting pneumococcal meningitis diagnoses among these patients was also collected. Trend analysis of prevalences of admission for AOM/CAOM and for pneumococcal meningitis occurring in the setting of AOM/CAOM from 2000 to 2012 was performed. Results Between 2000 and 2012, annual prevalence of admission for AOM/CAOM decreased from 3.956 to 2.618 per 100,000 persons ( P < .0001) (relative risk reduction 34%). Declines in admission prevalence were most pronounced in children <1 year of age (from 22.647 to 8.715 per 100,000 persons between 2000 and 2012, P < .0001) and 1 to 2 years of age (from 13.652 to 5.554 per 100,000 persons between 2000 and 2012, P < .0001). For all ages, the admission prevalence for pneumococcal meningitis and concomitant AOM/CAOM decreased (from 1.760 to 0.717 per 1,000,000 persons, P < .0001) over the study period. Conclusions The prevalence of hospital admission for pediatric AOM/CAOM has declined since the advent of pneumococcal vaccination. Admission rates for pneumococcal meningitis with AOM/CAOM have similarly declined.

  19. Synchronous Malignant Otitis Externa and Squamous Cell Carcinoma of the External Auditory Canal

    Directory of Open Access Journals (Sweden)

    R. Y. Chin

    2013-01-01

    Full Text Available Objectives. To discuss the management of a squamous cell carcinoma in the presence of malignant otitis externa. Study Design. We present only the third reported case in the literature of a synchronous tumour with malignant otitis externa in the literature. Methods. A case report and review of malignant otitis externa and squamous cell carcinomas of the external auditory canal are discussed. Results. A 66-year-old female is presented here with a 2-month history of a painful, discharging left ear refractory to standard antibiotic therapy. Computerised tomography, magnetic resonance imaging, technetium 99 m, and gallium citrate Ga67 scans were consistent with malignant otitis externa. Biopsy in the operating theatre revealed a synchronous squamous cell carcinoma of the external auditory canal. Primary resection of the tumour and surrounding tissues was performed with concomitant treatment with intravenous antibiotics. Conclusions. This is only the third case to be reported in the literature and highlights several important diagnostic and management issues of these two rare conditions. Both conditions may present in a similar manner on clinical assessment and radiological investigations. Aggressive management with surgical resection and treatment with appropriate intravenous antibiotics is necessary to give the best chance for cure.

  20. [Acute otitis media: could it be a sentinel indicator of health care?].

    Science.gov (United States)

    Cabrera-Gaytán, David Alejandro; Valle-Alvarado, Gabriel; Krug-Llamas, Ernesto; Grajales-Muñiz, Concepción

    2014-01-01

    Acute otitis media is the most common bacterial disease in children under five years; therefore, is one of the most common causes of pediatric consultation. Our objective was to determine the feasibility to consider this disease as a sentinel factor of medical attention. All the new cases of acute otitis media registered between 2008 and 2011 were collected and analyzed. Proportions, ratios, and incidence rates were determined. Also, the limits for proportions were calculated using mid P exact test. In children under five years, we observed 20 % of the cases of non-suppurative otitis media, and suppurative otitis media in 17 %. The reason for acute respiratory infection in relation to cases of otitis media in children of this age increased from 87:1 in 2008 to 53:1 in 2011. The reason of suppurative otitis media decreased in children under five years, even in 2009, when it was registered the highest number of new cases of acute respiratory infection. It was not feasible to determine if acute otitis media is a sentinel indicator; however, we could monitor medical attention indirectly.

  1. [Cerebral artery infarction presented as an unusual complication of acute middle otitis].

    Science.gov (United States)

    Moscote-Salazar, Luis Rafael; Alcalá-Cerra, Gabriel; Castellar-Leones, Sandra Milena; Gutiérrez-Paternina, Juan José

    2013-01-01

    acute otitis media is a frequent disease in the pediatric age. About 2 % of all cases develop intracranial complications such as meningitis. The cerebral infarction originates meningitis and usually occurs in the venous system. The presence of a cerebral artery infarction secondary to acute otitis media is a rare cause described in the literature. a girl of 12 months who presented a febrile syndrome due to acute otitis media and mental confusion. On physical examination, she appeared sleepy with anisocoria, mydriasis in the right eye and left hemiparesis. The computed tomography examination showed extensive cerebral artery infarction. The patient's parents refused the proposed surgical treatment and the girl died 48 hours later. regardless of the current technological advances, the clinical prognosis of cerebral infarction associated with acute otitis media is bad. The focused neurological signs and progressive clinical deterioration should raise suspicion that antimicrobial therapy is not effective.

  2. Efficacy and safety of cefpodoxime in the treatment of acute otitis media in children

    Directory of Open Access Journals (Sweden)

    Mortada H. El-Shabrawi

    2016-06-01

    Conclusion: Cefpodoxime proxetil is an effective, safe, well-tolerated antimicrobial agent for treatment of acute otitis media in children. It can be considered as an excellent choice for the empirical treatment of bacterial AOM.

  3. Cost effectiveness of pneumococcal conjugate vaccination against acute otitis media in children: a review.

    NARCIS (Netherlands)

    Boonacker, C.W.; Broos, P.H.; Sanders, E.A.; Schilder, A.G.M.; Rovers, M.M.

    2011-01-01

    While pneumococcal conjugate vaccines have shown to be highly effective against invasive pneumococcal disease, their potential effectiveness against acute otitis media (AOM) might become a major economic driver for implementing these vaccines in national immunization programmes. However, the

  4. Viral-bacterial interactions in acute otitis media.

    Science.gov (United States)

    Marom, Tal; Nokso-Koivisto, Johanna; Chonmaitree, Tasnee

    2012-12-01

    Acute otitis media (AOM) is a polymicrobial disease, which usually occurs as a complication of viral upper respiratory tract infection (URI). While respiratory viruses alone may cause viral AOM, they increase the risk of bacterial middle ear infection and worsen clinical outcomes of bacterial AOM. URI viruses alter Eustachian tube (ET) function via decreased mucociliary action, altered mucus secretion and increased expression of inflammatory mediators among other mechanisms. Transient reduction in protective functions of the ET allows colonizing bacteria of the nasopharynx to ascend into the middle ear and cause AOM. Advances in research help us to better understand the host responses to viral URI, the mechanisms of viral-bacterial interactions in the nasopharynx and the development of AOM. In this review, we present current knowledge regarding viral-bacterial interactions in the pathogenesis and clinical course of AOM. We focus on the common respiratory viruses and their established role in AOM.

  5. Dilemmas in primary care: antibiotic treatment of acute otitis media.

    Science.gov (United States)

    True, B L; Helling, D K

    1986-09-01

    Antibiotic treatment of acute otitis media (AOM) accounts for a significant number of all antibiotic prescriptions each year. In the primary care setting, initial antibiotic selection is rarely based on direct evidence, such as cultures of middle ear fluid. Initial antibiotic therapy by the primary care practitioner involves the evaluation and application of information related to prevalence of infecting organisms; in vitro antibiotic spectrum and penetration into middle ear fluid; initial cure rate, relapse and recurrence rates; and antibiotic cost, safety, and convenience. The influence of these factors on the initial antibiotic choice for AOM is reviewed. Several therapeutic dilemmas confronting the prescriber are discussed and a rational approach to initial antibiotic therapy is presented.

  6. Pediatric acute otitis media: the case for delayed antibiotic treatment.

    Science.gov (United States)

    Johnson, Nicholas C; Holger, Joel S

    2007-04-01

    Acute otitis media (AOM) is both a commonly diagnosed condition and a frequent indication for antibiotic use in children. Recent literature suggests that antibiotics are not needed in many children with AOM, as most cases resolve spontaneously without complication. However, a majority of AOM infections in children are still treated with antibiotics. The American Academy of Pediatrics and American Academy of Family Physicians released a guideline for treatment of AOM in children. We review the guideline as well as scientific evidence related to AOM treatment options. We support a set of evidence-based guidelines employing a delayed prescription option for antibiotic therapy in selected children. If used appropriately, these cost-effective guidelines will reduce the amount of antibiotics prescribed, increase parental satisfaction, and may lower rates of antibiotic resistance while producing similar rates of resolution of AOM.

  7. Genetic polymorphisms in immunoresponse genes TNFA, IL6, IL10, and TLR4 are associated with recurrent acute otitis media

    NARCIS (Netherlands)

    Emonts, Marieke; Veenhoven, Reinier H.; Wiertsema, Selma P.; Houwing-Duistermaat, Jeanine J.; Walraven, Vanessa; de Groot, Ronald; Hermans, Peter W. M.; Sanders, Elisabeth A. M.

    2007-01-01

    OBJECTIVE. Cytokines and other inflammatory mediators are involved in the pathogenesis of otitis media. We hypothesized that polymorphisms in inflammatory response genes contribute to the increased susceptibility to acute otitis media in otitis-prone children. PATIENTS AND METHODS. DNA samples from

  8. Genetic polymorphisms in immunoresponse genes TNFA, IL6, IL10, and TLR4 are associated with recurrent acute otitis media.

    NARCIS (Netherlands)

    Emonts, M.; Veenhoven, R.H.; Wiertsema, S.P.; Houwing-Duistermaat, J.J.; Walraven, V.; Groot, R. de; Hermans, P.W.M.; Sanders, E.A.M.

    2007-01-01

    OBJECTIVE: Cytokines and other inflammatory mediators are involved in the pathogenesis of otitis media. We hypothesized that polymorphisms in inflammatory response genes contribute to the increased susceptibility to acute otitis media in otitis-prone children. PATIENTS AND METHODS: DNA samples from

  9. Genetic polymorphisms in immunoresponse genes TNFA, IL6, IL10, and TLR4 are associated with recurrent acute otitis media

    NARCIS (Netherlands)

    Emonts, Marieke; Veenhoven, Reinier H.; Wiertsema, Selma P.; Houwing-Duistermaat, Jeanine J.; Walraven, Vanessa; de Groot, Ronald; Hermans, Peter W. M.; Sanders, Elisabeth A. M.

    2007-01-01

    OBJECTIVE. Cytokines and other inflammatory mediators are involved in the pathogenesis of otitis media. We hypothesized that polymorphisms in inflammatory response genes contribute to the increased susceptibility to acute otitis media in otitis-prone children. PATIENTS AND METHODS. DNA samples from

  10. Genetic polymorphisms in immunoresponse genes TNFA, IL6, IL10, and TLR4 are associated with recurrent acute otitis media.

    NARCIS (Netherlands)

    Emonts, M.; Veenhoven, R.H.; Wiertsema, S.P.; Houwing-Duistermaat, J.J.; Walraven, V.; Groot, R. de; Hermans, P.W.M.; Sanders, E.A.M.

    2007-01-01

    OBJECTIVE: Cytokines and other inflammatory mediators are involved in the pathogenesis of otitis media. We hypothesized that polymorphisms in inflammatory response genes contribute to the increased susceptibility to acute otitis media in otitis-prone children. PATIENTS AND METHODS: DNA samples from

  11. Parents' beliefs and knowledge about the management of acute otitis media: a qualitative study.

    Science.gov (United States)

    Hansen, Malene Plejdrup; Howlett, Janine; Del Mar, Chris; Hoffmann, Tammy C

    2015-07-07

    Acute otitis media is a common reason for antibiotic prescribing, despite strong evidence that antibiotics provide minimal benefit. Studies have demonstrated that patients' (or parents') expectations of antibiotics often influence general practitioners' (GPs) decision to prescribe antibiotics, but few have explored parents' expectations of the management of infections in children, or which factors influence the development of these expectations. This study aimed to explore parents' knowledge and beliefs about the management of acute otitis media in children. Individual semi-structured interviews were conducted with 15 parents of children who had recently presented to their GP with acute otitis media. Parents were recruited at childcare centres or playgroups in Brisbane, Australia. Many parents did not have an accurate understanding of what causes acute otitis media. GPs were primarily consulted for the management of symptoms such as pain and fever. Others specifically wanted reassurance or were concerned about hearing loss. Most parents assumed that antibiotics were the best treatment option. Parents' perceptions about the best treatment were mainly based on their previous experience and the advice of the GP. Pain relief medications, such as paracetamol and non-steroidal anti-inflammatory drugs, were not considered by parents to be sufficient treatment on their own. There is discrepancy between parents' beliefs and expectations of management of acute otitis media and the evidence-based recommendations. This study provides insights into parents' expectations of management of acute otitis media, which may help inform clinicians about perceptions and misperceptions that may be valuable to elicit and discuss.

  12. The role of respiratory syncytial virus and other viral pathogens in acute otitis media.

    Science.gov (United States)

    Klein, B S; Dollete, F R; Yolken, R H

    1982-07-01

    We utilized recently developed enzyme immunoassay techniques to examine the role of selected viruses in the etiology of acute otitis media. Viral pathogens were found in middle ear fluids obtained from 13 (24%) of 53 children with acute otitis media; respiratory syncytial virus accounted for ten of the 13 viral agents identified. In addition, respiratory syncytial viral antigen was found in nasopharyngeal washings obtained from 15 of the 53 children. Seven of these children had RSV identified as the sole middle ear pathogen, whereas six children had otitis caused by Streptococcus pneumoniae as either the sole middle ear pathogen or in combination with RSV. Similarly, all three children with respiratory infections caused by influenza virus had ear infections caused by bacterial pathogens, either alone or in combination with influenza virus. These findings suggest that, in patients with viral respiratory infection, coexisting acute otitis media may be associated with the recovery of either viruses or bacteria from the middle ear exudates.

  13. Prevention of acute otitis media using currently available vaccines.

    Science.gov (United States)

    Principi, Nicola; Baggi, Elena; Esposito, Susanna

    2012-04-01

    Acute otitis media (AOM) is common in infants and children. Although approximately two-thirds of cases are due to bacteria, almost all of the episodes are preceded by upper respiratory viral infection. Several viruses, among which respiratory syncytial virus is the most common, are involved in the determination of AOM. However, a significant number of AOM cases are associated with influenza infection, and influenza viruses are among the most frequently found respiratory viruses in the middle ear fluid during an acute episode of AOM. Consequently, influenza vaccination may have a favorable impact on the incidence and course of AOM. Moreover, as Streptococcus pneumoniae is one of the leading AOM bacterial pathogens and it is well known that influenza virus infection predisposes to pneumococcal infection, there is a further reason to suggest the use of influenza vaccine to reduce the risk of AOM. On the other hand, the administration of pneumococcal conjugate vaccine is considered per se a possible means of reducing the incidence of the disease. However, although a number of studies have measured the impact of both vaccines on AOM, it is still not known whether (and to what extent) they are really effective, nor what impact the more recently licensed vaccines may have. The aim of this review is to examine the clinical impact of vaccinations on AOM.

  14. Failure of antibiotic therapy in acute otitis media.

    Science.gov (United States)

    Babin, Emmanuel; Lemarchand, Vincent; Moreau, Sylvain; Goullet de Rugy, Marc; Valdazo, André; Bequignon, Arnaud

    2003-03-01

    The aim of this retrospective study was to determine the possible causes of failure of antibiotic therapy in children with acute otitis media (AOM). Thirty-nine samples of middle-ear fluid were obtained by myringotomy from 31 children suffering from AOM, unrelieved by antibiotic therapy administered for over 48 hours. The samples were analysed by the usual microbiological techniques, including cultures, tests for beta-lactamase producing strains and the determination of the minimal inhibitory concentration of penicillin for Streptococcus pneumoniae. In 14 samples, no bacterial strains were detected in the cultures of middle-ear fluid; and in two samples the cultures revealed two strains of bacteria. The bacteria most frequently identified were Haemophilus influenzae, found in 11 samples, and Streptococcus pneumoniae, found in seven samples, of which four produced strains with reduced susceptibility to penicillin. The failure of antibiotic therapy in AOM appears to be related to the increased resistance of Haemophilus influenzae and to the reduced susceptibility of Streptococcus pneumoniae to penicillin. Other factors contributing to the failure of antibiotic therapy in AOM may be the viruses or the bacteria that produce multiple pathogens in the middle ear.

  15. [Acute otitis media: do not change the Dutch practice guideline].

    Science.gov (United States)

    Damoiseaux, Roger A M J

    2012-01-01

    Two recent clinical trials have again shown that antibiotics are effective in the management of young children with acute otitis media (AOM). Should this change our reserved attitude towards the use of antibiotics? According to the rules for evidence-based medicine, we cannot ignore the vast body of evidence already existing unless new trials are methodologically better and their results differ from previous trials. This does not seem to be the case. The patient characteristics of these trials are similar to those of a previously published individual patient data meta-analysis. The primary outcome 'symptom scores' reported by Hoberman et al. is also comparable, but Tähtinen et al. may have overestimated the effect of antibiotics. Their primary outcome 'time to treatment failure' does not take later improvement or recovery into account. In both trials, the greatest benefit is related to otoscopic recovery of AOM, which is clinically not the most relevant outcome. For now, there is no reason to adapt the current AOM practice guideline of the Dutch College of General Practitioners.

  16. Occurrence and identification of yeasts in dogs external ear canal with and without otitis

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    Elidiana de Bona

    2012-08-01

    Full Text Available Objective. To analyze the presence of yeast in the external ear canal of 116 dogs with and without a diagnosis of otitis from veterinary clinic in the Chapecó city, Santa Catarina, Brazil, and to examine the secretion of the proteinase in isolates. Materials and methods. Were collected cerumen of conduct hearing of dogs of 16 different races 71% with pendular ear type, 5% of semi-pendular and 24% of the erect type. All dogs were previously evaluated by otoscopy and grouped in dogs with and without otitis. Results. Yeasts were isolated in 44 samples (approximately 36%, where Malassezia pachydermatis was identified in 95% of samples where were observed growth of yeasts. On 20 samples the proteinase enzyme showed strong activity in 31% isolates, were 21% of the dogs with otitis tested showed high proteolytic activity. Conclusions. We observed a variation of strains of M. pachydermatis-producing enzymes. The variation in production of these enzymes is probably more associated with different response to the action of the immune system of the animal in the tissue injury.

  17. Microbiology of acute otitis media in children with tympanostomy tubes : prevalences of bacteria and viruses

    NARCIS (Netherlands)

    Ruohola, Aino; Meurman, Olli; Nikkari, Simo; Skottman, Tuukka; Salmi, Aimo; Waris, Matti; Osterback, Riikka; Eerola, Erkki; Allander, Tobias; Niesters, Hubert; Heikkinen, Terho; Ruuskanen, Olli

    2006-01-01

    BACKGROUND: Bacteria are found in 50%-90% of cases of acute otitis media (AOM) with or without otorrhea, and viruses are found in 20%-49% of cases. However, for at least 15% of patients with AOM, the microbiological etiology is never determined. Our aim was to specify the full etiology of acute

  18. Microbiology of acute otitis media in children with tympanostomy tubes : prevalences of bacteria and viruses

    NARCIS (Netherlands)

    Ruohola, Aino; Meurman, Olli; Nikkari, Simo; Skottman, Tuukka; Salmi, Aimo; Waris, Matti; Osterback, Riikka; Eerola, Erkki; Allander, Tobias; Niesters, Hubert; Heikkinen, Terho; Ruuskanen, Olli

    2006-01-01

    BACKGROUND: Bacteria are found in 50%-90% of cases of acute otitis media (AOM) with or without otorrhea, and viruses are found in 20%-49% of cases. However, for at least 15% of patients with AOM, the microbiological etiology is never determined. Our aim was to specify the full etiology of acute midd

  19. Acute otitis media associated bilateral sudden hearing loss: case report and literature review.

    Science.gov (United States)

    Smith, A; Gutteridge, I; Elliott, D; Cronin, M

    2017-07-01

    Sudden sensorineural hearing loss is a rare otological condition with potential for dire outcomes including permanent hearing loss. Although the majority of cases are deemed idiopathic, bilateral sudden sensorineural hearing loss represents a rare subset typically related to systemic conditions, with higher morbidity and mortality. A controversial association with acute otitis media has been reported, with few bilateral cases published in the literature. A very rare case of bilateral sudden sensorineural hearing loss associated with acute otitis media is described, with a review of the literature. The limited evidence available suggests that acute otitis media with tinnitus and/or bacterial pathology may have an increased risk of sudden sensorineural hearing loss, which is consistent with the case described. Although there is no sufficiently powered published evidence to provide definitive treatment guidelines, the literature reviewed suggests that early myringotomy and antibiotics may greatly improve treatment outcomes.

  20. Parents' beliefs and knowledge about the management of acute otitis media

    DEFF Research Database (Denmark)

    Hansen, Malene Plejdrup; Howlett, Janine; Del Mar, Chris

    2015-01-01

    BACKGROUND: Acute otitis media is a common reason for antibiotic prescribing, despite strong evidence that antibiotics provide minimal benefit. Studies have demonstrated that patients' (or parents') expectations of antibiotics often influence general practitioners' (GPs) decision to prescribe...... antibiotics, but few have explored parents' expectations of the management of infections in children, or which factors influence the development of these expectations. This study aimed to explore parents' knowledge and beliefs about the management of acute otitis media in children. METHODS: Individual semi...... experience and the advice of the GP. Pain relief medications, such as paracetamol and non-steroidal anti-inflammatory drugs, were not considered by parents to be sufficient treatment on their own. CONCLUSION: There is discrepancy between parents' beliefs and expectations of management of acute otitis media...

  1. [Acute otitis media and antibiotics. Evidence-based guidelines for antibiotic therapy?].

    Science.gov (United States)

    Thorøe, J; Lous, J

    1999-09-27

    Antibiotic treatment of acute otitis media is controversial. The questions are when to treat, with which antibiotic, and for how long? Within the last years three reviews attempting to discuss these questions have been published. All three found only a marginal effect of antibiotic treatment. The effect was less earache after the first day. The meta-analyses showed that between eight and 22 children had to be treated before one had any benefit of the treatment. The randomized studies did not find a greater effect of amoxicillin than of penicillin. The marginal effect of antibiotics on acute otitis media supports watchful waiting and individualized care and follow-up. There is a need for well-organized, randomized, placebo-controlled trials including the youngest children and the more severe cases of acute otitis media where the effect of antibiotic treatment may turn out to be most beneficial.

  2. In vitro antifungal susceptibility of Malassezia pachydermatis strains isolated from dogs with chronic and acute otitis externa.

    Science.gov (United States)

    Chiavassa, E; Tizzani, P; Peano, A

    2014-10-01

    Malassezia pachydermatis is a yeast that is frequently involved as a secondary/perpetuating factor in canine otitis externa. Topical therapies with different antifungal agents, mainly azole compounds, are generally successful in controlling the yeast overgrowth, but treatment failure and rapid recurrences are common. This study compared the in vitro antifungal susceptibility of M. pachydermatis isolates obtained from chronic and acute cases of otitis externa. The aim was to assess the possible onset of resistance mechanisms in isolates involved in long-lasting episodes with poor response to treatment. We evaluated the in vitro susceptibility to miconazole (MCZ) and clotrimazole (CTZ) of 42 isolates of M. pachydermatis obtained from dogs with chronic (group A, n = 25) and acute otitis (group B, n = 17), using a modified CLSI M27-A3 microdilution method. All isolates were inhibited by the antifungal agents employed, but Malassezia isolates from group A were significantly associated with higher minimum inhibitory concentration (MIC) values for both agents (Median MIC values: MCZ group A 2 µg/ml, group B 1 µg/ml; CTZ group A 8 µg/ml, group B 4 µg/ml). These findings prove that these isolates had a reduced in vitro susceptibility to the antifungal agents tested. However, it is unlikely that this could have any influence on the outcome of a topical treatment. Indeed, marketed products include concentrations of the tested agents that largely exceed even the highest MICs found in this study (in most cases at least 1,000 × the MIC, or greater). In conclusion, this study suggests that isolates of M. pachydermatis involved in chronic cases of canine external otitis and exposed to repeated antifungal treatments are unlikely to develop mechanisms of resistance of clinical relevance.

  3. Optical-fiber-coupled inferometric measurement of tympanic membrane temperature: a new diagnostic tool for acute otitis media

    Science.gov (United States)

    DeRowe, Ari; Ophir, Eyal; Sade, Sharon; Fishman, Gadi; Ophir, Dov; Grankin, Mila; Katzir, Abraham

    1998-07-01

    A novel infrared (IR) transparent optical fiber coupled to a hand held otoscope and a radiometer was constructed and used to measure the temperatures of the tympanic membrane (TM) and to distinguish between diseased and healthy middle ears. A greater temperature difference between TM readings was found when Acute Otitis Media (AOM) existed in one of the ears examined. This supports the hypothesis that acute inflammation of the middle ear will result in elevated local temperature when measured in such a way that the reading is taken only from the TM without interference of the external canal. The use of an optical fiber enabled temperature measurements of the TM with high spatial resolution eliminating the external ear canal interference. A small patient population was examined and the initial results were statistically significant. In the hands of the primary care physician, this tool would prevent misdiagnosis of AOM preventing indiscriminate use of antibiotics and avoiding complications by early diagnosis.

  4. Mycological investigation in patients with acute otitis media

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    O. J. Akinjogunla

    2012-07-01

    Full Text Available Middle ear swabbed samples from 272 patients with acute otitis media (AOM attending Ear, Nose and Throat clinics were collected and cultured using standard mycological technique. Deoxyribonuclease and In-vitro susceptibility of the fungal isolates to Flucytosine (Flu, Nystatin (Nys, Voriconazole (Vor and Ketoconazole (Ket were evaluated using DNase agar and disc diffusion techniques, respectively. The results showed the highest prevalence of AOM in age group ≤ 10 years with 84 (30.9% cases and lowest prevalence in age group ≥ 61 having 12 (4.4% cases. Only 124 (45.6% samples showed positive growth, while 148 (54.4% showed no growth. Of the 124 samples with growth, 9(36.4% samples showed growth of single fungal isolate, while 18 (6.6% and 7 (2.6% showed growth of two and three fungal isolates, respectively. Aspergillus niger was the predominant fungal isolate, followed by Candida albicans with 38 (24.4%, Cryptococcus neoformans 32 (20.5%, Candida spp 21 (13.5% and Aspergillus flavus 14 (9.0%. Only 46 (29.5% of fungal isolates were deoxyribonuclease producers, with 30/38 (78.9% being C. albicans and 16/21 (76.2% being Candida spp. The results of antifungal susceptibility showed that between 65.8 to 71.1% C. albicans, 64.3 to 85.7% A. flavus, 64.7 to 78.4% A. niger, 53.1 to 75.0% C. neoformans, and 52.4 to 57.1% Candida spp. were sensitive to Ket, Vor and Flu, while between 81.6-84.4% of C. albicans and C. neoformans were sensitive to Nys. In overall, 72.4%, 76.3%, 67.9% and 62.2% of the fungal isolates were sensitive to Flu, Nys, Vor and Ket, respectively. Consequently, Nystatin will be highly effective in treating AOM caused by fungi.

  5. The diagnosis and management of acute otitis media.

    Science.gov (United States)

    Lieberthal, Allan S; Carroll, Aaron E; Chonmaitree, Tasnee; Ganiats, Theodore G; Hoberman, Alejandro; Jackson, Mary Anne; Joffe, Mark D; Miller, Donald T; Rosenfeld, Richard M; Sevilla, Xavier D; Schwartz, Richard H; Thomas, Pauline A; Tunkel, David E

    2013-03-01

    This evidence-based clinical practice guideline is a revision of the 2004 acute otitis media (AOM) guideline from the American Academy of Pediatrics (AAP) and American Academy of Family Physicians. It provides recommendations to primary care clinicians for the management of children from 6 months through 12 years of age with uncomplicated AOM. In 2009, the AAP convened a committee composed of primary care physicians and experts in the fields of pediatrics, family practice, otolaryngology, epidemiology, infectious disease, emergency medicine, and guideline methodology. The subcommittee partnered with the Agency for Healthcare Research and Quality and the Southern California Evidence-Based Practice Center to develop a comprehensive review of the new literature related to AOM since the initial evidence report of 2000. The resulting evidence report and other sources of data were used to formulate the practice guideline recommendations. The focus of this practice guideline is the appropriate diagnosis and initial treatment of a child presenting with AOM. The guideline provides a specific, stringent definition of AOM. It addresses pain management, initial observation versus antibiotic treatment, appropriate choices of antibiotic agents, and preventive measures. It also addresses recurrent AOM, which was not included in the 2004 guideline. Decisions were made on the basis of a systematic grading of the quality of evidence and benefit-harm relationships. The practice guideline underwent comprehensive peer review before formal approval by the AAP. This clinical practice guideline is not intended as a sole source of guidance in the management of children with AOM. Rather, it is intended to assist primary care clinicians by providing a framework for clinical decision-making. It is not intended to replace clinical judgment or establish a protocol for all children with this condition. These recommendations may not provide the only appropriate approach to the management of this

  6. Concordance between otic cytology and culture in diagnosis of external otitis canine by Malassezia spp

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    Adriana Pulido-Villamarín

    2015-09-01

    Full Text Available Objective. To determine the correlation between microbiological culture and otic cytology for diagnoses of external otitis by Malassezia in dogs. Materials and methods. 158 ear swabs of dogs with clinical diagnosis of external otitis were analyzed by cytology, mycological culture and metabolic tests. Results. Were obtained a positive results by cytology of 62% and 75.3% by culture. The 31.1% of isolates were identified as M. pachydermatis, 12.6% as M. furfur and 56.3% were classified as Malassezia spp., because was not possible to define the species. We found a positive concordance between cytology and culture for Malassezia spp., of 0.76 with a kappa index of 0.448 (95% CI 0.30 to 0.60 which represents a moderate strength of concordance between the two techniques, without regard the identified species. Conclusions. The use of a diagnostic test is not enough to establish the participation of Malassezia spp., as a causal disease agent.

  7. Presence of human herpesviruses in young children with acute otitis media.

    Science.gov (United States)

    Shinogami, Masanobu; Ishibashi, Toshio

    2004-02-01

    Some herpesviruses have been detected in middle ear fluid (MEF) of patients with acute otitis media (AOM), but their role in middle ear disease is unknown. We examined 73 middle ear fluid samples from 73 children with acute otitis media for the presence of four major herpesviral DNA, respiratory viral genomes, and bacterial DNA by multiplex polymerase chain reaction (PCR). Herpesviruses were detected in 16 specimens (22%), with 18 viral infections were identified overall. Respiratory viruses were detected in 35 specimens (48%), 39 viral infections overall. Bacterial DNA was detected in 51 specimens (70%), 60 bacterial infections overall. Clinical outcome was compared in patients with and without herpesvirus DNA, respiratory viral genomes, or bacterial DNA. Progression to otitis media with effusion (OME) was more common when herpesviral DNA was present. Presence of herpesvirus DNA may reflect an immunocompromised state that may make it difficult to eliminate bacteria from the middle ear after infection.

  8. Update on Otitis Media in Children.

    Science.gov (United States)

    Schoem, Scott R.

    1997-01-01

    This article discusses otitis media in children. It addresses risk factors for otitis media, pathogenesis, diagnosis, bacteria causing otitis media, and treatment for acute otitis media, recurrent acute otitis media, and persistent otitis media with effusion, including antibiotics, steroids, allergy control, autoinflation, mechanical ventilation,…

  9. ACUTE OTITIS EXTERNA AS SEEN AT THE UNIVERSITY OF NIGERIA TEACHING HOSPITAL, ENUGU.

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    Francis A Ibiam

    2013-03-01

    Full Text Available Aim: is to evaluate clinical features of AOE diagnosed in and to update the previous study from our facility.Methods: A prospective, clinical and laboratory study in a tertiary health facilityResults: A total of 3793 consecutive patients that attended the otorhinolaryngology clinics of the university of Nigeria teaching hospital Enugu during the period under study were assessed for clinical diagnosis of otitis externa. A total of 155 ears from127 patients were diagnosed clinically and confirmed by microbial studies as having acute otitis externa. There were 66 males and 61 females out of the 127 patients seen.71 ears had only bacteria isolated from the culture of their ear swab specimens, 28 fungus only and, 32 ears had both bacterial and fungal isolates while 24 ears had no isolates of microbes of the 3793 patients assessed.Conclusions: Acute otitis externa is a common disease in Enugu with no gender bias and there were three times more cases of bacterial otitis externa than fungal otitis externa.

  10. Streptococcus salivarius 24SMB administered by nasal spray for the prevention of acute otitis media in otitis-prone children.

    Science.gov (United States)

    Marchisio, P; Santagati, M; Scillato, M; Baggi, E; Fattizzo, M; Rosazza, C; Stefani, S; Esposito, S; Principi, N

    2015-12-01

    This paper reports the results of the first study in which Streptococcus salivarius 24SMB, a safe α-haemolytic strain capable of producing bacteriocin-like substances with significant activity against acute otitis media (AOM) pathogens, was intranasally administered in an attempt to reduce the risk of new episodes of AOM in otitis-prone children. In this prospective, randomized, double-blind, placebo-controlled study, 100 children aged 1-5 years with histories of recurrent AOM were randomized 1:1 to receive an intranasal S. salivarius 24SMB or placebo twice daily for 5 days each month for 3 consecutive months. Fifty treated children and 47 who received placebo who were compliant with study protocol were followed monthly for 6 months. The number of children who did not experience any AOM was higher among the children treated with the S. salivarius 24SMB preparation than among those in the placebo group (30.0 vs 14.9%; p = 0.076). Moreover, the number of children who received antibiotics during the study period was lower among the children treated with S. salivarius 24 SMB than among those who received placebo (70 vs 83.0%; p = 0.13). Compared with the children who were not colonized by S. salivarius 24SMB after treatment, the number of colonized children who experienced any AOM was significantly lower (42.8 vs 13.6%; p = 0.03). Similar results were observed when the children treated with antibiotics for AOM were analysed (67.8 vs 95.5%; p = 0.029). This study revealed the ability of intranasally administered S. salivarius 24SMB to reduce the risk of AOM in otitis-prone children.

  11. Toward an Improved Scale for Assessing Symptom Severity in Children With Acute Otitis Media.

    Science.gov (United States)

    Shaikh, Nader; Hoberman, Alejandro; Rockette, Howard E; Kurs-Lasky, Marcia; Paradise, Jack L

    2015-12-01

    The objective of the present study was to determine whether changes in the previously developed 7-item Acute Otitis Media Severity of Symptoms scale could improve its responsiveness and its longitudinal construct validity. The items "diminished activity" and "diminished appetite" had low or borderline levels of responsiveness and longitudinal construct validity. Dropping these items seems to be potentially advantageous.

  12. High-Dose Amoxicillin with Clavulanate for the Treatment of Acute Otitis Media in Children

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    Chia-Huei Chu

    2014-01-01

    Full Text Available Objective. This study uses the acute otitis media clinical practice guideline proposed in 2004 as a reference to evaluate whether antibiotics doses that are in line with the recommendations lead to better prognosis. The study also attempts to clarify possible factors that influence the outcome. Study Design. Retrospective cohort study. Subjects and Methods. A total of 400 children with acute otitis media were enrolled. The dosage of amoxicillin was considered to be appropriate when in accord with clinical practice guidelines, that is, 80–90 mg/kg/day. The outcome was defined according to the description of tympanic membrane on medical records. Multivariate logistic regression was used to analyze the relationship between antibiotic dosage and prognosis after adjusting for baseline factors. Results. The majority of prescriptions were under dosage (89.1% but it was not noticeably associated with outcome (P= 0.41. The correlation between under dosage and poor prognosis was significant in children below 20 kg with bilateral acute otitis media (odds ratio 1.63; 95% CI 1.02–2.59, P=0.04. Conclusion. Treating acute otitis media in children, high-dose amoxicillin with clavulanate as recommended in the clinical practice guideline was superior to conventional doses only in children under 20 kg with bilateral diseases.

  13. Intratemporal and intracranial complications of acute suppurative otitis media in children : renewed interest

    NARCIS (Netherlands)

    Dhooge, IJM; Albers, FWJ; Van Cauwenberge, PB

    1999-01-01

    In recent years, a rise in the incidence of intratemporal and intracranial complications of acute otitis media (AOM) has been mentioned in the literature. Lack of a well-developed immune system and difficulties in diagnosing AOM, can account for part of the rise in the incidence of complications of

  14. Active middle ear implantation for patients with sensorineural hearing loss and external otitis: long-term outcome in patient satisfaction

    NARCIS (Netherlands)

    Zwartenkot, J.W.; Hashemi, J.; Cremers, C.W.R.J.; Mulder, J.J.S.; Snik, A.F.M.

    2013-01-01

    OBJECTIVE: To study long-term subjective benefit of patients with sensorineural hearing loss and chronic external otitis who use active middle ear implants. DESIGN: Single-subject repeated measures in a preintervention and postintervention design with multiple postintervention measurements (question

  15. [Nasopharyngeal and middle ear flora in children with acute otitis media].

    Science.gov (United States)

    Zielnik-Jurkiewicz, Beata; Kolczyńska, Magdalena

    2005-01-01

    Nasopharyngeal flora can be a reservoir of bacteria caused acute otitis media in children. The aim of the study was to identify microorganisms and antimicrobial susceptibilities of pathogens from the nasopharynx and middle ear of children with acute otitis media. The study comprised 128 children ages 1 year to 14 years with diagnosed of acute otitis media with purulent discharge. The nasopharyngeal and middle ear samples were collected at the same time. Agar, chocolate, blood and Chapman plates were inoculated for isolation of bacteria. The plates were incubated at 37 degrees C and examined at 24 hours. The susceptibility of bacteria was determined by disk diffusion technique containing concentration gradients for following antibiotics: penicillin, amoxicillin/clavulanate, ampicillin/sulbactam, cefaclor, cefprozil, cefuroxime, erythromycin, azithromycin, clindamycin and trimethoprim/sulfamethoxazole. 196 organisms from nasopharynx and 325 organisms from middle ear were isolated. Most frequent cultured bacteria were: Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis--75.6% in nasopharynx and 77.8% in middle ear. We observed statistically significant (p bacteria from nasopharynx and 81.8% of bacteria from middle ear. Most organisms were resistant to trimethoprim/sulfamethoxazole--60.7% of bacteria from nasopharynx and 62.6% of bacteria from middle ear. Penicillin resistance was observed in 25.0% of bacteria from nasopharynx and 25.6% of bacteria from middle ear. The correlation in resistance of bacteria between trimethoprim/sulfamethoxazole and erythromycin (r = 0.4886) and between trimethoprim/sulfamethoxazole and penicillin (r = 0.5027) was observed. Nasopharyngeal and middle ear flora in children with acute otitis media is similar. In that case susceptibility of bacteria from the nasopharynx can be useful for empirical treatment of acute otitis media in children.

  16. Aspergillus spp. invasive external otitis: favourable outcome with a medical approach.

    Science.gov (United States)

    Marchionni, E; Parize, P; Lefevre, A; Vironneau, P; Bougnoux, M E; Poiree, S; Coignard-Biehler, H; DeWolf, S E; Amazzough, K; Barchiesi, F; Jullien, V; Alanio, A; Garcia-Hermoso, D; Wassef, M; Kania, R; Lortholary, O; Lanternier, F

    2016-05-01

    Aspergillus spp. invasive external otitis (IEO) is a rare infection. We performed a seven-year, single-centre retrospective study from 2007 to 2014 including all patients with proven Aspergillus spp. IEO. Twelve patients were identified. All patients had a poorly controlled diabetes mellitus and one underwent solid organ transplant. The most frequently isolated species was Aspergillus flavus (n = 10) and voriconazole was the first-line therapy in all cases, with a median length of treatment of 338.5 days (158-804 days). None of the patients underwent extensive surgery. The clinical outcome was excellent. However, otological sequelae were reported, including hearing impairment (n = 7) and facial palsy (n = 3).

  17. Viral-bacterial co-infection in Australian Indigenous children with acute otitis media

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    Whiley David

    2011-06-01

    Full Text Available Abstract Background Acute otitis media with perforation (AOMwiP affects 40% of remote Indigenous children during the first 18 months of life. Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis are the primary bacterial pathogens of otitis media and their loads predict clinical ear state. Our hypothesis is that antecedent respiratory viral infection increases bacterial density and progression to perforation. Methods A total of 366 nasopharyngeal swabs from 114 Indigenous children were retrospectively examined. A panel of 17 respiratory viruses was screened by PCR, and densities of S. pneumoniae, H. influenzae and M. catarrhalis were estimated by quantitative real time PCR. Data are reported by clinical ear state. Results M. catarrhalis (96%, H. influenzae (91%, S. pneumoniae (89% and respiratory viruses (59% were common; including rhinovirus (HRV (38%, polyomavirus (HPyV (14%, adenovirus (HAdV (13%, bocavirus (HBoV (8% and coronavirus (HCoV (4%. Geometric mean bacterial loads were significantly higher in children with acute otitis media (AOM compared to children without evidence of otitis media. Children infected with HAdV were 3 times more likely (p Conclusion This study confirms a positive association between nasopharyngeal bacterial load and clinical ear state, exacerbated by respiratory viruses, in Indigenous children. HAdV was independently associated with acute ear states.

  18. Anti-inflammatory and anti-oxidative effects of alpha-lipoic acid in experimentally induced acute otitis media.

    Science.gov (United States)

    Tatar, A; Korkmaz, M; Yayla, M; Gozeler, M S; Mutlu, V; Halici, Z; Uslu, H; Korkmaz, H; Selli, J

    2016-07-01

    To investigate the anti-inflammatory, anti-oxidative and tissue protective effects, as well as the potential therapeutic role, of alpha-lipoic acid in experimentally induced acute otitis media. Twenty-five guinea pigs were assigned to one of five groups: a control (non-otitis) group, and otitis-induced groups treated with saline, penicillin G, alpha-lipoic acid, or alpha-lipoic acid plus penicillin G. Tissue samples were histologically analysed, and oxidative parameters in tissue samples were measured and compared between groups. The epithelial integrity was better preserved, and histological signs of inflammation and secretory metaplasia were decreased, in all groups compared to the saline treated otitis group. In the alpha-lipoic acid plus penicillin G treated otitis group, epithelial integrity was well preserved and histological findings of inflammation were significantly decreased compared to the saline, penicillin G and alpha-lipoic acid treated otitis groups. The most favourable oxidative parameters were observed in the control group, followed by the alpha-lipoic acid plus penicillin G treated otitis group. Alpha-lipoic acid, with its antioxidant, anti-inflammatory and tissue protective properties, may decrease the clinical sequelae and morbidity associated with acute otitis media.

  19. First report of a Staphylococcus caprae isolated from middle ear fluid of an infant with recurrent acute otitis media

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    Elżbieta Mazur

    2017-09-01

    Full Text Available Staphylococcus caprae was originally isolated from goat milk. This uncommon coagulase-negative staphylococcus, usually associated with animals, has only infrequently been detected in human clinical specimens. Its association with acute otitis media has not been demonstrated so far. The study reports the first isolation of S. caprae from the middle ear fluid of a 12-month-old infant with recurrent, bilateral acute otitis media. Biochemical traits and susceptibility pattern of the isolated strain are also presented

  20. Middle ear infection (otitis media) (image)

    Science.gov (United States)

    Otitis media is an inflammation or infection of the middle ear. Acute otitis media (acute ear infection) occurs when there is ... which causes production of fluid or pus. Chronic otitis media occurs when the eustachian tube becomes blocked ...

  1. The effects of ventilation tubes versus no ventilation tubes for recurrent acute otitis media or chronic otitis media with effusion in 9 to 36 month old Greenlandic children, the SIUTIT trial

    DEFF Research Database (Denmark)

    Demant, Malene Nøhr; Jensen, Ramon Gordon; Jakobsen, Janus Christian

    2017-01-01

    BACKGROUND: The prevalence of otitis media in Greenlandic children is one of the highest in the world. International studies have shown that otitis-prone children may benefit from tubulation of the tympanic membrane. However, it is unknown whether these results can be applied to Greenlandic......) in Greenlandic children aged 9-36 months with chronic otitis media with effusion or recurrent acute otitis media. With randomization stratified by otitis media subtype and trial site, a type 1 error of 5% and a power of 80%, a total of 230 participants are needed to detect a decrease of two visits to a health...... clinic during 2 years, which is considered the minimal clinical relevant difference. The primary outcome measure will be assessed blindly by investigating medical records. Secondary outcome measures are number of episodes of acute otitis media, quality of life, number of episodes of antibiotics...

  2. Initial impact of the acute otitis externa clinical practice guideline on clinical care.

    Science.gov (United States)

    Bhattacharyya, Neil; Kepnes, Lynn J

    2011-09-01

    Objectives. Determine the influence of the acute otitis externa clinical practice guideline on clinical care. Study Design. Cross-sectional study with historical controls. Setting. Outpatient departments in the United States. Methods. Cases of acute otitis externa occurring in 2004-2005 (before guideline publication) and 2007-2008 (after guideline publication) were extracted from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Care Survey. Prescribing rates for ototopical medications, analgesic recommendations, and oral antibiotics were determined and compared before and after guideline publication and relative to guideline recommendations. Results. An estimated 5.50 (standard error of the estimated mean, 0.38) million visits (mean age, 27.7 [1.7] years; 49.8% male) with a primary and singular coded diagnosis of acute otitis externa were studied (2.64 [0.26] million visits for 2004-2005 and 2.86 [0.28] million visits for 2007-2008). Prescribing rates for ototopical preparations were 67.2% (5.3%) and 67.6% (5.0%) before and after guideline publication, respectively (P = .955). Recommendation rates for analgesics were 14.2% (3.3%) and 20.6% (3.9%), respectively (P = .248). Prescription rates for oral antibiotics were 21.7% (4.8%) and 30.5% (3.6%), before and after, respectively (P = .166). Conclusion. Clinician behavior in the medical treatment of acute otitis externa has not significantly changed after guideline publication, despite clear, evidence-based guideline recommendations. These data have important implications for performance measures based on the guideline. Further efforts toward guideline dissemination are likely needed.

  3. Moraxella catarrhalis Might Be More Common than Expected in Acute Otitis Media in Young Finnish Children.

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    Sillanpää, Saara; Oikarinen, Sami; Sipilä, Markku; Kramna, Lenka; Rautiainen, Markus; Huhtala, Heini; Aittoniemi, Janne; Laranne, Jussi; Hyöty, Heikki; Cinek, Ondrej

    2016-09-01

    According to studies based on bacterial cultures of middle ear fluids, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis have been the most common pathogens in acute otitis media. However, bacterial culture can be affected by reduced viability or suboptimal growth of bacteria. PCR detects bacterial DNA from samples with greater sensitivity than culture. In the present study, we analyzed the middle ear pathogens with both conventional culture and semiquantitative real-time PCR in 90 middle ear fluid samples obtained from children aged 5 to 42 months during acute otitis media episodes. Samples were tested for the presence of S. pneumoniae, H. influenzae, M. catarrhalis, Alloiococcus otitidis, Staphylococcus aureus, and Pseudomonas aeruginosa One or more bacterial pathogens were detected in 42 (47%) samples with culture and in 69 (77%) samples with PCR. According to PCR analysis, M. catarrhalis results were positive in 42 (47%) samples, H. influenzae in 30 (33%), S. pneumoniae in 27 (30%), A. otitidis in 6 (6.7%), S. aureus in 5 (5.6%), and P. aeruginosa in 1 (1.1%). Multibacterial etiology was seen in 34 (38%) samples, and M. catarrhalis was detected in most (85%) of those cases. Fifteen signals for M. catarrhalis were strong, suggesting a highly probable etiological role of the pathogen. In conclusion, even though M. catarrhalis is often a part of mixed flora in acute otitis media, a considerable proportion of cases may be primarily attributable to this pathogen.

  4. [The clinical picture and specific microbiological features of acute otitis media].

    Science.gov (United States)

    Kryukov, A I; Kunel'skaya, N L; Gurov, A B; Elchueva, Z G; Sokolov, S S

    2015-01-01

    The objective of the present work was to study the spectrum of bacterial pathogenic agents responsible for the development of acute otitis media under present conditions and to elucidate the relationship between the pathogen species and the clinical course of the inflammatory process in the middle ear. A total of 60 patients of either sex at the age varying from 18 to 64 patients were available for the examination. All of them complained of ear pain, purulent discharge from the ears, hearing impairment, and general weakness. The following methods were employed: the analysis of the patients' complaints and their medical histories, visualexamination of the ENT organs, tonal threshold audiometry, tympanometry, and the analysis of secretion from the tympanic cavity using the real-time PCR technique. The study has demonstrated some regular patterns of the clinical manifestations of the disease depending on its causative agent. Specifically, it turned out that acute otitis media associated with the infection by Streptоcoccus pneumoniae is characterized by the more reactive clinical symptoms and the greater amount of complications compared with acute otitis media caused by Haemophilus influenzae that is largely a subclinical pathology. However, the latter condition more frequently leads to chronization of the pathological process.

  5. Respiratory virus infection as a cause of prolonged symptoms in acute otitis media.

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    Arola, M; Ziegler, T; Ruuskanen, O

    1990-05-01

    We studied respiratory viruses in 22 children with acute otitis media who had failed to improve after at least 48 hours of antimicrobial therapy. The mean duration of preenrollment antimicrobial therapy was 4.8 days. For comparison we studied 66 children with newly diagnosed acute otitis media. Respiratory viruses were isolated from middle ear fluid or from the nasopharynx, or both, significantly more often in the patients unresponsive to initial antimicrobial therapy than in the comparison patients (68% vs 41%, p less than 0.05). Viruses were recovered from the middle ear fluid in 32% of the study patients and from 15% of the comparison group. Bacteria were isolated from the middle ear fluid of four (18%) children in the study group; one child had an isolate resistant to initial antimicrobial therapy. All four children with bacteria in the middle ear fluid had evidence of concomitant respiratory virus infection. Our results indicate that respiratory virus infection is often present in patients with acute otitis media unresponsive to initial antimicrobial therapy, and may explain the prolongation of symptoms of infection. Resistant bacteria seem to be a less common cause of failure of the initial treatment.

  6. Otitis externa.

    Science.gov (United States)

    Wipperman, Jennifer

    2014-03-01

    Acute otitis externa (AOE) is most often infectious in origin, and can be easily treated with a combination of topical antibiotic and steroid preparations. Systemic antibiotics are rarely needed for AOE. Chronic otitis externa (COE) can be more difficult to treat, but if an underlying cause can be identified this condition can often be successfully managed. In both AOE and COE, prevention is fundamental. If patients are able to avoid precipitating factors, future episodes can often be averted.

  7. Acute bacterial meningitis caused by acute otitis media in adults: A series of 12 patients.

    Science.gov (United States)

    Kaplan, Daniel M; Gluck, Ofer; Kraus, Mordechai; Slovik, Youval; Juwad, Hindy

    2017-01-01

    We conducted a retrospective chart review to characterize the outcomes of 12 patients-9 men and 3 women, aged 21 to 79 years (mean: 49)-who had been treated at our tertiary care center for acute bacterial meningitis caused by acute otitis media (ABMAO). Fever was the most common presenting sign/symptom, observed in 8 patients, followed by otalgia, neck stiffness, headache, and confusion. An opaque and bulging tympanic membrane was observed in 8 patients. Cultures were positive for Streptococcus pneumoniae in the cerebrospinal fluid, ear, and blood in 7, 5, and 3 patients, respectively. Immediate treatment included tympanocentesis, with aspirates sent for bacteriologic cultures. Seven patients (58.3%) underwent surgery; 5 were operated on early, and 2 underwent surgery at a later stage because of a suspected defect in the mastoid bone. A cortical mastoidectomy was performed in 6 of the 7 surgical patients; the remaining patient underwent a canal-wall-down procedure. Ten patients experienced a full recovery, 1 died, and 1 had a poor neurologic outcome (vegetative state); both of the latter 2 patients were older than 60 years. We conclude that early diagnosis, administration of antibiotics, and myringotomy are crucial for control of ABMAO. A cortical mastoidectomy with ventilation tube insertion can be reserved for patients who do not respond, which is common.

  8. MRI findings and spreading patterns of necrotizing external otitis: Is a poor outcome predictable?

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    Kwon, B.J. [Department of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Han, M.H. [Department of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of) and Clinical Research Institute, Seoul National University Hospital, Seoul (Korea, Republic of) and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul (Korea, Republic of)]. E-mail: hanmh@radcom.snu.ac.kr; Oh, S.H. [Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Song, J.J. [Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Chang, K.-H. [Department of Radiology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Clinical Research Institute, Seoul National University Hospital, Seoul (Korea, Republic of); Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul (Korea, Republic of)

    2006-06-15

    AIM: To evaluate spreading patterns of necrotizing external otitis (NEO) by magnetic resonance imaging (MRI) and to identify spreading patterns related to a poor outcome. MATERIALS AND METHODS: Fourteen patients with NEO were divided into good and poor outcome groups according to their final clinical outcomes. Initial MRI images were retrospectively reviewed for regional abnormalities, and follow-up MRI images were reviewed for ICA flow void abnormality and for the following five spreading patterns: medial, crossed, anterior, intracranial, and combined. The frequencies of the abnormal flow void or spreading patterns were compared between the good and poor response groups. RESULTS: Seven (50%) and seven (50%) patients were respectively allocated to the good and poor outcome groups. Retrocondylar fat infiltration was the most commonest finding on initial MRI images (93%). The frequencies of the abnormal flow void and spreading patterns in the good and poor groups, respectively, were: abnormal flow void, 0 and four (57%); anterior, two (29%) and three (43%); medial, six (86%) and seven (100%); crossed, six (86%) and seven (100%); intracranial middle cranial fossa, one (14%) and four (57%); intracranial posterior cranial fossa, four (57%) and six (86%); intracranial foramen magnum, one (14%) and six (86%). CONCLUSIONS: NEO almost always involves the retrocondylar fat and spreads via various pathways to extracranial or intracranial spaces. The presence of an abnormal flow void and intracranial dural enhancement, particularly in the middle cranial fossa and foramen magnum, may indicate a poor prognosis.

  9. Alteración funcional de la ATM: Otitis externa de presentación atípica Functional Alteration of the temporomandibular joint: Infrequent clinical Presentation for external otitis

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    J.L. Cebrián Carretero

    2009-12-01

    Full Text Available Introducción: La Patología infecciosa del oído externo es relativamente frecuente en niños pequeños y en algunas ocasiones presentándose como una alteración de la articulación temporomandibular. Sin embargo, la patología aguda de esta articulación es muy poco frecuente en esta edad de la vida. Si existe, habitualmente es precedida por un episodio de traumatismo. Una adecuada anamnesis y exploración física suele resultar en un diagnostico acertado sin realizar pruebas complementarias adicionales. Materiales y métodos: Presentamos tres casos clínicos derivados al Servicio Pediátrico de Cirugía Oral y Maxilofacial del Hospital Universitario La Paz con el diagnóstico de patología ATM aguda. El diagnóstico final en los tres casos fue otitis externa aguda (OEA. Discusión: La OEA es la segunda causa mas frecuente de otalgia después de la otitis media aguda. La humedad, los traumas repetidos y la obstrucción glandular pueden promover la infección. Los síntomas incluyen dolor, prurito, supuración y en ocasiones pérdida auditiva. En ocasiones el movimiento mandibular sin maloclusión es doloroso. Este síntoma puede causar confusión e inducir a un diagnóstico erróneo de patología articular, lo cual es muy poco frecuente en niños. La patología de ATM en niños se caracteriza por dolor durante la apertura oral asociando disoclusión. Una correcta otoscopia permitirá realizar el diagnostico diferencial entre ambas entidades y evitar exploraciones radiológicas innecesarias. Conclusión: Debido a la poco frecuente presentación de patología ATM en niños pequeños, la OEA debe ser descartada antes de someter al paciente a exámenes radiológicos complementarios.Introduction: Infectious pathology of the external ear is quite frequent in small children and sometimes appears as an alteration of the temporomandibular joint function. However, acute pathology of this joint is quite rare in this age group and is nearly always

  10. Pott's puffy tumor: a rare complication of acute otitis media in child: a case report.

    Science.gov (United States)

    Urík, Milan; Machač, Josef; Šlapák, Ivo; Hošnová, Dagmar

    2015-09-01

    To describe a rare case of Potts' puffy tumor (PPT) in the zygomatic area, which developed as a complication of acute otitis media in a 6-year-old child. To date, only one case of PPT has been described in the literature as a complication of latent mastoiditis in an adult, and one case of PPT as a complication of acute mastoiditis in a 10-year-old child. Urgent surgical intervention, including evacuation of the purulent lesion, removal of inflamed soft tissue and osteolysis of the involved bone, and antromastoidectomy, intravenous treatment with broad-spectrum antibiotics, including G+, G-, anaerobes and fungi, and local therapy.

  11. [Acute otitis media in children: an evidence-based practice guideline].

    Science.gov (United States)

    Koneczny, N; Schmidt-Troschke, S; Berger, T; Isfort, J; Floer, B; Vollmar, H C; Butzlaff, M

    2004-01-01

    Acute Otitis media is one of the most common acute respiratory infections managed in primary care and the most common infection among in children. Diagnostic criteria, however, do not always correspond to scientific evidence. They often differ depending on individual preferences and competences. Treatment, also, is controversial. In Germany, most children attending their pediatrician or primary care physician will be prescribed antibiotics. Evidence from several randomized studies and systematic reviews suggests that routine usage of antibiotics provides only modest benefit. The benefit of prescribing antibiotics should not only be balanced against the increased likelihood of side effects such as diarrhoea but also against the potential to contribute to longterm antibiotic resistance.

  12. Comparing Cerumen Bacterial Flora in Acute Otitis Externa Patients and Healthy Controls

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    Keyvan Kiakojori

    2010-07-01

    Full Text Available Introduction: In spite of the fact that acute otitis media is a systemic and symptomatic disease with sever otalgia, otitis media with effusion (OME is an asymptomatic and silent disease. OME is the most common cause of conductive hearing loss in children and has adverse effects on speech development and cognitive skills. Results: Among 1001 children under study, 57 subjects (5.7% were diagnosed with OME, more than 50% of which were asymptomatic. Periodic otalgia and turning up television volume were the most common symptoms. Conclusion: Regarding the improved knowledge on diagnosis and treatment of OME especially in younger children, hearing problems or cognitive and linguistic skills retardation may be avoided by promoting general information.

  13. Virus and bacteria enhance histamine production in middle ear fluids of children with acute otitis media.

    Science.gov (United States)

    Chonmaitree, T; Patel, J A; Lett-Brown, M A; Uchida, T; Garofalo, R; Owen, M J; Howie, V M

    1994-06-01

    Histamine levels were measured in 677 middle ear fluid (MEF) samples from 248 children (aged 2 months to 7 years) with acute otitis media (AOM); of these, 116 (47%) had documented viral infection. Histamine content was higher in bacteria-positive than in bacteria-negative MEF samples (P = .007) and higher in samples from patients with viral infection than in those from patients with no viral infection (P = .002). Bacteria and viruses together had an additive effect on histamine content in MEF. Histamine concentration in the initial MEF sample tended to be higher in patients with persistent otitis than in those with good response to treatment (P = .14). Results suggest that viruses, bacteria, or both induce histamine production, which leads to increased inflammation in the middle ear. Antihistaminic drugs may be beneficial. Large, prospective, controlled trials of the effects of antihistamine as an adjunct therapy in bacterial and viral AOM are required before recommendations can be made.

  14. Cellular Immune Response in Young Children Accounts for Recurrent Acute Otitis Media

    Science.gov (United States)

    Sharma, Sharad K.; Pichichero, Michael E.

    2013-01-01

    Acute otitis media (AOM) is a common disease in young children. Streptococcus pneumoniae(Spn) and Haemophilus influenzae (NTHi) are the two most common pathogens that cause AOM. Over the past 5 years our group has been studying the immunologic profile of children that experience repeated AOM infections despite tympanocentesis drainage of middle ear fluid and individualized antibiotic treatment; we call these children stringently-defined otitis-prone (sOP). Although protection against AOM is primarily mediated by ototpathogen-specific antibody, our recent studies suggest that suboptimal memory B-& T- cell responses and an immaturity in antigen presenting cells may play a significant role in the propensity to recurrent AOM infections. This review focuses on the studies performed to define immunologic dysfunction in sOP children. PMID:24022464

  15. Acute Otitis Media-Induced Gradenigo Syndrome, a Dramatic Response to Intravenous Antibiotic

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    Tayebeh Kazemi

    2017-05-01

    Full Text Available Introduction: Petrositis is a rare but severe complication of acute otitis media and mastoiditis. Despite efficient antibiotic therapy, there are still reports of both intratemporal and intracranial complications of otitis media with the potential risk of high morbidity and mortality. Petrositis has traditionally been treated with surgery, but recent advances in imaging, with improved antibiotic treatment, allow more conservative management.   Case Report: In this case report we describe the clinical course and treatment of a 33-year-old man with petrous apicitis who presented with severe otalgia, retro-orbital pain, and sixth cranial nerve palsy Gradenigo syndrome. Our patient showed a dramatic response to intravenous antibiotics only, without need for any surgical intervention, even myringotomy.   Conclusion: It seems that early detection and management of this syndrome before development of other intratemporal or intracranial complications may prevent the need for surgical intervention.

  16. Bacterial Species and Antibiotic Sensitivity in Korean Patients Diagnosed with Acute Otitis Media and Otitis Media with Effusion

    Science.gov (United States)

    2017-01-01

    Changes over time in pathogens and their antibiotic sensitivity resulting from the recent overuse and misuse of antibiotics in otitis media (OM) have complicated treatment. This study evaluated changes over 5 years in principal pathogens and their antibiotic sensitivity in patients in Korea diagnosed with acute OM (AOM) and OM with effusion (OME). The study population consisted of 683 patients who visited the outpatient department of otorhinolaryngology in 7 tertiary hospitals in Korea between January 2010 and May 2015 and were diagnosed with acute AOM or OME. Aural discharge or middle ear fluid were collected from patients in the operating room or outpatient department and subjected to tests of bacterial identification and antibiotic sensitivity. The overall bacteria detection rate of AOM was 62.3% and OME was 40.9%. The most frequently isolated Gram-positive bacterial species was coagulase negative Staphylococcus aureus (CNS) followed by methicillin-susceptible S. aureus (MSSA), methicillin-resistant S. aureus (MRSA), and Streptococcus pneumonia (SP), whereas the most frequently isolated Gram-negative bacterium was Pseudomonas aeruginosa (PA). Regardless of OM subtype, ≥ 80% of CNS and MRSA strains were resistant to penicillin (PC) and tetracycline (TC); isolated MRSA strains showed low sensitivity to other antibiotics, with 100% resistant to PC, TC, cefoxitin (CFT), and erythromycin (EM); and isolated PA showed low sensitivity to quinolone antibiotics, including ciprofloxacin (CIP) and levofloxacin (LFX), and to aminoglycosides. Bacterial species and antibiotic sensitivity did not change significantly over 5 years. The rate of detection of MRSA was higher in OME than in previous studies. As bacterial predominance and antibiotic sensitivity could change over time, continuous and periodic surveillance is necessary in guiding appropriate antibacterial therapy. PMID:28244296

  17. Bacterial Species and Antibiotic Sensitivity in Korean Patients Diagnosed with Acute Otitis Media and Otitis Media with Effusion.

    Science.gov (United States)

    Kim, Sang Hoon; Jeon, Eun Ju; Hong, Seok Min; Bae, Chang Hoon; Lee, Ho Yun; Park, Moo Kyun; Byun, Jae Yong; Kim, Myung Gu; Yeo, Seung Geun

    2017-04-01

    Changes over time in pathogens and their antibiotic sensitivity resulting from the recent overuse and misuse of antibiotics in otitis media (OM) have complicated treatment. This study evaluated changes over 5 years in principal pathogens and their antibiotic sensitivity in patients in Korea diagnosed with acute OM (AOM) and OM with effusion (OME). The study population consisted of 683 patients who visited the outpatient department of otorhinolaryngology in 7 tertiary hospitals in Korea between January 2010 and May 2015 and were diagnosed with acute AOM or OME. Aural discharge or middle ear fluid were collected from patients in the operating room or outpatient department and subjected to tests of bacterial identification and antibiotic sensitivity. The overall bacteria detection rate of AOM was 62.3% and OME was 40.9%. The most frequently isolated Gram-positive bacterial species was coagulase negative Staphylococcus aureus (CNS) followed by methicillin-susceptible S. aureus (MSSA), methicillin-resistant S. aureus (MRSA), and Streptococcus pneumonia (SP), whereas the most frequently isolated Gram-negative bacterium was Pseudomonas aeruginosa (PA). Regardless of OM subtype, ≥ 80% of CNS and MRSA strains were resistant to penicillin (PC) and tetracycline (TC); isolated MRSA strains showed low sensitivity to other antibiotics, with 100% resistant to PC, TC, cefoxitin (CFT), and erythromycin (EM); and isolated PA showed low sensitivity to quinolone antibiotics, including ciprofloxacin (CIP) and levofloxacin (LFX), and to aminoglycosides. Bacterial species and antibiotic sensitivity did not change significantly over 5 years. The rate of detection of MRSA was higher in OME than in previous studies. As bacterial predominance and antibiotic sensitivity could change over time, continuous and periodic surveillance is necessary in guiding appropriate antibacterial therapy. © 2017 The Korean Academy of Medical Sciences.

  18. Influence of Pneumococcal Conjugate Vaccine on Acute Otitis Media with Severe Middle Ear Inflammation: A Retrospective Multicenter Study.

    Science.gov (United States)

    Sugino, Hirotoshi; Tsumura, Shigeru; Kunimoto, Masaru; Noda, Masuhiro; Chikuie, Daisuke; Noda, Chieko; Yamashita, Mariko; Watanabe, Hiroshi; Ishii, Hidemasa; Tashiro, Toru; Iwata, Kazuhiro; Kono, Takashi; Tsumura, Kaoru; Sumiya, Takahiro; Takeno, Sachio; Hirakawa, Katsuhiro

    2015-01-01

    The Japanese guidelines for acute otitis media in children recommend classifying acute otitis media by age, manifestations and local findings, and also recommend myringotomy for moderate-grade cases with severe local findings, severe-grade cases, and treatment-resistant cases. The heptavalent pneumococcal conjugate vaccine was released in Japan in February 2010. In Hiroshima City, public funding allowing free inoculation with this vaccine was initiated from January 2011, and the number of vaccinated individuals has since increased dramatically. This study investigated changes in the number of myringotomies performed to treat acute otitis media during the 5-year period from January 2008 to December 2012 at two hospitals and five clinics in the Asa Area of Hiroshima City, Japan. A total of 3,165 myringotomies for acute otitis media were performed. The rate of procedures per child-year performed in media in 1-year-old infants decreased significantly in the 2 years after the introduction of public funding for heptavalent pneumococcal conjugate vaccine compared to all years before introduction (pmedia in reducing the financial burden of myringotomy. In addition, this vaccine may help prevent acute otitis media with severe middle ear inflammation in 1-year-old infants.

  19. Ear infections: otitis externa and otitis media.

    Science.gov (United States)

    Lee, Hobart; Kim, Jeffrey; Nguyen, Van

    2013-09-01

    This article reviews the diagnosis and treatment of acute otitis externa and acute otitis media, and will be helpful to primary care physicians who diagnose and treat these common diseases in the clinic. The pathophysiology, microbiology, clinical features, diagnosis, treatment, prognosis, and complications are discussed.

  20. Effects of amoxicillin treatment on the salivary microbiota in children with acute otitis media.

    Science.gov (United States)

    Lazarevic, V; Manzano, S; Gaïa, N; Girard, M; Whiteson, K; Hibbs, J; François, P; Gervaix, A; Schrenzel, J

    2013-08-01

    Amoxicillin is a first-line antibiotic treatment for acute otitis media in children and one of the most commonly used antibiotics for human bacterial infections. We investigated changes in salivary bacterial communities among children treated with amoxicillin for acute otitis media (n = 18), using a culture-independent approach based on pyrosequencing of the V3 region of the bacterial 16S rRNA gene. The control group consisted of children with acute otitis media who were not given antibiotics (n = 15). One species-level phylotype assigned to the genus Streptococcus was identified across all (n = 99) saliva samples. Two additional species-level phylotypes from the genera Gemella and Granulicatella were shared by all (n = 45) samples of control subjects. Amoxicillin treatment resulted in reduced species richness and diversity, and a significant shift in the relative abundance of 35 taxa at different ranks from phylum to species-level phylotype. At the phylum level, prevalence of TM7 and Actinobacteria decreased at the end of treatment, whereas Proteobacteria had a higher relative abundance post-treatment. Multivariate analysis showed that samples from the same control subject taken over time intervals tended to cluster together. Among antibiotic-treated subjects, samples taken before and at the end of amoxicillin treatment formed two relatively well-separated clusters both of which greatly overlapped with samples taken about 3 weeks post-treatment. Our results point to a substantial but incomplete recovery of the salivary bacterial community from the antibiotic about 3 weeks after the end of treatment.

  1. Lateral sinus thrombosis in setting of Acute otitis media: An atypical presentation

    Directory of Open Access Journals (Sweden)

    Rajeev Kumar

    2013-01-01

    Full Text Available Lateral sinus thrombosis (LST is a rare complication of Acute Otitis Media and associated mastoiditis. Although, in the era of antibiotics, the presentation may be variable and diagnosis is difficult. High index of suspicion is required to diagnose the atypical presentation. We report an atypical presentation of LST wherein a 12-year-old female presented with sudden onset severe occipital headache following ear syringing. Contrast enhanced computed tomography of temporal bone revealed LST without coalescent mastoiditis. Patient was managed conservatively with intravenous antibiotics and low-dose heparin. The management protocols in such cases are discussed and relevant literature reviewed.

  2. Clinical effects of clarithromycin on persistent inflammation following Haemophilus influenzae-positive acute otitis media.

    Science.gov (United States)

    Iino, Yukiko; Yoshida, Naohiro; Kato, Toshinori; Kakizaki, Keiko; Miyazawa, Tetsuo; Kakuta, Hiroyuki

    2015-03-01

    Additional treatment with clarithromycin (CAM) reduced persistent middle ear inflammation after acute otitis media (AOM) caused by Haemophilus influenzae in children. CAM is a treatment option for persistent inflammation following AOM and to prevent continuing otitis media with effusion. We conducted a clinical study to evaluate a new method of treatment for persistent inflammation after AOM in children. H. influenzae-infected children with AOM were treated acutely with antimicrobial agents, after which those still demonstrating effusion of the middle ear cavity received additional treatment with carbocysteine (S-CMC) alone or S-CMC combined with clarithromycin (CAM) for 1 week. The two regimens were compared in terms of clinical effects. After the initial acute treatment, many patients still showed abnormal otoscopic findings. At the completion of additional treatment, there were no significant differences between the two treatment groups. However, 1 week after completion of additional treatment, the prevalence of a diminished light reflex was significantly lower in the CAM + S-CMC group than in the S-CMC group (p = 0.017). The prevalence of redness of the tympanic membrane also tended to be lower in the combined treatment group than in those receiving a single drug (p = 0.097).

  3. Incidence survey of acute otitis media in children in Sado Island, Japan--Sado Otitis Media Study (SADOMS.

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    Taketo Otsuka

    Full Text Available BACKGROUND: Acute otitis media (AOM is one of the most common forms of bacterial infection and cause for clinic visits in children. The incidence of AOM was 0.9-1.2 episodes per person-year during the first 2 years of life in previous reports conducted before 2000. The aim of this study was to 1 evaluate the latest AOM incidence in pediatric outpatients and 2 identify the bacterial pathogens from these patients and ascertain their serotypes and resistance. METHODS: The study was conducted in a closed population, involving all pediatricians and otolaryngologists in Sado Island allowing accurate determination of AOM incidence. In each month, one week was assigned as "surveillance week", and all outpatients with acute illness aged 0-18 years examined during the surveillance weeks were enrolled. AOM was diagnosed on the basis of otoscopic findings and clinical symptoms were recorded. Specimens were collected from the nasopharynx or middle ear cavity of AOM patients and examined for bacteria. Antimicrobial susceptibilities, serotypes, and molecular typing for resistance were determined among Streptococcus pneumoniae and Haemophilus influenzae. RESULTS: In total, 8,283 clinic visits were conducted, and 354 episodes (4.3%, 95% CI: 3.9-4.7% among 312 children were diagnosed as AOM. The incidence of AOM was highest in children of 1 year of age (0.54 episodes/child/year, 95% CI: 0.44-0.64. Serotype coverage of 7- and 13-valent pneumococcal conjugate vaccines in this study were 38.0% (95% CI: 29.3-47.3 and 62.8% (95% CI: 53.6-71.4, respectively. Of 122 H.influenzae isolates available for typing, 120 were nontypeable and 2 were type b. A high proportion of S. pneumoniae isolates (46% showed resistance to penicillin. Approximately half of H. influenzae isolates had genetic markers for beta-lactamase-negative ampicillin-resistance. CONCLUSIONS: Approximately 4-5% of pediatric outpatients, even without AOM-related symptoms, had AOM in our study. Pediatricians

  4. The effect of the leukotriene antagonist pranlukast on pediatric acute otitis media.

    Science.gov (United States)

    Nakamura, Yoshihisa; Hamajima, Yuki; Suzuki, Motohiko; Esaki, Shinichi; Yokota, Makoto; Oshika, Masanori; Takagi, Ippei; Yasui, Keiko; Miyamoto, Naoya; Sugiyama, Kazuko; Nakayama, Meiho; Murakami, Shingo

    2016-08-01

    Conventional treatment for acute otitis media mainly targets bacteria with antibiotics, neglecting to control for mediators of inflammation. Mediators of inflammation, such as leukotrienes, have been identified in patients with acute otitis media (AOM) or subsequent secretory otitis media (SOM). They can cause functional eustachian tube dysfunction or increase mucous in the middle ear, causing persistent SOM following AOM. The objective of the present study was to evaluate whether or not administration of pranlukast, a widely used leukotriene C4, D4, and E4 antagonist, together with antibiotics could inhibit the progression to SOM. Children with AOM, who were from two to 12 years old, were randomly divided into two groups as follows: a control group in which 50 patients received antibiotic-based conventional treatment according to guidelines for treating AOM proposed by the Japan Otological Society (version 2006); and a pranlukast group, in which 52 patients were administered pranlukast for up to 28 days as well as given conventional treatment. Cases were regarded as persistent SOM when a tympanogram was type B or C2 four weeks after treatment was initiated. Two patients in the pranlukast group and 3 patients in the control group were excluded because they relapsed AOM within 28 days after initial treatment. Therefore, the analysis included 50 and 47 subjects in the pranlukast and control groups, respectively. The percentage of patients diagnosed with persistent SOM (22.0%) was significantly smaller in the pranlukast group compared with the control group (44.7%) (p = 0.018, chi-squared test). The results indicate that combined treatment of AOM with antibiotics and a leukotriene antagonist to control inflammation is useful for preventing progression to persistent SOM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Temporomandibular joint involvement as a positive clinical prognostic factor in necrotising external otitis.

    Science.gov (United States)

    Yeheskeli, E; Eta, R Abu; Gavriel, H; Kleid, S; Eviatar, E

    2016-05-01

    Necrotising otitis externa is associated with high morbidity and mortality rates. This study investigated whether temporomandibular joint involvement had any prognostic effect on the course of necrotising otitis externa in patients who had undergone hyperbaric oxygen therapy after failed medical and sometimes surgical therapy. A retrospective case series was conducted of patients in whom antibiotic treatment and surgery had failed, who had been hospitalised for further treatment and hyperbaric oxygen therapy. Twenty-three patients with necrotising otitis externa were identified. The temporomandibular joint was involved in four patients (17 per cent); these patients showed a constant gradual improvement in C-reactive protein and were eventually discharged free of disease, except one patient who was lost to follow up. Four patients (16 per cent) without temporomandibular joint involvement died within 90 days of discharge, while all patients with temporomandibular joint involvement were alive. Three patients (13 per cent) without temporomandibular joint involvement needed recurrent hospitalisation including further hyperbaric oxygen therapy; no patients with temporomandibular joint involvement required such treatment. Patients with temporomandibular joint involvement had lower rates of recurrent disease and no mortality. Therefore, we suggest considering temporomandibular joint involvement as a positive prognostic factor in necrotising otitis externa management.

  6. Literature review: use of xylitol for prevention of acute otitis media

    Directory of Open Access Journals (Sweden)

    Pereira, Agnes de Fátima Faustino

    2009-03-01

    Full Text Available Introduction: Xylitol is a sugar naturally found in various vegetables and fruits. Studies have demonstrated that the xylitol can be used as new preventive method for acute otitis media (AOM. Objective: To clarify the possible mechanisms of xylitol actions to inhibit the growth of otopathogenic bacteria and to describe researches that contribute for the discussion about the feasibility of the use of this sugar in the prevention of AOM. Method: Literature review based on scientific articles selected by means of the medical databases: MEDLINE, Cochrane, PubMed (MeSH and Web of Science. Results: Studies have demonstrated the efficacy of xylitol to prevent the AOM, when it is administered five times a day in chewing gum. However, this sugar is not so effective in the prevention of AOM during upper airways infections. Final Comments: Xylitol seems to be an effective strategy in prevention of acute otitis media. However, new studies are necessary to establish ideal doses, frequencies and vehicles for the correct administration of the sugar, which allows for its utilization in the public health system.

  7. [Analysis of the Cochrane Review: Antibiotics for acute otitis media in children. Cochrane Database Syst Rev. 2013;1:CD000219].

    Science.gov (United States)

    Pinto, Sara; Costa, João; Vaz Carneiro, António; Fernandes, Ricardo

    2013-01-01

    Acute otitis media is one of the most common infections in children and one of the leading causes for antibiotic prescription. In this paper, we assess and comment the Cochrane systematic review 'Antibiotics for acute otitis media in children', which aimed at assessing the efficacy and safety of antibiotics for acute otitis media in children and identifying subgroups of children who might benefit more than others from antibiotic treatment. This review showed spontaneous resolution of acute otitis media in most children (82%) and a favorable but modest effect of antibiotics, namely in pain control (number needed to treat to benefit: 20), reduction of tympanic membrane perforations and reduction of contralateral acute otitis media. Adverse effects such as vomiting, diarrhea or rash were more common in the antibiotic group (number needed to treat to harm: 14). Thus, for most children, an expectant observational approach during 48-72h without immediate antibiotic prescription seems justified. An additional meta-analysis found that antibiotics appear to be most useful in children with both acute otitis media and otorrhoea and children under two years of age with bilateral acute otitis media.

  8. "Swimmer's Ear" (Otitis Externa) Prevention

    Science.gov (United States)

    ... infections, swimmer’s ear, and healthy swimming. "Swimmer's Ear" (Otitis Externa) What are the symptoms of swimmer's ear? ... Healthy page. Reference CDC. Estimated burden of acute otitis externa —United States, 2003–2007 . MMWR Morb Mortal ...

  9. Molecular epidemiology of pneumococcal colonization in response to pneumococcal conjugate vaccination in children with recurrent acute otitis media.

    NARCIS (Netherlands)

    D. Bogaert (Debby); R.H. Veenhoven (Reinier); M. Sluijter (Marcel); W.J. Wannet; G.T. Rijkers; T.J. Mitchell; S.C. Clarke; W.H.F. Goessens (Wil); A.G. Schilder (Anne); E.A. Sanders (Elisabeth); R. de Groot (Ronald); P.W.M. Hermans (Peter)

    2005-01-01

    textabstractA randomized double-blind trial with a 7-valent pneumococcal conjugate vaccine was conducted in The Netherlands among 383 children, aged 1 to 7 years, with a history of recurrent acute otitis media. No effect of vaccination on the pneumococcal colonization rate was found. However, a shif

  10. The health care burden and societal impact of acute otitis media in seven European countries: results of an Internet survey

    NARCIS (Netherlands)

    J.H. Wolleswinkel-van den Bosch (Judith); E.A. Stolk (Elly); M. Francois (Martine); R. Gasparini (Roberto); M. Brosa (Max)

    2010-01-01

    textabstractThis paper estimates medical resource use, direct costs, and productivity losses and costs (indirect costs) during episodes of acute otitis media (AOM) in young children. A 24-item Internet questionnaire was developed for parents in Belgium (Flanders), France, Germany, Italy, The Netherl

  11. The 4G/4G plasminogen activator inhibitor-1 genotype is associated with frequent recurrence of acute otitis media.

    NARCIS (Netherlands)

    Emonts, M.; Wiertsema, S.P.; Veenhoven, R.H.; Houwing-Duistermaat, J.J.; Walraven, V.; Groot, R. de; Hermans, P.W.M.; Sanders, E.A.M.

    2007-01-01

    OBJECTIVES: Plasminogen activator inhibitor-1 counterregulates cell migration, adhesion, and tissue repair. The PAI1 4G/5G promoter polymorphism has an effect on expression levels of PAI1. After a first acute otitis media episode, children are at increased risk for a next episode. Because the PAI1 4

  12. Will Parents Participate in and Comply with Programs and Regimens Using Xylitol for Preventing Acute Otitis Media in Their Children?

    Science.gov (United States)

    Danhauer, Jeffrey L.; Johnson, Carole E.; Baker, Jason A.; Ryu, Jung A.; Smith, Rachel A.; Umeda, Claire J.

    2015-01-01

    Purpose: Antiadhesive properties in xylitol, a natural sugar alcohol, can help prevent acute otitis media (AOM) in children by inhibiting harmful bacteria from colonizing and adhering to oral and nasopharyngeal areas and traveling to the Eustachian tube and middle ear. This study investigated parents' willingness to use and comply with a regimen…

  13. Will Parents Participate in and Comply with Programs and Regimens Using Xylitol for Preventing Acute Otitis Media in Their Children?

    Science.gov (United States)

    Danhauer, Jeffrey L.; Johnson, Carole E.; Baker, Jason A.; Ryu, Jung A.; Smith, Rachel A.; Umeda, Claire J.

    2015-01-01

    Purpose: Antiadhesive properties in xylitol, a natural sugar alcohol, can help prevent acute otitis media (AOM) in children by inhibiting harmful bacteria from colonizing and adhering to oral and nasopharyngeal areas and traveling to the Eustachian tube and middle ear. This study investigated parents' willingness to use and comply with a regimen…

  14. Restricted Consonant Inventories of 2-Year-Old Finnish Children with a History of Recurrent Acute Otitis Media

    Science.gov (United States)

    Haapala, Sini; Niemitalo-Haapola, Elina; Raappana, Antti; Kujala, Tiia; Kujala, Teija; Jansson-Verkasalo, Eira

    2015-01-01

    Many children experience recurrent acute otitis media (RAOM) in early childhood. In a previous study, 2-year-old children with RAOM were shown to have immature neural patterns for speech sound discrimination. The present study further investigated the consonant inventories of these same children using natural speech samples. The results showed…

  15. Trends in broad-spectrum antibiotic prescribing for children with acute otitis media in the United States, 1998–2004

    Directory of Open Access Journals (Sweden)

    Gambler Angela S

    2009-06-01

    Full Text Available Abstract Background Overuse of broad-spectrum antibiotics is associated with antibiotic resistance. Acute otitis media (AOM is responsible for a large proportion of antibiotics prescribed for US children. Rates of broad-spectrum antibiotic prescribing for AOM are unknown. Methods Analysis of the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, 1998 to 2004 (N = 6,878. Setting is office-based physicians, hospital outpatient departments, and emergency departments. Patients are children aged 12 years and younger prescribed antibiotics for acute otitis media. Main outcome measure is percentage of broad-spectrum antibiotics, defined as amoxicillin/clavulanate, macrolides, cephalosporins and quinolones. Results Broad-spectrum prescribing for acute otitis media increased from 34% of visits in 1998 to 45% of visits in 2004 (P Conclusion Prescribing of broad-spectrum antibiotics for acute otitis media has steadily increased from 1998 to 2004. Associations with non-clinical factors suggest potential for improvement in prescribing practice.

  16. Restricted Consonant Inventories of 2-Year-Old Finnish Children with a History of Recurrent Acute Otitis Media

    Science.gov (United States)

    Haapala, Sini; Niemitalo-Haapola, Elina; Raappana, Antti; Kujala, Tiia; Kujala, Teija; Jansson-Verkasalo, Eira

    2015-01-01

    Many children experience recurrent acute otitis media (RAOM) in early childhood. In a previous study, 2-year-old children with RAOM were shown to have immature neural patterns for speech sound discrimination. The present study further investigated the consonant inventories of these same children using natural speech samples. The results showed…

  17. Molecular epidemiology of pneumococcal colonization in response to pneumococcal conjugate vaccination in children with recurrent acute otitis media.

    NARCIS (Netherlands)

    Bogaert, D.; Veenhoven, R.H.; Sluijter, M.; Wannet, W.J.B.; Rijkers, G.T.; Mitchell, T.J.; Clarke, S.C.; Goessens, W.H.F.; Schilder, A.G.M.; Sanders, E.A.M.; Groot, R. de; Hermans, P.W.M.

    2005-01-01

    A randomized double-blind trial with a 7-valent pneumococcal conjugate vaccine was conducted in The Netherlands among 383 children, aged 1 to 7 years, with a history of recurrent acute otitis media. No effect of vaccination on the pneumococcal colonization rate was found. However, a shift in serotyp

  18. Pneumococcal conjugate vaccination does not induce a persisting mucosal IgA response in children with recurrent acute otitis media.

    NARCIS (Netherlands)

    Bogaert, D.; Veenhoven, R.H.; Ramdin, R.; Luijendijk, I.H.; Rijkers, G.T.; Sanders, E.A.M.; Groot, R. de; Hermans, P.W.M.

    2005-01-01

    AIM: In a prospective controlled study in young children with a history of recurrent acute otitis media, we analyzed the salivary IgA and IgG antibody titers upon vaccination with a 7-valent pneumococcal conjugate vaccine (PCV) given once or twice, followed by a 23-valent polysaccharide booster vacc

  19. The 4G/4G plasminogen activator inhibitor-1 genotype is associated with frequent recurrence of acute otitis media.

    NARCIS (Netherlands)

    Emonts, M.; Wiertsema, S.P.; Veenhoven, R.H.; Houwing-Duistermaat, J.J.; Walraven, V.; Groot, R. de; Hermans, P.W.M.; Sanders, E.A.M.

    2007-01-01

    OBJECTIVES: Plasminogen activator inhibitor-1 counterregulates cell migration, adhesion, and tissue repair. The PAI1 4G/5G promoter polymorphism has an effect on expression levels of PAI1. After a first acute otitis media episode, children are at increased risk for a next episode. Because the PAI1 4

  20. Molecular epidemiology of pneumococcal colonization in response to pneumococcal conjugate vaccination in children with recurrent acute otitis media.

    NARCIS (Netherlands)

    D. Bogaert (Debby); R.H. Veenhoven (Reinier); M. Sluijter (Marcel); W.J. Wannet; G.T. Rijkers; T.J. Mitchell; S.C. Clarke; W.H.F. Goessens (Wil); A.G. Schilder (Anne); E.A. Sanders (Elisabeth); R. de Groot (Ronald); P.W.M. Hermans (Peter)

    2005-01-01

    textabstractA randomized double-blind trial with a 7-valent pneumococcal conjugate vaccine was conducted in The Netherlands among 383 children, aged 1 to 7 years, with a history of recurrent acute otitis media. No effect of vaccination on the pneumococcal colonization rate was found. However, a

  1. Burden of acute otitis media in primary care pediatrics in Italy: A secondary data analysis from the Pedianet database

    NARCIS (Netherlands)

    P. Marchisio (Paola); L. Cantarutti (Luigi); M.C.J.M. Sturkenboom (Miriam); S. Girotto; G. Picelli (Gino); D. Dona (Daniele); A. Scamarcia (Anthonio); A.M. Villa; C. Giaquinto (Carlo)

    2012-01-01

    textabstractBackground: The incidence of acute otitis media (AOM) vary from country to country. Geographical variations together with differences in study designs, reporting and settings play a role. We assessed the incidence of AOM in Italian children seen by primary care paediatricians (PCPs), and

  2. [Treatment of acute otitis media in paediatrics: a meta-analysis].

    Science.gov (United States)

    Esposito, Silvano; Novelli, Andrea; Noviello, Silvana

    2005-06-01

    Otitis represents the second most common infection of the upper respiratory tract, its treatment being the most common cause for prescribing antibiotics in the United States. A large number of antimicrobials, especially beta-lactams and macrolides, are generally used for treating acute otitis media (AOM) in paediatric patients, owing to their antibacterial spectrum including the main aetiological pathogens. Efficacy, safety and compliance of Cefaclor were compared with those of other antibiotics in the treatment of paediatric AOM in a meta-analysis of randomized controlled trials published between 1981 and 2004. Overall, evaluations were performed on 24 studies (Medline/PubMed, keywords "Cefaclor and otitis") which proved eligible (jadad score > or = 1); sixteen out of the 24 studies were multicentre, seven were double-blind. Mostly, the comparator agent was a beta-lactam, in four and three cases it was a macrolide or the association trimethoprim-sulfamethoxazole, respectively. Efficacy and safety were end-points of all studies whereas only 9 studies evaluated compliance. For the majority of studies (16/24) Cefaclor was administered for 10-day course. The analysis was based on a 2 x 2 contingency table with classification by treatment and number of improvements/cures, side-effects, and compliance of individual studies. The global estimate of the effective treatments was obtained with the weighted mean of the log OR (Odd Ratio) according to Mantel-Haenszel and associated confidence intervals (CI) at 95%. All the calculations were performed using SAS v.8. Chi-square test was performed. Clinical efficacy evaluation, number of improvements/cures, did not evidence a statistically significant difference among Cefaclor and comparators (86.8% vs 88.7%; Odds Ratio 0.77, IC 0.61/0.94). In the Cefaclor-treated patients, adverse events were observed in a statistically significant lower percentage compared to other antibiotics: 13.3% vs 19.4% (P antibiotics usually employed in

  3. [Acute otitis media in children. Comparison between conventional and homeopathic therapy].

    Science.gov (United States)

    Friese, K H; Kruse, S; Moeller, H

    1996-08-01

    Within a prospective group study of five practicing otorhinolaryngologists, conventional therapy of acute otitis media in children was compared with homeopathic treatments. Group A (103 children) was primarily treated with homeopathic single remedies (Aconitum napellus, Apis mellifica, Belladonna, Capsicum, Chamomilla, Kalium bichromicum, Lachesis, Lycopodium, Mercurius solubilis, Okoubaka, Pulsatilla, Silicea). Group B (28 children) was treated by decongestant nose-drops, antibiotics, secretolytics and/or antipyretics. Comparisons were done by symptoms, physical findings, duration of therapy and number of relapses. The children of the study were between 1 and 11 years of age. The difference in numbers was explained by the children with otitis media being primarily treated by pediatricians using conventional methods. The median duration of pain in group A was 2 days and in group B 3 days. Median therapy in group A lasted 4 days and in group B 10 days. Antibiotics were given over a period of 8-10 days, while homeopathic treatments were stopped after healing. In group A 70.7% of the patients were free of relapses within 1 years and 29.3% had a maximum of three relapses. Group B had 56.5% without relapses and 43.5% a maximum of six relapses. Five children in group A were given antibiotics and 98 responded solely to homeopathic treatments. No side effects of treatment were found in either group.

  4. Diagnosis and management of acute otitis media in the urgent care setting.

    Science.gov (United States)

    McCracken, George H

    2002-04-01

    The prevalence of otitis media is increasing, which affects health care resource utilization across all segments, including the urgent care setting. One of the greatest challenges in the management of acute otitis media (AOM) is the effective treatment of cases caused by pathogens that are resistant to commonly used antibiotics. Whereas the production of beta-lactamases among strains of Haemophilus influenzae and Moraxella catarrhalis is an important consideration for antimicrobial therapy, the high prevalence of resistance to penicillin and other classes of antibiotics among strains of Streptococcus pneumoniae represents a greater clinical concern. The Centers for Disease Control and Prevention (CDC) recently convened the Drug Resistant S. pneumoniae Therapeutic Working Group to develop evidence-based recommendations for the treatment of AOM in an era of prevalent resistance. The recommendations from this group included amoxicillin as the preferred first-line drug because of the demonstrated activity against penicillin-intermediate and -resistant strains of S. pneumoniae, using higher dosages of up to 90 mg/kg per day in certain settings. For patients in whom initial treatment is unsuccessful after 3 days, the recommended agents included high-dose amoxicillin-clavulanate (for activity against beta-lactamase-producing pathogens), clindamycin, cefuroxime axetil, or 1 to 3 doses of intramuscular ceftriaxone. The principles set forth in these guidelines can assist the therapeutic decisionmaking process for practitioners in the urgent care setting.

  5. Defective serum opsonization activity in children aged 6-48 months having acute purulent otitis media.

    Science.gov (United States)

    Tezcan, I; Yilmaz, Y; Oner, F; Yel, L; Sanal, O; Ersoy, F; Onerci, M; Berkel, A I

    1997-01-01

    Serum opsonization of yeast (Saccharomyces) was investigated in 51 patients whose ages were between six and 48 months (median 15 months) with acute purulent otitis media and in an age-matched control group (median 13 months). Opsonization was assessed by measuring yeast particle uptake in an assay based on an electronic count of the unphagocytosed particles in serum by polymorphonuclear leukocytes. Despite normal levels of CH50 and serum immunoglobulins, a defective opsonization was determined in 13.7 percent of the patients (7 in 51). The corresponding figure was 2.9 percent in 103 healthy controls (p < 0.001). On the other hand, 218 percent (5 in 23) of the children having a history of recurrent purulent otitis media showed defective opsonization (p < 0.001). Previously, the presence of an opsonization defect has been linked to low levels of mannan binding lectin (MBL), a calcium dependent serum lectin that acts as an opsonin. Therefore, our findings indirectly support the idea that MBL has an important role as host defense, particularly in the earlier period of life when the antibody repertoire is restricted.

  6. Antibiotic resistance in pathogens causing acute otitis media in Finnish children.

    Science.gov (United States)

    Sillanpää, Saara; Sipilä, Markku; Hyöty, Heikki; Rautiainen, Markus; Laranne, Jussi

    2016-06-01

    Microbiology and susceptibility of middle ear pathogens in children change over time and antibiotic resistance is increasing globally. For the clinicians it is important to be up to date about the resistance situation when considering antibiotic treatment in acute otitis media (AOM). In this study we analysed the resistance profile of AOM pathogens in out-patient children in Finland. A total of 41 culture positive middle ear fluid (MEF) samples were analysed for bacteria and the presence of antibiotic resistant strains. The samples were obtained from children aged six - 39 months who participated in the otitis media trial during one year period. The most common pathogen was Haemophilus influenzae 17 (40%), followed by Streptococcus pneumoniae in 15 (35%) and Moraxella catarrhalis in 8 (19%). Other pathogens were detected in 3 (7%) of cases. Antibiotic resistance or diminished sensitivity was seen in 63% of the detected bacteria and 28% of pathogens produced beta-lactamase. Antibiotic resistant bacterial strains causing AOM have increased in Finland. Nevertheless, most of the pathogens (72%) were sensitive to amoxicillin, which is still recommended as the first line antibiotic in the treatment of AOM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Effectiveness of a propolis and zinc solution in preventing acute otitis media in children with a history of recurrent acute otitis media.

    Science.gov (United States)

    Marchisio, P; Esposito, S; Bianchini, S; Desantis, C; Galeone, C; Nazzari, E; Pignataro, L; Principi, N

    2010-01-01

    Recurrent acute otitis media (rAOM) is frequently encountered in infants and children and the lack of any definitive treatment has led parents and physicians to try complementary and alternative therapies. We evaluated the efficacy of a propolis and zinc suspension in preventing AOM in 122 children aged 1-5 years with a documented history of rAOM, who were prospectively, blindly, randomized 1:1 to receive the suspension plus elimination of environmental risk factors or elimination of environmental risk factors only. AOM- and respiratory-related morbidity were assessed at study entry and every four weeks. In the 3-month treatment period AOM was diagnosed in 31 (50.8%) children given the propolis and zinc suspension and in 43 (70.5%) controls (p=0.04). The mean number of episodes of AOM per child/month was 0.23+/-0.26 in the propolis and zinc group and 0.34+/-0.29 in controls (reduction 32.0%, p=0.03). The administration of a propolis and zinc suspension to children with a history of rAOM can significantly reduce the risk of new AOM episodes and AOM-related antibiotic courses, with no problem of safety or tolerability, and with a very good degree of parental satisfaction. No effect can be expected on respiratory infections other than AOM.

  8. Comparison of Boric Acid and Combination Drug of Polymyxin, Neomycin and Hydrocortisone (polymyxin NH) in the Treatment of Acute Otitis Externa.

    Science.gov (United States)

    Amani, Soroush; Moeini, Mohammad

    2016-07-01

    Acute otitis externa is an inflammation of the external auditory canal known as "swimmer's ear". Direct costs including medical treatment, painkillers, antibiotics, steroids or both and indirect costs are also remarkable. The aim of this study was to compare the effect of boric acid and polymyxin, neomycin and hydrocortisone composition in the treatment of acute otitis externa. This randomized clinical trial was carried out on 80 patients aged more than 17-year-old who were referred to Kashani hospital clinic with a diagnosis of acute otitis externa by otolaryngologist. The patients were randomly allocated to two groups (A: Boric acid and B: polymyxin NH ear drops) and Painkiller was prescribed and administered orally for all patients and in the presence of fever, cellulitis around the ears and neck adenopathy, broad-spectrum systemic antibiotics were used besides topical treatment. Symptoms of patients who were evaluated by a physician includes pain, discharge from the ear, swelling of the ear canal, auricle swelling, tenderness, and ear itching. In addition, pain was evaluated in patients and was recorded by Macgill Pain Questionnaire, in the first, third, seventh and tenth days. Results showed that itching on third day (p=0.007) and swelling of the ear canal in the examination of the third day (p=0.006) and the seventh day (p=0.001) in the polymyxin NH group was more than those of boric acid group. Overall mean pain based on McGill questionnaire was 11.10±1.49 in boric acid group in the examination on the first day and was 4.05±0.22 in the examination on the tenth day and in the polymyxin NH group, it was 10.9±0.99 on the first day and 4.20±0.40 on the tenth day. In both groups, pain relief was the same and there was no significant difference between two groups (p=0.075). The findings of this study showed slight differences in the effectiveness of the boric acid drug and combination of polymyxin, neomycin and hydrocortisone in the treatment of patients with

  9. CT of malignant otitis externa. Computertomographie der malignen Otitis externa

    Energy Technology Data Exchange (ETDEWEB)

    Klose, K.C.; Elies, W. (Technische Hochschule Aachen (Germany, F.R.). Klinik fuer Radiologische Diagnostik Technische Hochschule Aachen (Germany, F.R.). Klinik fuer HNO)

    1991-06-01

    Computed tomography was performed preoperatively in 20 patients suffering from malignant external otitis. The CT findings were nearly completely confirmed by the intraoperative findings. A circumscribed or diffuse thickening of the cartilaginous wall of the external auditory canal and an inflammatory infiltration of the subtemporal fossa are, in combination, most suspicious signs of malignant external otitis. Computed tomography enabels detailed information on the extension of the pneumatic system and the grade of involvement of bones and soft tissues in malignant external otitis. A modified classification of malignant external otitis based on computed tomographic findings is proposed. (orig.).

  10. Effect of low-intensity focused ultrasound on the middle ear in a mouse model of acute otitis media.

    Science.gov (United States)

    Noda, Kanako; Hirano, Takashi; Noda, Kenji; Kodama, Satoru; Ichimiya, Issei; Suzuki, Masashi

    2013-03-01

    We hypothesized that low-intensity focused ultrasound (LIFU) increases vessel permeability and antibacterial drug activity in the mouse middle ear. We determined appropriate settings by applying LIFU to mouse ears with the external auditory canal filled with normal saline and performed histologic and immunohistologic examination. Acute otitis media was induced in mice with nontypable Haemophilus influenzae, and they were given ampicillin (50, 10, or 2 mg/kg) intraperitoneally once daily for 3 days with or without LIFU (1.0 W/cm(2), 20% duty cycle, 30 s). In the LIFU(+) groups receiving the 2- and 10-mg/kg doses, viable bacteria counts, number of inflammatory cells and IL-1β and TNF-α levels in middle ear effusion were significantly lower than in the LIFU(-) groups on the same doses. Severity of AOM also tended to be reduced more in the LIFU(+) groups than in the LIFU(-) groups. LIFU application with antibiotics may be effective for middle ear infection.

  11. Homeopathic Ear Drops as an Adjunct in Reducing Antibiotic Usage in Children With Acute Otitis Media.

    Science.gov (United States)

    Taylor, James A; Jacobs, Jennifer

    2014-01-01

    Objective. To determine if use of a homeopathic ear drop preparation reduces antibiotic use in children diagnosed with acute otitis media (AOM). Methods. Children 6 months to 11 years old, diagnosed with AOM and managed with a delayed antibiotic approach, were randomized to standard therapy alone or standard therapy plus a homeopathic ear drop preparation. The primary outcome was whether or not the antibiotic prescription given at the index visit was filled during a 12- to 15-day follow-up period. Results. Among 210 enrolled children, follow-up antibiotic data were collected on 206. During the 12- to 15-day follow-up period, fewer parents of children randomized to the homeopathic ear drops group filled the antibiotic prescription compared with those of children receiving standard therapy alone (26.9% and 41.2%, respectively, P = .032). Conclusion. Homeopathic ear drops may be effective in reducing the use of antibiotics in children with AOM managed with a delayed antibiotic approach.

  12. Acute otitis media guidelines in selected developed and developing countries: uniformity and diversity.

    Science.gov (United States)

    Ovnat Tamir, Sharon; Shemesh, Shay; Oron, Yahav; Marom, Tal

    2017-05-01

    Acute otitis media (AOM) is a common childhood disease, with an enormous economic and healthcare-related burden. Guidelines and consensus papers for AOM diagnosis and management were published in many countries. Our objective was to study the differences and similarities between these protocols in developing and developed countries. The keywords: 'acute otitis media' AND 'children' AND ['treatment' or 'management'] AND ['guideline' or 'consensus'] were used in various electronic databases between 1 January 1989 through 31 December 2015. Overall, 99 sources from 62 countries were retrieved: 53 from 22 developed countries, and 46 from 40 developing countries. Representative guidelines from America (the USA, Argentina), Europe (Italy, Moldova), Africa (South Africa, Tanzania, Ethiopia), Asia (Japan, Afghanistan, Sri Lanka),and Oceania (South Australia, Fiji) were compared. Paediatric societies publish guidelines in most developed countries; in developing countries, the Ministry of Health usually initiates guideline formulation. Most guidelines use the same diagnostic criteria and offer watchful waiting in mild-moderate scenarios. Amoxicillin is the suggested first-line antibiotic, whereas options for second-line and third-line therapies vary. Duration of therapy varies and is usually age dependent: 5-7 days for children 2 years in developed countries, while duration and age groups vary greatly in developing countries. Reduction of AOM risk factors is encouraged in developed countries, but rarely in developing countries. Guidelines for AOM from developing and developed countries are similar in many aspects, with variation in specific recommendations, due to local epidemiology and healthcare accessibility. Formulation of regional guidelines may help reduce AOM burden. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. Cost and Utilization of Retail Clinics vs. Other Providers for Treatment of Pediatric Acute Otitis Media.

    Science.gov (United States)

    Duncan, Ian; Clark, Kara; Wang, Stacy

    2016-10-01

    A common acute condition seen by providers in retails clinics is the evaluation and treatment of acute otitis media (AOM) in children younger than age 20. Annual direct treatment costs for AOM were US $5.3 billion in 1998 dollars. Based on the experience of a large retail pharmacy employer, the authors compared AOM episodes in covered dependents younger than age 20 in retail clinic states to those in states without retail clinic access. Relative costs as well as frequency of visits and antibiotic prescriptions were analyzed for both retail clinic-based, and non-retail clinic-based episodes. Rates of AOM episodes were lower in retail clinic than in non-retail clinic states (62.5 vs. 76.9 per 1000 members per year; P retail clinic and non-retail clinic states (1.417 vs. 1.430, respectively; P = 0.657), suggesting that retail clinics do not result in an increase in overall utilization. On a risk-adjusted basis, retail clinic episodes cost approximately $30-$130 less than community episodes, depending on year. In retail clinic states, the antibiotic prescription fill rate was 95.4% for retail clinic episodes and 82.8% for community episodes, consistent with rates in the literature. This study confirms results of earlier studies that retail clinics are a less costly setting than the community for the treatment of episodes of otitis media There also is little evidence that retail clinics lead to duplication of services (patients receiving follow-up care in other settings).

  14. A longitudinal study of respiratory viruses and bacteria in the etiology of acute otitis media with effusion.

    Science.gov (United States)

    Henderson, F W; Collier, A M; Sanyal, M A; Watkins, J M; Fairclough, D L; Clyde, W A; Denny, F W

    1982-06-10

    We analyzed data from a 14-year longitudinal study of respiratory infections in young children to determine the relative importance of viral respiratory infection and nasopharyngeal colonization with Streptococcus pneumoniae and Haemophilus influenzae as factors influencing the occurrence of acute otitis media with effusion. The incidence of this disorder was increased in children with viral respiratory infections (average relative risk, 3.2; P less than 0.0001). Infection with respiratory syncytial virus, influenza virus (type A or B), and adenovirus conferred a greater risk of otitis media than did infection with parainfluenza virus, enterovirus, or rhinovirus. Colonization of the nasopharynx with Str. pneumoniae or H. influenzae had a lesser effect on the incidence of the disease (average relative risk; 1.5; P less than 0.01). Infections with the viruses more closely associated with acute otitis media (respiratory syncytial virus, adenovirus, and influenza A or B) were correlated with an increased risk of recurrent disease. Prevention of selected otitis-associated viral infections should reduce the incidence of this disease.

  15. Panel 7 : Otitis Media: Treatment and Complications

    NARCIS (Netherlands)

    Schilder, Anne G M; Marom, Tal; Bhutta, Mahmood F; Casselbrant, Margaretha L; Coates, Harvey; Gisselsson-Solén, Marie; Hall, Amanda J; Marchisio, Paola; Ruohola, Aino; Venekamp, Roderick P; Mandel, Ellen M

    Objective We aimed to summarize key articles published between 2011 and 2015 on the treatment of (recurrent) acute otitis media, otitis media with effusion, tympanostomy tube otorrhea, chronic suppurative otitis media and complications of otitis media, and their implications for clinical practice.

  16. Outcomes of Recurrent Acute Otitis Media in Children Treated for Dental Malocclusion: A Preliminary Report

    Science.gov (United States)

    Bernkopf, Edoardo; Bernkopf, Giulia; Giacomelli, Luciano; De Vincentis, Giovanni Carlo; Macrì, Francesco; de Filippis, Cosimo

    2016-01-01

    Aim. To investigate the role of dental malocclusion treatment in the outcomes of Recurrent Acute Otitis Media (RAOM). Materials and Methods. The clinical outcome (number of acute recurrences in 12 months) of 61 consecutive children treated medically for RAOM was analysed. Children underwent an odontostomatologic evaluation, a fiberoptic endoscopy, and skin-prick tests. Results. 32 children (group A) were diagnosed with dental malocclusion and treated with a mandibular repositioning plate. Dental malocclusion was ruled out in the other 29 patients with RAOM, and they were used as controls (group B). The two groups were homogeneous in terms of sex, exposure to RAOM risk factors, skin test results, and adenoid hypertrophy, while age was significantly higher in group A. Age, sex, exposure to RAOM risk factors, adenoid hypertrophy, and skin test results were not associated with RAOM outcome. Children in group A treated for dental malocclusion were strongly associated with a lower number of acute episode recurrences at both univariate (p malocclusion wearing a mandibular repositioning device. Dental malocclusion in children with RAOM may play a role in the pathogenesis of Eustachian tube dysfunction. PMID:27965974

  17. Outcomes of Recurrent Acute Otitis Media in Children Treated for Dental Malocclusion: A Preliminary Report

    Directory of Open Access Journals (Sweden)

    Edoardo Bernkopf

    2016-01-01

    Full Text Available Aim. To investigate the role of dental malocclusion treatment in the outcomes of Recurrent Acute Otitis Media (RAOM. Materials and Methods. The clinical outcome (number of acute recurrences in 12 months of 61 consecutive children treated medically for RAOM was analysed. Children underwent an odontostomatologic evaluation, a fiberoptic endoscopy, and skin-prick tests. Results. 32 children (group A were diagnosed with dental malocclusion and treated with a mandibular repositioning plate. Dental malocclusion was ruled out in the other 29 patients with RAOM, and they were used as controls (group B. The two groups were homogeneous in terms of sex, exposure to RAOM risk factors, skin test results, and adenoid hypertrophy, while age was significantly higher in group A. Age, sex, exposure to RAOM risk factors, adenoid hypertrophy, and skin test results were not associated with RAOM outcome. Children in group A treated for dental malocclusion were strongly associated with a lower number of acute episode recurrences at both univariate (p<0.0001 and multivariate analysis (p=0.001. Conclusions. RAOM showed better outcomes in children with dental malocclusion wearing a mandibular repositioning device. Dental malocclusion in children with RAOM may play a role in the pathogenesis of Eustachian tube dysfunction.

  18. MICROBIOLOGICAL STUDY OF ACUTE OTITIS MEDIA IN CHILDREN AGED 2 MONTHS TO 18 YEARS

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    Ramakrishna Pai

    2014-01-01

    Full Text Available Acute Suppurative Otitis media (ASOM is one of the diseases that causedeath in children below the age of 5 years. The pathogens causing otitis media (OM vary from region to region. Both Gram positive and Gram negative bacteria are responsible f or OM. So this study was conducted to know the aerobic bacterial pathogens causing OM and their susceptibility pattern in children below 18 years attending a rural tertiary health care center in north Kerala . MATERIALS AND METHODS : A total of 75 patients in pediatric age group 2 months to 18 years clinically havingASOM , were included in the study . Ear discharge was collected using sterile cotton swabs and processed accordingly. RESULTS : A total of 75 patients aged 2 months to 18 years with discharging ears wer e included in the study. Among them , forty one (54.7% were males and thirty four (45.3% were females. Forty five children were below years. Sixty five (86.6% had unilateral ear discharge. Among the 75 ear swabs cultured , 66 (88% had aerobic bacteria is olated. S.aureus was themost common isolate accounting to 32(47% followed by P.aeruoginosa 19(27.9%. It was observed that most of the Staphylococcus aureusisolates were resistant to p en i cillins and first generation cephalosporins while Pseudomonas aerugi nosa to fluoroquinolones. CONCLUSION : Since there is reduced susceptibility of the pathogens isolated to first and second line antibacterials it is necessary to use these antibacterials judiciously and in the right dosage

  19. Immunization Str.pneumonia vaccine reduces the incidence orphanage children’s acute otitis media (preliminary results

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    A. A. Dzhumagaziev

    2012-01-01

    Full Text Available In order to assess the impact of pneumococcal vaccine on the incidence of ear infections in children in the first four years of life, the comparative analysis of monthly incidence of the disease in 18 months in previously vaccinated children, and for the first six months after the catch-up immunization of 7- (PCV7 or 23 – valent (PPV23 pneumococcal vaccine . Traced threefold reduction in the incidence of hospitalization 114 children being raised in orphanages for acute otitis after a single use of pneumococcal vaccine. Early immunization of 101 children against pneumococcus contributes monthly prevent 1 case of hospitalization for acute otitis media.

  20. Is a positive family history predictive for recurrent acute otitis media in children? An evidence-based case report.

    Science.gov (United States)

    Albersen, Monique; Bulatović, Maja; Lindner, Sanneke H; van Stiphout, Feikje; van der Heijden, Geert J M G; Schilder, Anne G M; Rovers, Maroeska M

    2010-01-01

    In this evidence-based case report, we studied the clinical question: Is a positive family history of acute otitis media (AOM) predictive for recurrent acute otitis media (rAOM) in children between zero and two years of age? The search yielded 3178 articles, of which only two were relevant and had a high validity regarding our clinical question. Neither of these two studies provided the final answer to our clinical question because they did not report stratified absolute risks for a positive family history. Fortunately, we were able to study the absolute risks in one of the two studies. The absolute risk of rAOM without distinguishing family history was 33 percent; the risk was 27 percent for children without a family history and 45 percent for children with a positive family history. Family history increases the absolute risk, but not in a way that it will help to predict rAOM accurately.

  1. The clinical course of acute otitis media in high-risk Australian Aboriginal children: a longitudinal study

    OpenAIRE

    Skull Susan A; Carapetis Jonathan R; Morris Peter S; Gibney Katherine B; Smith-Vaughan Heidi C; Stubbs Elizabeth; Leach Amanda J

    2005-01-01

    Abstract Background It is unclear why some children with acute otitis media (AOM) have poor outcomes. Our aim was to describe the clinical course of AOM and the associated bacterial nasopharyngeal colonisation in a high-risk population of Australian Aboriginal children. Methods We examined Aboriginal children younger than eight years who had a clinical diagnosis of AOM. Pneumatic otoscopy and video-otoscopy of the tympanic membrane (TM) and tympanometry was done every weekday if possible. We ...

  2. A Cost-Utility Analysis of 5 Strategies for the Management of Acute Otitis Media in Children.

    Science.gov (United States)

    Shaikh, Nader; Dando, Emily E; Dunleavy, Mark L; Curran, Dorothy L; Martin, Judith M; Hoberman, Alejandro; Smith, Kenneth J

    2017-10-01

    To assess whether antimicrobial therapy in young children with acute otitis media reduces time to resolution of symptoms, overall symptom burden, and persistence of otoscopic evidence of infection. We used a cost-utility model to evaluate whether immediate antimicrobial treatment seems to be worthwhile, and if so, which antimicrobial agent is most cost effective. We compared the cost per quality-adjusted life-day of 5 treatment regimens in children younger than 2 years of age with acute otitis media: immediate amoxicillin/clavulanate, immediate amoxicillin, immediate cefdinir, watchful waiting, and delayed prescription (DP) for antibiotic. The 5 treatment regimens, listed in order from least effective to most effective were DP, watchful waiting, immediate cefdinir, immediate amoxicillin, and immediate amoxicillin/clavulanate. Listed in order from least costly to most costly, the regimens were DP, immediate amoxicillin, watchful waiting, immediate amoxicillin/clavulanate, and immediate cefdinir. The incremental cost-utility ratio of immediate amoxicillin compared with DP was $101.07 per quality-adjusted life-day gained. The incremental cost-utility ratio of immediate amoxicillin/clavulanate compared with amoxicillin was $2331.28 per quality-adjusted life-day gained. In children younger than 2 years of age with acute otitis media and no recent antibiotic exposure, immediate amoxicillin seems to be the most cost-effective initial treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Molecular epidemiology of nonencapsulated Streptococcus pneumoniae among Japanese children with acute otitis media.

    Science.gov (United States)

    Hotomi, Muneki; Nakajima, Kouji; Hiraoka, Masanobu; Nahm, Moon H; Yamanaka, Noboru

    2016-02-01

    The introduction of pneumococcal conjugate vaccine may change the epidemiology of Streptococcus pneumoniae. The increased prevalence of non-vaccine serotypes as the cause of pneumococcal diseases has already reported in the United States and Europe. However, little attention has been focused on the S. pneumoniae. In this study, nonencapsulated S. pneumoniae were identified in 15 isolates (6.4%) out of 236 pneumococcal strains obtained from the nasopharynges of children with acute otitis media (AOM), in 3 isolates (14.3%) out of 21 strains from acute rhinosinusitis, and in 2 isolates (12.5%) out of 16 nasopharyngeal carriage strains obtained from normal healthy children. Among the 20 nonencapsulated S. pneumoniae isolates, 15 (75.0%) isolates had the pspK gene. Seven sequence types (STs) were identified: ST7502 (5 strains), ST1106 (2 strains), ST7803 (2 strains), ST7786 (1 strain), ST6741 (1 strain), ST7496 (1 strain), and ST8642 (1 strain). Because nonencapsulated S. pneumoniae strains are not targeted by the current available pneumococcal vaccines, these strains will gradually become more common in nasopharyngeal carriage. The increase in colonization and dissemination of these strains would increase the risk of AOM and other systemic pneumococcal diseases against which current vaccines cannot provide protection. Nonencapsulated S. pneumoniae may thus become more prevalent as human pathogen.

  4. Microbiology of acute otitis media in children with tympanostomy tubes: prevalences of bacteria and viruses.

    Science.gov (United States)

    Ruohola, Aino; Meurman, Olli; Nikkari, Simo; Skottman, Tuukka; Salmi, Aimo; Waris, Matti; Osterback, Riikka; Eerola, Erkki; Allander, Tobias; Niesters, Hubert; Heikkinen, Terho; Ruuskanen, Olli

    2006-12-01

    Bacteria are found in 50%-90% of cases of acute otitis media (AOM) with or without otorrhea, and viruses are found in 20%-49% of cases. However, for at least 15% of patients with AOM, the microbiological etiology is never determined. Our aim was to specify the full etiology of acute middle ear infection by using modern microbiological methods concomitantly for bacterial and viral detection. The subjects were 79 young children having AOM with new onset (Bacteria were sought by culture and polymerase chain reaction; viruses were analyzed by culture, antigen detection, and polymerase chain reaction. At least 1 respiratory tract pathogen was noted in 76 children (96%). Bacteria were found in 73 cases (92%), and viruses were found in 55 (70%). In 52 patients (66%), both bacteria and viruses were found. Bacteria typical of AOM were detected in 86% of patients. Picornaviruses accounted for 60% of all viral findings. In the great majority of children, AOM is a coinfection with bacteria and viruses. The patent tympanostomy tube does not change the spectrum of causative agents in AOM. A microbiological etiology can be established in practically all cases.

  5. IgG responses to Pneumococcal and Haemophilus influenzae protein antigens are not impaired in children with a history of recurrent acute otitis media.

    Science.gov (United States)

    Wiertsema, Selma P; Corscadden, Karli J; Mowe, Eva N; Zhang, Guicheng; Vijayasekaran, Shyan; Coates, Harvey L; Mitchell, Timothy J; Thomas, Wayne R; Richmond, Peter C; Kirkham, Lea-Ann S

    2012-01-01

    Vaccines including conserved antigens from Streptococcus pneumoniae and nontypeable Haemophilus influenzae (NTHi) have the potential to reduce the burden of acute otitis media. Little is known about the antibody response to such antigens in young children with recurrent acute otitis media, however, it has been suggested antibody production may be impaired in these children. We measured serum IgG levels against 4 pneumococcal (PspA1, PspA 2, CbpA and Ply) and 3 NTHi (P4, P6 and PD) proteins in a cross-sectional study of 172 children under 3 years of age with a history of recurrent acute otitis media (median 7 episodes, requiring ventilation tube insertion) and 63 healthy age-matched controls, using a newly developed multiplex bead assay. Children with a history of recurrent acute otitis media had significantly higher geometric mean serum IgG levels against NTHi proteins P4, P6 and PD compared with healthy controls, whereas there was no difference in antibody levels against pneumococcal protein antigens. In both children with and without a history of acute otitis media, antibody levels increased with age and were significantly higher in children colonised with S. pneumoniae or NTHi compared with children that were not colonised. Proteins from S. pneumoniae and NTHi induce serum IgG in children with a history of acute otitis media. The mechanisms in which proteins induce immunity and potential protection requires further investigation but the dogma of impaired antibody responses in children with recurrent acute otitis media should be reconsidered.

  6. IgG responses to Pneumococcal and Haemophilus influenzae protein antigens are not impaired in children with a history of recurrent acute otitis media.

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    Selma P Wiertsema

    Full Text Available BACKGROUND: Vaccines including conserved antigens from Streptococcus pneumoniae and nontypeable Haemophilus influenzae (NTHi have the potential to reduce the burden of acute otitis media. Little is known about the antibody response to such antigens in young children with recurrent acute otitis media, however, it has been suggested antibody production may be impaired in these children. METHODS: We measured serum IgG levels against 4 pneumococcal (PspA1, PspA 2, CbpA and Ply and 3 NTHi (P4, P6 and PD proteins in a cross-sectional study of 172 children under 3 years of age with a history of recurrent acute otitis media (median 7 episodes, requiring ventilation tube insertion and 63 healthy age-matched controls, using a newly developed multiplex bead assay. RESULTS: Children with a history of recurrent acute otitis media had significantly higher geometric mean serum IgG levels against NTHi proteins P4, P6 and PD compared with healthy controls, whereas there was no difference in antibody levels against pneumococcal protein antigens. In both children with and without a history of acute otitis media, antibody levels increased with age and were significantly higher in children colonised with S. pneumoniae or NTHi compared with children that were not colonised. CONCLUSIONS: Proteins from S. pneumoniae and NTHi induce serum IgG in children with a history of acute otitis media. The mechanisms in which proteins induce immunity and potential protection requires further investigation but the dogma of impaired antibody responses in children with recurrent acute otitis media should be reconsidered.

  7. Correlative mRNA and protein expression of middle and inner ear inflammatory cytokines during mouse acute otitis media.

    Science.gov (United States)

    Trune, Dennis R; Kempton, Beth; Hausman, Frances A; Larrain, Barbara E; MacArthur, Carol J

    2015-08-01

    Although the inner ear has long been reported to be susceptible to middle ear disease, little is known of the inflammatory mechanisms that might cause permanent sensorineural hearing loss. Recent studies have shown inner ear tissues are capable of expressing inflammatory cytokines during otitis media. However, little quantitative information is available concerning cytokine gene expression in the inner ear and the protein products that result. Therefore, this study was conducted of mouse middle and inner ear during acute otitis media to measure the relationship between inflammatory cytokine genes and their protein products with quantitative RT-PCR and ELISA, respectively. Balb/c mice were inoculated transtympanically with heat-killed Haemophilus influenzae and middle and inner ear tissues collected for either quantitative RT-PCR microarrays or ELISA multiplex arrays. mRNA for several cytokine genes was significantly increased in both the middle and inner ear at 6 h. In the inner ear, these included MIP-2 (448 fold), IL-6 (126 fold), IL-1β (7.8 fold), IL-10 (10.7 fold), TNFα (1.8 fold), and IL-1α (1.5 fold). The 24 h samples showed a similar pattern of gene expression, although generally at lower levels. In parallel, the ELISA showed the related cytokines were present in the inner ear at concentrations higher by 2-122 fold higher at 18 h, declining slightly from there at 24 h. Immunohistochemistry with antibodies to a number of these cytokines demonstrated they occurred in greater amounts in the inner ear tissues. These findings demonstrate considerable inflammatory gene expression and gene products in the inner ear following acute otitis media. These higher cytokine levels suggest one potential mechanism for the permanent hearing loss seen in some cases of acute and chronic otitis media.

  8. Laser treatment of otitis media in children

    Energy Technology Data Exchange (ETDEWEB)

    Podoynitsyna, L.F.

    1984-08-01

    Clinical trials were conducted with the helium-neon LG-75 laser (632.8 nm, 0.1 W/cm/sup 2/) in the management of 50 children with acute and chronic otitis media. The sessions consisted of 30 sec irradiation directed at the middle ear through the external meatus for a period of 5 days. Positive results were obtained in 45 of the patients with cessation of discharge on the 2nd or 3rd day, and return of hearing by the end of the week. The remission was not permanent in one patient with recurrent otitis media. These observations indicate that the anti-inflammatory effects of helium-neon irradiation constitute an effective treatment modality in children with otitis media. 6 references.

  9. Cochlear implants in children: surgical site infections and prevention and treatment of acute otitis media and meningitis.

    Science.gov (United States)

    Rubin, Lorry G; Papsin, Blake

    2010-08-01

    The use of cochlear implants is increasingly common, particularly in children younger than 3 years. Bacterial meningitis, often with associated acute otitis media, is more common in children with cochlear implants than in groups of control children. Children with profound deafness who are candidates for cochlear implants should receive all age-appropriate doses of pneumococcal conjugate and Haemophilus influenzae type b conjugate vaccines and appropriate annual immunization against influenza. In addition, starting at 24 months of age, a single dose of 23-valent pneumococcal polysaccharide vaccine should be administered. Before implant surgery, primary care providers and cochlear implant teams should ensure that immunizations are up-to-date, preferably with completion of indicated vaccines at least 2 weeks before implant surgery. Imaging of the temporal bone/inner ear should be performed before cochlear implantation in all children with congenital deafness and all patients with profound hearing impairment and a history of bacterial meningitis to identify those with inner-ear malformations/cerebrospinal fluid fistulas or ossification of the cochlea. During the initial months after cochlear implantation, the risk of complications of acute otitis media may be higher than during subsequent time periods. Therefore, it is recommended that acute otitis media diagnosed during the first 2 months after implantation be initially treated with a parenteral antibiotic (eg, ceftriaxone or cefotaxime). Episodes occurring 2 months or longer after implantation can be treated with a trial of an oral antimicrobial agent (eg, amoxicillin or amoxicillin/clavulanate at a dose of approximately 90 mg/kg per day of amoxicillin component), provided the child does not appear toxic and the implant does not have a spacer/positioner, a wedge that rests in the cochlea next to the electrodes present in certain implant models available between 1999 and 2002. "Watchful waiting" without antimicrobial

  10. Pattern of otitis externa in Kaduna Nigeria.

    Science.gov (United States)

    Musa, Thomas Samdi; Bemu, Alfred Nicholas; Grema, Umar Sambo; Kirfi, Abdullahi Musa

    2015-01-01

    Otitis externa (OE) is an inflammation or infection of the external auditory canal (EAC), the auricle, or both this condition has been reported to be found in all age groups. The aims and objectives were, study/determine the prevalence of Otitis externa in the specialist otolaryngology clinic in National Ear Care Center Kaduna, study the pattern of presentation among patients with otitis externa in the specialist otolaryngology clinic in National Ear Care Center Kaduna, and evaluate the choice of drug treatment for otitis externa in the specialist otolaryngology clinic in National Ear Care Center Kaduna. Data of patients diagnosed with otitis externa between January 2009 and March 2013 were extracted from the recorded cases of ear disease seen within the same period. The ages, sex/ gender, complains(symptoms), duration of symptoms, clinical examination findings, diagnosis, mode of drug treatment, number of visits and complication records were extracted from the case notes of the patients and analyzed descriptively using SPSS (Statistical package for Social Sciences) version. Out of 13,328 cases of ear diseases seen within the period under review, 133 cases were diagnosed with otitis externa across all age groups. Hospital prevalence stands at 1.0%. There were 81(60.9%) males and 52(39.1%) females in ratio 1.5:1. Children age 0-15 constitute 55(41.3%) while young adults and adults were 78(58.6%). The minimum age at presentation was one year, while maximum age was 64 years. Mean age was 24 years with a standard deviation of ± 1.12 Years. Ear pain as only presenting symptom was the major complain found in this study accounting for 68(51.1%). Acute diffuse otitis externa was the commonest diagnosis accounting for 101(75.9%) and associated clinical findings ranging from tragal tenderness, hyperaemia and oedema of ear canal in 57 (54.9%). Ear swab was not routinely done and only 6(15.8%) of the discharging ears had microscopy done and the organisms were Pseudomonas spp

  11. Complicaciones de las otitis medias agudas y crónicas en el niño Complications of acute and chronic otitis media in the child

    Directory of Open Access Journals (Sweden)

    Julianis Loraine Quintero Noa

    2013-03-01

    Full Text Available Gracias al descubrimiento de los antibióticos, la incidencia de complicaciones en las otitis medias agudas y crónicas ha descendido significativamente, aunque continúan siendo un peligro potencial de morbilidad y mortalidad. La disminución de las complicaciones puede condicionar retrasos diagnósticos por falta de sospecha clínica, enmascaramiento por tratamientos antibióticos previos y mal pronóstico, por lo cual siguen siendo procesos graves que ponen en peligro la vida del enfermo. Se definen actualmente con igual sistema de clasificación: extracraneales e intracraneales. Las primeras se subdividen en extratemporal e intratemporal, y constituyen un problema de salud en la población pediátrica a pesar del uso extendido de antibióticos. La evaluación clínico-otomicroscópica e imaginológica se reporta como criterio diagnóstico predictivo de sospecha y de confirmación. La parálisis facial, el vértigo, los vómitos, la cefalea, el dolor irradiado a la mastoides o a la región temporoparietal, y la hipertermia, deben alertar al médico sobre la presencia de una complicación supurada.Thanks to the discovery of antiobiotics, the incidence of complications in the chronic and acute otitis media has significantly decreased, though they remain a potential mortality and morbidity risk. The reduction of complications can be conditional on some diagnostic delays, on account of lack of clinical suspicions, symptoms disguised by previous antibiotic treatments and wrong prognosis; therefore, the complications continue to be severe processes that endanger the patient's life. They are currently classified as extracranial and intracranial. The former are divided into extratemporal and intratemporal and represent a health problem for the pediatric population despite the extended use of antibiotics. The clinical, otomicroscopic and imaging assessment is reported as a diagnostic criterion predictive of suspicions and of confirmation. Facial

  12. Comparison of Axillary and Tympanic Temperature Measurements in Children Diagnosed with Acute Otitis Media

    Science.gov (United States)

    Doğan, Hatice Hilal; Kırkgöz, Tarık; Bozaykut, Abdulkadir

    2016-01-01

    Background. Acute otitis media [AOM] may affect the accuracy of tympanic temperature measurements. We aimed to compare tympanic temperature measurements in patients with AOM against control groups, as well as compare the tympanic temperatures with axillary thermometry. Methods. This is a prospective, observational study. Patients from pediatric outpatient and emergency clinics who were diagnosed as single-sided AOM were included consecutively in the study. Normal ears of patients and children having the same age and gender who were not diagnosed as AOM were also studied as controls. Results. In patients with AOM, infected ears had higher temperatures than normal ears with a mean of 0.48 ± 0.01°C. There was no significant difference between the right and left tympanic temperatures in control group. Compared with axillary temperature, the sensitivity of tympanic temperature in the infected ear was 91.7% and the specificity was 74.8%. Conclusion. Comparisons of axillary and tympanic temperatures in children with AOM during the active infection concluded higher tympanic temperatures in infected ears. We suggest that the higher tympanic temperatures, approximately 0.5°C in our study, in infected ears may aid in diagnosis of patients with fever without a source in pediatric clinics. PMID:27648079

  13. Homeopathic Ear Drops as an Adjunct in Reducing Antibiotic Usage in Children With Acute Otitis Media

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    James A. Taylor MD

    2014-11-01

    Full Text Available Objective. To determine if use of a homeopathic ear drop preparation reduces antibiotic use in children diagnosed with acute otitis media (AOM. Methods. Children 6 months to 11 years old, diagnosed with AOM and managed with a delayed antibiotic approach, were randomized to standard therapy alone or standard therapy plus a homeopathic ear drop preparation. The primary outcome was whether or not the antibiotic prescription given at the index visit was filled during a 12- to 15-day follow-up period. Results. Among 210 enrolled children, follow-up antibiotic data were collected on 206. During the 12- to 15-day follow-up period, fewer parents of children randomized to the homeopathic ear drops group filled the antibiotic prescription compared with those of children receiving standard therapy alone (26.9% and 41.2%, respectively, P = .032. Conclusion. Homeopathic ear drops may be effective in reducing the use of antibiotics in children with AOM managed with a delayed antibiotic approach.

  14. Divergent mucosal and systemic responses in children in response to acute otitis media.

    Science.gov (United States)

    Verhoeven, D; Pichichero, M E

    2014-10-01

    Acute otitis media (AOM), induced by respiratory bacteria, is a significant cause of children seeking medical attention worldwide. Some children are highly prone to AOMs, suffering three to four recurrent infections per year (prone). We previously determined that this population of children could have diminished anti-bacterial immune responses in peripheral blood that could fail to limit bacterial colonization in the nasopharynx (NP). Here, we examined local NP and middle ear (ME) responses and compared them to peripheral blood to examine whether the mucosa responses were similar to the peripheral blood responses. Moreover, we examined differences in effector cytokine responses between these two populations in the NP, ME and blood compartments at the onset of an AOM caused by either Streptococcus pneumoniae or non-typeable Haemophilus influenzae. We found that plasma effector cytokines patterned antigen-recall responses of CD4 T cells, with lower responses detected in prone children. ME cytokine levels did not mirror blood, but were more similar to the NP. Interferon (IFN)-γ and interleukin (IL)-17 in the NP were similar in prone and non-prone children, while IL-2 production was higher in prone children. The immune responses diverged in the mucosal and blood compartments at the onset of a bacterial ME infection, thus highlighting differences between local and systemic immune responses that could co-ordinate anti-bacterial immune responses in young children.

  15. Payment analysis of two diagnosis and management approaches of acute otitis media.

    Science.gov (United States)

    Casey, Janet R; Pichichero, Michael E

    2014-08-01

    We determined the cost of care for 2 diagnosis and management approaches for acute otitis media (AOM) among children 6 to 30 months old. A case-control design was used. Cases included 208 children diagnosed with AOM based on a bulging tympanic membrane (TM) and treated with amoxicillin/clavulanate. Controls (5:1 ratio) included 1020 children with AOM diagnosed not requiring bulging of the TM and treated with amoxicillin. Fewer cases (49%) than controls (69%) were diagnosed with AOM (P < .001), fewer were diagnosed with recurrent AOM or AOM treatment failure (0.34 vs 1.6/child; P < .0001), and fewer had insertion of tympanostomy tubes (6.3% vs 14.8%) due to recurrent AOM (P < .0001). The combined direct payments and indirect costs for management of AOM were $539/case versus $1,023/control. Using Rochester NY payments generalized to the US birth cohort, this case diagnosis and treatment strategy could save $1.008 billion per year.

  16. Nystagmus in patients with unilateral acute otitis media complicated by serous labyrinthitis.

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    Kim, Chang-Hee; Yang, Young Soo; Im, Donghyuk; Shin, Jung Eun

    2016-06-01

    Conclusion The patients with serous labyrinthitis caused by acute otitis media (AOM) exhibited various patterns of nystagmus in which direction-fixed irritative-type nystagmus was the most common pattern. Differential effects on inner ear function by toxic or inflammatory mediators may be responsible for the various manifestation of nystagmus. Objective This study aimed to investigate nystagmus patterns in patients with serous labyrinthitis, and discuss possible mechanisms. Methods From October 2011 to March 2014, 13 consecutive patients with serous labyrinthitis were included. Eye movements of the patients were serially examined using video-nystagmography, and patterns of nystagmus were investigated. Results The most commonly observed pattern was direction-fixed nystagmus (nine of 13 patients). Of these, eight showed irritative-type, and one showed paretic-type. Direction of nystagmus, although the intensity gradually decreased, was not changed during the course of treatment. One patient showed direction-changing spontaneous nystagmus, which changed into paretic-type direction-fixed nystagmus 1 day after myringotomy. Three patients exhibited persistent direction-changing positional nystagmus in a supine head-roll test. Of them, two showed apogeotropic and one showed geotropic type. In all 13 patients, vertigo and hearing loss were improved after the treatment.

  17. Incidence and recurrence of acute otitis media in Taiwan's pediatric population

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    Pa-Chun Wang

    2011-01-01

    Full Text Available OBJECTIVE: To report the incidence and recurrence of acute otitis media (AOM in Taiwan's pediatric population. METHODS: Information from children (aged <= 12 years with a diagnosis of AOM was retrieved from the 2006 National Healthcare Insurance claims database. We calculated the cumulative incidence rate and the incidence density rate of recurrent AOM within one year after the initial diagnosis in 2006. We used a multivariate logistic regression model to assess the predictors for recurrence of AOM. RESULTS: The annual incidence rate of AOM was estimated to be 64.5 cases per 1,000 children. The overall one-year cumulative incidence rate of recurrence was 33.1%, and the incidence density rate was 33.5 cases per 100 personyears, with the highest figure (41.2 cases per 100 person-years noted for children aged 0-2 years. Recurrence was significantly associated with age, gender, place of treatment, and physician specialty. CONCLUSION: AOM remains a major threat to children's health in Taiwan. Male children and very young children require more aggressive preventive strategies to reduce the risk of recurrence.

  18. Human parechovirus as a minor cause of acute otitis media in children.

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    Sillanpää, Saara; Oikarinen, Sami; Sipilä, Markku; Seppälä, Elina; Nurminen, Noora; Rautiainen, Markus; Laranne, Jussi; Hyöty, Heikki

    2015-01-01

    Human parechoviruses (HPeVs) cause mild upper respiratory infections, gastrointestinal symptoms, central nervous system infections and some studies have linked them with acute otitis media (AOM). The aim of the present study was to study further the role of HPeV infections in AOM by detecting these viruses directly from middle ear fluid (MEF), respiratory and stool samples collected from children during AOM episodes. A total of 91 MEF samples, 98 nasal swab (NS) samples and 92 stool samples were collected during 100 AOM episodes in a total of 87 children aged between five to 42 months. All specimens were analyzed by real time RT-PCR for the presence of HPeV RNA. HPeV infection was diagnosed in 12 (14%) patients. HPeV RNA was detected in altogether 13 samples, including four MEF samples, three NS samples and six stool samples. One patient was positive in both stool and MEF samples. The results suggest that HPeV may play a role in some AOM cases, but it is not a major cause of AOM in children.

  19. Clinical implications of antibiotic resistance for management of acute otitis media.

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    Klein, J O

    1998-11-01

    Antibiotic resistance to available antimicrobial agents has been constant since the introduction of the sulfonamides in the 1930s. Multidrug-resistant Streptococcus pneumoniae and beta-lactamase-producing Haemophilus influenzae are a concern now because of the importance of these pathogens in infections of the respiratory tract in infants and children. Amoxicillin remains the drug of choice for initial episodes of acute otitis media (AOM) although increase of the dosage schedule to 80 mg/kg/day has been recommended by some investigators. There are 15 additional antimicrobial agents approved by the Food and Drug Administration for the indication of AOM. All approved drugs are clinically effective but some have been suggested to have priority for patients who fail amoxicillin: amoxicillin-clavulanate; an oral cephalosporin such as cefuroxime axetil; and intramuscular ceftriaxone. Management of the child with severe and recurrent disease should include antibiotic prophylaxis but the increased incidence of resistance requires selective use. Prevention of infection may be achieved by innovative techniques for interference with attachment of bacteria to the nasal mucosa such as administration of oligosaccharides in a nasal spray. The currently available polysaccharide pneumococcal vaccines have limited immunogenicity in infants, but the vaccine is useful in children 2 years of age and older who still have recurrent AOM. Children with frequent AOM during the prior respiratory season are candidates also for influenza virus vaccine. If medical management fails to prevent new episodes of AOM in children with severe and recurrent disease, placement of tympanostomy tubes and possible adenoidectomy should be considered.

  20. Management of acute otitis media in children six months of age and older

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    Le Saux, Nicole; Robinson, Joan L

    2016-01-01

    Acute otitis media (AOM) continues to be a common infection in young children. Milder disease, usually due to viruses or less virulent bacteria, resolves equally quickly with or without antibiotics. A bulging tympanic membrane, especially if yellow or hemorrhagic, has a high sensitivity for AOM that is likely to be bacterial in origin and is a major diagnostic criterion for AOM. Perforation of the tympanic membrane with purulent discharge similarly indicates a bacterial cause. Immediate antibiotic treatment is recommended for children who are highly febrile (≥39°C), moderately to severely systemically ill or who have very severe otalgia, or have already been significantly ill for 48 h. For all other cases, parents can be provided with a prescription for antibiotics to fill if the child does not improve in 48 h or the child can be reassessed if this occurs. Amoxicillin remains the clear drug of choice. Ten days of therapy is appropriate for children <2 years of age, whereas older children can be treated for five days. PMID:26941560

  1. Management of acute otitis media in children six months of age and older.

    Science.gov (United States)

    Le Saux, Nicole; Robinson, Joan L

    2016-01-01

    Acute otitis media (AOM) continues to be a common infection in young children. Milder disease, usually due to viruses or less virulent bacteria, resolves equally quickly with or without antibiotics. A bulging tympanic membrane, especially if yellow or hemorrhagic, has a high sensitivity for AOM that is likely to be bacterial in origin and is a major diagnostic criterion for AOM. Perforation of the tympanic membrane with purulent discharge similarly indicates a bacterial cause. Immediate antibiotic treatment is recommended for children who are highly febrile (≥39°C), moderately to severely systemically ill or who have very severe otalgia, or have already been significantly ill for 48 h. For all other cases, parents can be provided with a prescription for antibiotics to fill if the child does not improve in 48 h or the child can be reassessed if this occurs. Amoxicillin remains the clear drug of choice. Ten days of therapy is appropriate for children <2 years of age, whereas older children can be treated for five days.

  2. Presence of viral nucleic acids in the middle ear: acute otitis media pathogen or bystander?

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    Chonmaitree, Tasnee; Ruohola, Aino; Hendley, J Owen

    2012-04-01

    Viruses play an important role in acute otitis media (AOM) pathogenesis, and live viruses may cause AOM in the absence of pathogenic bacteria. Detection of AOM pathogens generally relies on bacterial culture of middle ear fluid. When viral culture is used and live viruses are detected in the middle ear fluid of children with AOM, the viruses are generally accepted as AOM pathogens. Because viral culture is not sensitive and does not detect the comprehensive spectrum of respiratory viruses, polymerase chain reaction assays are commonly used to detect viral nucleic acids in the middle ear fluid. Although polymerase chain reaction assays have greatly increased the viral detection rate, new questions arise on the significance of viral nucleic acids detected in the middle ear because nucleic acids of multiple viruses are detected simultaneously, and nucleic acids of specific viruses are detected repeatedly and in a high proportion of asymptomatic children. This article first reviews the role of live viruses in AOM and presents the point-counterpoint arguments on whether viral nucleic acids in the middle ear represent an AOM pathogen or a bystander status. Although there is evidence to support both directions, helpful information for interpretation of the data and future research direction is outlined.

  3. High cytokine levels in perforated acute otitis media exudates containing live bacteria.

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    Skovbjerg, S; Roos, K; Nowrouzian, F; Lindh, M; Holm, S E; Adlerberth, I; Olofsson, S; Wold, A E

    2010-09-01

    Acute otitis media (AOM) is an inflammatory response to microbes in the middle ear, sometimes associated with rupture of the tympanic membrane. Human leukocytes produce different patterns of inflammatory mediators in vitro when stimulated with Gram-positive and Gram-negative bacteria, respectively. Here, we investigated the cytokine and prostaglandin E2 (PGE2) responses in middle ear fluids (MEFs) from children with spontaneously perforated AOM, and related the mediator levels to the presence of pathogens detected by culture (live) or PCR (live or dead). Furthermore, the in vivo cytokine pattern was compared with that induced in leukocytes stimulated by dead bacteria in vitro. MEFs with culturable pathogenic bacteria contained more interleukin (IL)-1β (median: 110 μg/L vs. bacteria. Cytokine levels were unrelated to bacterial species and to the presence or absence of virus. Similar levels of TNF and IL-6 as found in the MEFs were obtained by in vitro stimulation of leukocytes, whereas 11 times more IL-1β and 3.5 times more IL-8 were produced in vivo, and 22 times more IL-10 was produced in vitro. Vigorous production of proinflammatory cytokines accompanies AOM with membrane rupture, regardless of the causative agent, but the production seems to cease rapidly once the bacteria are killed and fragmented. IL-6 and PGE2, however, remain after bacterial disintegration, and may play a role in the resolution phase.

  4. Prevalence of acute otitis media among children with pyrexia in a Nigerian hospital.

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    Alabi, B Sulyman; Abdulkarim, A Aishat; Fatai, Olatoke; Abdulmajeed, Suleiman O

    2009-10-01

    This was to determine the prevalence of acute otitis media in children with pyrexia in an area with malaria endemicity and also the relevance of socio-economic factors on AOM. This prospective study was conducted between January 2004 and June 2005 at the emergency paediatric unit of the hospital among children aged 0-15 years presenting with pyrexia. All the children had full ENT examinations in addition to the evaluation by the emergency paediatricians. Diagnosis of AOM was based on history, examinations and otoscopic findings. Two-hundred children with pyrexia were seen and the age range was 3 months to 15 years (mean 4.73). The male/female ratio was 1.7:1.03 years; 32 had features of AOM. Two third of the children were from the low socio-economic class. AOM with late presentation in the suppurative stage of the disease is a common cause of pyrexia in children with a male preponderance and two third of the children were from the low socio-economic status. There is the need for otoscopic examinations of all pyretic children as the resultant hearing loss is related to difficulties in language acquisition in children below 2 years of age with effects on literacy and school achievement.

  5. Transcriptome signature in young children with acute otitis media due to non-typeable Haemophilus influenzae.

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    Liu, Keyi; Chen, Linlin; Kaur, Ravinder; Pichichero, Michael E

    2013-06-01

    Non-typeable Haemophilus influenzae (NTHi) causes acute otitis media (AOM) in young children. In our recent paper in Microbes and Infection we described the transcriptome signature elicited from PBMCs at onset of AOM caused by Streptococcus pneumoniae. In the current study we found very different results with NTHi AOM infections; 5.1% of 29 187 genes were differentially regulated by more than 2-fold at the onset of AOM compared with the pre-infection healthy state in the same children. Among the 1487 transcripts, 100 genes associated with the immune defense response were specifically analyzed. About half of the differentially regulated genes associated with antibacterial activity and the cell-mediated immune response were activated and half were suppressed. The important signatures for NTHi in children suggested that the balance of the immune response was toward suppression. Moreover, 90% of the genes associated with a pro-inflammatory cytokine response were down-regulated. The genes associated with the classic complement pathway were down-regulated, although the alternative complement pathway genes were up-regulated. These results provide the first human transcriptome data identifying gene expression in the immune response to be predominantly down-regulated at the onset of AOM due to NTHi.

  6. Comparison of Axillary and Tympanic Temperature Measurements in Children Diagnosed with Acute Otitis Media

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    Hatice Hilal Doğan

    2016-01-01

    Full Text Available Background. Acute otitis media [AOM] may affect the accuracy of tympanic temperature measurements. We aimed to compare tympanic temperature measurements in patients with AOM against control groups, as well as compare the tympanic temperatures with axillary thermometry. Methods. This is a prospective, observational study. Patients from pediatric outpatient and emergency clinics who were diagnosed as single-sided AOM were included consecutively in the study. Normal ears of patients and children having the same age and gender who were not diagnosed as AOM were also studied as controls. Results. In patients with AOM, infected ears had higher temperatures than normal ears with a mean of 0.48±0.01°C. There was no significant difference between the right and left tympanic temperatures in control group. Compared with axillary temperature, the sensitivity of tympanic temperature in the infected ear was 91.7% and the specificity was 74.8%. Conclusion. Comparisons of axillary and tympanic temperatures in children with AOM during the active infection concluded higher tympanic temperatures in infected ears. We suggest that the higher tympanic temperatures, approximately 0.5°C in our study, in infected ears may aid in diagnosis of patients with fever without a source in pediatric clinics.

  7. Educational intervention for parents and healthcare providers leads to reduced antibiotic use in acute otitis media.

    Science.gov (United States)

    Småbrekke, Lars; Berild, Dag; Giaever, Anton; Myrbakk, Torni; Fuskevåg, Airin; Ericson, Johanna U; Flaegstad, Trond; Olsvik, Orjan; Ringertz, Signe H

    2002-01-01

    We used a controlled before-and-after design with the aims of reducing both the total consumption of antibiotics and the use of broad-spectrum antibiotics against acute otitis media (AOM), and to study to what extent prescriptions for antibiotics against AOM were dispensed. Information on evidence-based treatment of uncomplicated AOM was provided to doctors and nurses, and written guidelines were implemented. Pamphlets and oral information concerning symptomatic treatment and the limited effect of antibiotic use in AOM were given to parents. Eligible patients were 819 children aged 1-15 y. The proportion of patients receiving a prescription for antibiotics was reduced from 90% at baseline to 74% during the study period. The proportion of prescriptions for penicillin V increased from 72% at baseline to 85% during the study period. There were no significant changes at the control site. The proportion of dispensed prescriptions was 70% both at baseline and during the study period. Educational efforts reduced the total consumption of antibiotics and the use of broad-spectrum antibiotics for AOM in children aged 1-15 y at an emergency call service. Data on antibiotic use in AOM based only on prescribing overestimates the use of antibiotics.

  8. Evolving microbiology and molecular epidemiology of acute otitis media in the pneumococcal conjugate vaccine era.

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    Pichichero, Michael E; Casey, Janet R

    2007-10-01

    The addition of the 7-valent pneumococcal conjugate vaccine (PCV7) to the routine immunization schedule in the United States for infants has produced a much more favorable impact on the incidence of acute otitis media (AOM) than anticipated. Because the serotypes included in PCV7 were those most frequently expressing antibiotic resistance in 2001, predictions were made that up to 98% of pneumococcal AOM episodes would be caused by penicillin susceptible strains. However, recent studies have shown that the benefits of PCV7 are becoming eroded. Replacement serotypes of pneumococci have emerged, expressing polysaccharide capsules different from those included in PCV7, with increasing frequency. These replacement strains are coming to dominate in the nasopharynx and in AOM isolates (and in invasive disease). Expansion in the isolation of serotypes 3, 7F, 15B/C/F, 19A, 22F, 33F, and 38 has been described in various surveillance systems. Pneumococcal strains expressing non-PCV7 capsular serotypes also appear to be rapidly acquiring resistance to penicillin and other antibiotics. Emergence of strains of pneumococci expressing non-PCV7 capsular serotypes is occurring by multiple mechanisms including capsular switching as suggested by molecular epidemiology studies. Expansion of the number of serotypes included in pneumococcal conjugate vaccines is needed to sustain a long-term benefit from immunization against these bacteria.

  9. Pharmacoeconomic evaluation of cefaclor in the pharyngo-tonsillitis and acute otitis in children

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    Mario Eandi

    2006-03-01

    Full Text Available Pharyngotonsillitis (FT and acute otitis media (OMA are among the most frequent infectious diseases of the childhood and exact a heavy toll on the Italian national health service (INHS, families and society as a whole. In case of established or suspected bacterial origin, current treatment guidelines for FT recommend 5-10 days of oral antibiotics, chosen among available penicillins, cephalosporins, or macrolides. More controversial appears the systematical use of an antibiotic for OMAs, but prevalent expert opinion suggests use of the same agents. In this paper, an economical appraisal of five of the most prescribed oral antibiotics for these indications in Italy (cefaclor, amoxicyllin, amoxicyllin/clavulanate, clarithromycin and azithromycin is provided. The evaluation was conducted through the development and implementation of two distinct models, constructed to reflect national treatment patterns of these infections. Clinical and economical data were obtained from several sources: literature review, including published meta-analyses, consultation of an expert panel and, most importantly, from the results of a specific questionnaire-based survey completed by 136 pediatricians, based throughout Italy. The models were run to conduct both cost-effectiveness and cost-minimization analyses, that consistently indicated cefaclor and amoxicyllin to be substantially equivalent in terms of total costs to the INHS and the Italian society, but significantly more convenient than amoxicyllin/clavulanate, claritrhomycin or azithromycin. Extensive probabilistic sensitivity analyses confirmed the robustness of this conclusion.

  10. Antibiotic Treatment for First Episode of Acute Otitis Media Is Not Associated with Future Recurrences

    Science.gov (United States)

    te Molder, Marthe; de Hoog, Marieke L. A.; Uiterwaal, Cuno S. P. M.; van der Ent, Cornelis K.; Smit, Henriette A.; Schilder, Anne G. M.; Damoiseaux, Roger A. M. J.; Venekamp, Roderick P.

    2016-01-01

    Objective Antibiotic treatment of acute otitis media (AOM) has been suggested to increase the risk of future AOM episodes by causing unfavorable shifts in microbial flora. Because current evidence on this topic is inconclusive and long-term follow-up data are scarce, we wanted to estimate the effect of antibiotic treatment for a first AOM episode occurring during infancy on AOM recurrences and AOM-related health care utilization later in life. Methods We obtained demographic information and risk factors from data of the Wheezing Illnesses Study Leidsche Rijn, a prospective birth cohort study in which all healthy newborns born in Leidsche Rijn (between 2001 and 2012), The Netherlands, were enrolled. These data were linked to children’s primary care electronic health records up to the age of four. Children with at least one family physician-diagnosed AOM episode before the age of two were included in analyses. The exposure of interest was the prescription of oral antibiotics (yes vs no) for a child’s first AOM episode before the age of two years. Results 848 children were included in analyses and 512 (60%) children were prescribed antibiotics for their first AOM episode. Antibiotic treatment was not associated with an increased risk of total AOM recurrences (adjusted rate ratio: 0.94, 95% CI: 0.78–1.13), recurrent AOM (≥3 episodes in 6 months or ≥4 in one year; adjusted risk ratio: 0.79, 95% CI: 0.57–1.11), or with increased AOM-related health care utilization during children’s first four years of life. Conclusions Oral antibiotic treatment of a first AOM episode occurring during infancy does not affect the number of AOM recurrences and AOM-related health care utilization later in life. This information can be used when weighing the pros and cons of various AOM treatment options. PMID:27632355

  11. [Bacterial etiology of acute otitis media in Spain in the post-pneumococcal conjugate vaccine era].

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    Pumarola, Felix; Salamanca de la Cueva, Ignacio; Sistiaga-Hernando, Alessandra; García-Corbeira, Pilar; Moraga-Llop, Fernando A; Cardelús, Sara; McCoig, Cynthia; Gómez Martínez, Justo Ramón; Rosell Ferrer, Rosa; Iniesta Turpin, Jesús; Devadiga, Raghavendra

    2016-11-01

    Acute otitis media (AOM) is common in children aged <3 years. A pneumococcal conjugate vaccine (PCV) (PCV7; Prevenar, Pfizer/Wyeth, USA) has been available in Spain since 2001, which has a coverage rate of 50-60% in children aged <5 years. Children aged ≥3 to 36 months with AOM confirmed by an ear-nose-throat specialist were enrolled at seven centers in Spain (February 2009-May 2012) (GSK study identifier: 111425). Middle-ear-fluid samples were collected by tympanocentesis or spontaneous otorrhea and cultured for bacterial identification. Culture-negative samples were further analyzed using polymerase chain reaction (PCR). Of 125 confirmed AOM episodes in 124 children, 117 were analyzed (median age: 17 months (range: 3-35); eight AOM episodes were excluded from analyses. Overall, 69% (81/117) episodes were combined culture- and PCR-positive for ≥1 bacterial pathogen; 44% (52/117) and 39% (46/117) were positive for Haemophilus influenzae (Hi) and Streptococcus pneumoniae (Spn), respectively. 77 of 117 episodes were cultured for ≥1 bacteria, of which 63 were culture-positive; most commonly Spn (24/77; 31%) and Hi (32/77; 42%). PCR on culture-negative episodes identified 48% Hi- and 55% Spn-positive episodes. The most common Spn serotype was 19F (4/24; 17%) followed by 19A (3/24; 13%); all Hi-positive episodes were non-typeable (NTHi). 81/117 AOM episodes (69%) occurred in children who had received ≥1 pneumococcal vaccine dose. NTHi and Spn were the main etiological agents for AOM in Spain. Impact of pneumococcal vaccination on AOM requires further evaluation in Spain, after higher vaccination coverage rate is reached. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Trends in antibiotic treatment of acute otitis media and treatment failure in children, 2000-2011.

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    Leah J McGrath

    Full Text Available OBJECTIVES: Guidelines to treat acute otitis media (AOM were published in 2004. Initial declines in prescribing were shown, but it's unknown if they were sustained. We examine trends in antibiotic dispensing patterns to treat AOM among a large population of children. We also document trends in antibiotic failure. STUDY DESIGN: Children aged 3 months to 12 years with an AOM diagnosis, enrolled in a commercial claims database between January 1, 2000-December 31, 2011 were included. Pharmacy claims within 7 days of diagnosis were searched for antibiotic prescriptions. Antibiotic failure was defined as a dispensing of a different antibiotic class within 2-18 days after the first prescription. We analyzed trends in antibiotic use and failure by class of antibiotic and year. RESULTS: We identified over 4 million children under 13 years with AOM. The proportion of antibiotic dispensing decreased from 66.0% in 2005 to 51.9% in 2007, after which the instances of dispensing rebounded to pre-guideline levels. However, levels began decreasing again in 2010 and the antibiotic use rate in 2011 was 57.6%. Cephalosporin prescriptions increased by 41.5% over eleven years. Antibiotic failure decreased slightly, and macrolides had the lowest proportion of failures, while all other classes had failure rates around 10%. CONCLUSIONS: In recent years, antibiotic dispensing to treat AOM remains high. In addition, the use of broad-spectrum antibiotics is increasing despite having a high rate of treatment failure. Overprescribing of antibiotics and use of non-penicillin therapy for AOM treatment could lead to the development of antibiotic-resistant infections.

  13. Clinical and microbiological impact of human bocavirus on children with acute otitis media.

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    Beder, Levent Bekir; Hotomi, Muneki; Ogami, Masashi; Yamauchi, Kazuma; Shimada, Jun; Billal, Dewan Sakhawat; Ishiguro, Nobuhisa; Yamanaka, Noboru

    2009-11-01

    Human Bocavirus (HBoV) as a newly discovered parvovirus has been commonly detected in respiratory tract infections. However, its role in acute otitis media (AOM) has not been well studied. We examined HBoV in Japanese children with AOM and evaluated the virus prevalence together with clinical manifestations and bacterial findings. Overall, 222 nasopharyngeal swabs and 176 middle ear fluids (MEF) samples were collected from 222 children with AOM (median age, 19 months) between May 2006 and April 2007. HBoV detection was performed by PCR and bacterial isolation by standard culture methods. HBoV was found in the nasopharyngeal aspirates of 14 children (6.3%) and in the MEF of six children (2.7%). When HBoV detection results were evaluated with clinical characteristics of children, resolution time of AOM was significantly longer (p=0.04), and rate of fever symptom was also higher in HBoV-positive group (p=0.04). Furthermore, we found positive correlation between detection of HBoV and Streptococcus pneumoniae in the MEF (p=0.004). Nevertheless, nasopharyngeal proportion of S. pneumoniae was similar between virus positive and negative groups. Furthermore, S. pneumoniae was detected as a single pathogen in all MEF of HBoV-positive cases but one, while it presents mixed with other pathogenic bacteria in nasopharynx. In conclusion, HBoV may worsen the clinical symptoms and prolong the clinical outcome of AOM in pediatric population. Finally, HBoV may prime the secondary bacterial infection in the middle ear in favor of S. pneumoniae.

  14. How to compare the efficacy of conjugate vaccines to prevent acute otitis media?

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    De Wals, Philippe; Erickson, Lonny; Poirier, Béatrice; Pépin, Jacques; Pichichero, Michael E

    2009-05-11

    Although the currently available 7-valent pneumococcal conjugate vaccine (PCV7-CRM(197)) has been primarily designed for the prevention of invasive pneumococcal disease, it has also demonstrated the potential to prevent acute otitis media (AOM) and its associated complications. A candidate 11-valent pneumococcal conjugate vaccine (PCV11-HiD), which utilizes Haemophilus influenzae (Hi)-derived protein D as a carrier has demonstrated the ability to prevent AOM caused by not only vaccine serotypes of Streptococcus pneumoniae (Sp), but also those caused by Hi. The methodological, clinical, and epidemiological factors influencing results of vaccine trials for AOM prevention were reviewed and a model-based approach was developed, in order to assess the relative efficacy of different vaccine formulations. Six randomized trials having AOM as a measured outcome were identified. Vaccine efficacy (VE) ranged from -1% to 34% for all-cause AOM and between 56% and 64% for AOM caused by vaccine-type Sp. Using otopathogen-specific VE rates from the FinOM and POET trials and otopathogen distributions observed in three relatively unbiased studies, VE against all-cause AOM episodes under different scenarios was modeled. The most important factor explaining variation in VE estimates was bacterial replacement, which was present in the PCV7-CRM(197) FinOM study but not in the PCV11-HiD POET study. Another contributing factor was increased protection conferred against Hi AOM by protein D. Geographical variation in the distribution of otopathogens was a third factor explaining differences between trials. More studies on the current aetiology of AOM need to be performed to accurately predict the marginal benefit of a switch from PCV7-CRM(197) to the newly licensed PCV10-HiD-DiT or to the future PCV13-CRM(197).

  15. Lower nasopharyngeal epithelial cell repair and diminished innate inflammation responses contribute to the onset of acute otitis media in otitis-prone children.

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    Verhoeven, David; Nesselbush, Monica; Pichichero, Michael E

    2013-08-01

    About 30 % of young children experience excessive, frequent episodes of middle ear infection and are classified as acute otitis media prone (OP). Streptococcus pneumoniae (Spn) is a predominant otopathogen in OP and non-OP (NOP) children. The pathogenesis of middle ear infection involves otopathogen nasopharyngeal (NP) colonization followed by an upper respiratory viral infection that modifies the NP environment to allow a sufficient inoculum of bacteria to reflux via the Eustachian tube into the middle ear space. Here, we analyzed the NP mucosal repair response between age-matched stringently defined OP (sOP) and NOP children who progressed to middle ear infection caused by Spn. We found lower epidermal growth factor, epidermal growth factor receptor, and angiogenin cytokine concentrations in nasal washes of sOP compared with NOP children. Despite higher expression of TLR2/4 transcript expression in nasal epithelium and in polymorphonuclear cells present in nasal secretions in sOP children, sOP children had lower expression of proinflammatory cytokines such as IL-6 and IL-8 in the NP. Chemotaxis-associated cytokine expression at onset of AOM in sOP children was also lower compared with NOP children, possibly indicating a lower capacity to signal the innate immune system. We conclude that lower epithelial cell repair responses during viral infection in the NP combined with diminished innate inflammatory responses potentiate Spn pathogenesis in the sOP child.

  16. Panel 7: Otitis Media: Treatment and Complications.

    Science.gov (United States)

    Schilder, Anne G M; Marom, Tal; Bhutta, Mahmood F; Casselbrant, Margaretha L; Coates, Harvey; Gisselsson-Solén, Marie; Hall, Amanda J; Marchisio, Paola; Ruohola, Aino; Venekamp, Roderick P; Mandel, Ellen M

    2017-04-01

    Objective We aimed to summarize key articles published between 2011 and 2015 on the treatment of (recurrent) acute otitis media, otitis media with effusion, tympanostomy tube otorrhea, chronic suppurative otitis media and complications of otitis media, and their implications for clinical practice. Data Sources PubMed, Ovid Medline, the Cochrane Library, and Clinical Evidence (BMJ Publishing). Review Methods All types of articles related to otitis media treatment and complications between June 2011 and March 2015 were identified. A total of 1122 potential related articles were reviewed by the panel members; 118 relevant articles were ultimately included in this summary. Conclusions Recent literature and guidelines emphasize accurate diagnosis of acute otitis media and optimal management of ear pain. Watchful waiting is optional in mild to moderate acute otitis media; antibiotics do shorten symptoms and duration of middle ear effusion. The additive benefit of adenoidectomy to tympanostomy tubes in recurrent acute otitis media and otitis media with effusion is controversial and age dependent. Topical antibiotic is the treatment of choice in acute tube otorrhea. Symptomatic hearing loss due to persistent otitis media with effusion is best treated with tympanostomy tubes. Novel molecular and biomaterial treatments as adjuvants to surgical closure of eardrum perforations seem promising. There is insufficient evidence to support the use of complementary and alternative treatments. Implications for Practice Emphasis on accurate diagnosis of otitis media, in its various forms, is important to reduce overdiagnosis, overtreatment, and antibiotic resistance. Children at risk for otitis media and its complications deserve special attention.

  17. [Otitis externa, a self-inflicted disease?].

    Science.gov (United States)

    Bizindavyi, F; Guyot, J-P; Kos, M-I

    2007-10-03

    Otitis externa, an inflammation of the external auditory canal is the most frequent cause of ENT consultation all over the world. It can be caused by viral, bacterial or fungal infections. In most of the cases it is provoked by anatomical causes and, even more frequently inadvertently, by the patient himself. Typically, otitis externa is an isolated episode of short duration, easily treated with topical medication. It evolves rarely to the atypical forms of chronic otitis externa and malignant otitis externa. It is important to search for an allergy, eczema or immunodepression in cases of chronic otitis externa and for diabetes in cases of malignant otitis externa.

  18. Bacteriotherapy with Streptococcus salivarius 24SMB and Streptococcus oralis 89a nasal spray for preventing recurrent acute otitis media in children: a real-life clinical experience.

    Science.gov (United States)

    La Mantia, Ignazio; Varricchio, Attilio; Ciprandi, Giorgio

    2017-01-01

    Recurrence of acute otitis media (RAOM) is a relevant issue in the clinical practice. "Bacteriotherapy" has been proposed as an option in children with RAOM. Streptococcus salivarius 24SMB nasal spray has been previously demonstrated to reduce the risk of acute otitis media (AOM) in otitis-prone children. The current retrospective and observational study aimed to confirm this outcome in a real-life setting, such as the common pediatric practice. Group A (108 children) served as control; group B (159 children) was treated with S. salivarius 24SMB and Streptococcus oralis 89a nasal spray after the first AOM episode. Active treatment consisted of 3 monthly courses: 2 puffs per nostril twice/day for a week. Group B showed a significant reduction of AOM episodes in comparison with group A (psalivarius 24SMB and S. oralis 89a nasal spray could be effective in the prevention of RAOM in a real-life setting.

  19. [Otitis externa and cerumen obturans].

    Science.gov (United States)

    Pieren, C

    1995-11-01

    Otitis externa and cerumen obturans are two of the most frequently encountered disturbances in the external auditory canal. Both conditions can lead to hearing loss due to reduced sound transmission. Other symptoms include ear pressure, pain and secretion. Acute otitis externa occurs frequently during the swimming season. The main symptoms are local pain and secretion. Treatment consists of careful and frequent cleaning and application of topical medication to the outer ear canal and prescription of medication against pain. Systemic antibiotics are only rarely necessary and are indicated if perichondritis or lymphadenitis are present. Chronic otitis externa is often caused by eczema of the outer ear canal. Allergies, systemic diseases, such as diabetes mellitus, and manipulation by the patient must be ruled out. Therapy includes the application of topical steroid solutions. The natural pH of the skin can be reestablished by use of diluted acetic acid solutions. Blockage of the outer ear canal by cerumen [cerumen obturans] can bring the patient to the office because of sudden hearing loss. After cleaning of the ear canal, a screening hearing test should be performed to assure that the problem has been resolved.

  20. [Assessment of the management of acute otitis media in children by family practitioners in the North of France].

    Science.gov (United States)

    Ganga-Zandzou, Patrice Serge; Fermantel, Aurore; Robic, Claire; Pouessel, Guillaume; Pierre, Marie-Hélène; Bourgois, Béatrice; Cixous, Emmanuel; Ythier, Hubert

    2009-12-01

    To assess the management of acute otitis media in children by paediatricians and general practitioners in the North of France compared with the AFSSAPS (Agence Française de Sécurité Sanitaire des Produits de Santé) guideline's recommendations of 2005. All eligible family paediatricians (n=68) and a group of general practitioners (n=200) first received a phone call invitation to participate to the study. The volunteers responded to a questionnaire by phone call. The response rates were 67, 6 % for the group of paediatricians and 64, 5 % for the group of general practitioners. The guideline's recommendations were followed by respectively 28, 3 % and 9, 3 % of primary care physicians. The observation option, recommended in children aged more than 2 years, was followed by 46, 5 % of general practitioners and 54, 3 % of paediatricians. The durations of antibiotics were poorly respected by the 2 groups of physicians. In case of allergy to penicillin, the paediatricians followed more the recommendations than the general practitioners. Educational interventions are needed in order to improve the adherence to guidelines of paediatricians and general practitioners for the management of acute otitis media in children.

  1. Septic Arthritis of the Temporomandibular Joint Secondary to Acute Otitis Media in an Adult: A Rare Case with Achromobacter xylosoxidans

    Directory of Open Access Journals (Sweden)

    Ryan Chin Taw Cheong

    2017-01-01

    Full Text Available Septic arthritis of the temporomandibular joint (SATMJ is a rare complication of acute otitis media (AOM with only four reported cases in the English and Japanese literature. Based on the unusual nature of this clinical condition, we discuss the first documented case due to Achromobacter xylosoxidans and the utility of myringotomy with long-term intravenous antibiotics via a peripherally inserted central catheter (PICC. We describe the case of a 76-year-old male patient that was brought in by ambulance to the accident and emergency (A&E department due to severe right-sided otalgia with increased hearing impairment. A clinical diagnosis of acute otitis media with sepsis was made and the patient was commenced on the sepsis protocol. He then developed symptoms of septic arthritis of the TMJ which was confirmed on radiological imaging. After a multidisciplinary team discussion, the patient was treated with a myringotomy and intravenous ceftriaxone for 8 weeks in the community via a PICC rather than TMJ arthrocentesis with positive outcomes at 3 months’ follow-up.

  2. 浅谈人群患外耳道疾病的原因,教你如何保健%Prevention and treatment of the external otitis

    Institute of Scientific and Technical Information of China (English)

    李富强

    2015-01-01

    The ears are very fragile and sensitive parts of the body; people are very prone to external otitis and other ear diseases. In this article, how to prevent and treat this disease was outlined.%耳朵是人体非常脆弱、敏感的部位,人们极容易患上外耳道炎等耳部疾病。本文概述了如何更好地预防和治疗这一疾病。

  3. Antihistamines for children with otitis media

    OpenAIRE

    Bonney, Asha G.; Goldman, Ran D.

    2014-01-01

    Question Otitis media is a very common condition in pediatrics and can be quite distressing for children and their parents. Is there a role for antihistamines and decongestants in the management of acute otitis media or otitis media with effusion in children?

  4. Antihistamines for children with otitis media

    OpenAIRE

    Bonney, Asha G.; Goldman, Ran D.

    2014-01-01

    Question Otitis media is a very common condition in pediatrics and can be quite distressing for children and their parents. Is there a role for antihistamines and decongestants in the management of acute otitis media or otitis media with effusion in children?

  5. Primary care based randomised, double blind trial of amoxicillin versus placebo for acute otitis media in children aged under 2 years

    NARCIS (Netherlands)

    Damoiseaux, RAMJ; van Balen, FAM; Hoes, AW; Verheij, TJM; de Melker, RA

    2000-01-01

    Objective To determine the effect of antibiotic treatment for acute otitis media in children between 6 months and 2 years of age. Design Practice based, double blind, randomised, placebo controlled trial. Setting 53 general practices in the Netherlands. Subjects 240 children aged 6 months to 2 years

  6. Paracetamol (acetaminophen) or non-steroidal anti-inflammatory drugs, alone or combined, for pain relief in acute otitis media in children

    NARCIS (Netherlands)

    Sjoukes, Alies; Venekamp, Roderick P; van de Pol, Alma C; Hay, Alastair D; Little, Paul; Schilder, Anne GM; Damoiseaux, Roger Amj

    2016-01-01

    BACKGROUND: Acute otitis media (AOM) is one of the most common childhood infectious diseases and a significant reason for antibiotic prescriptions in children worldwide. Pain from middle ear infection and pressure behind the eardrum is the key symptom of AOM. Ear pain is central to children's and

  7. Paracetamol (acetaminophen) or non-steroidal anti-inflammatory drugs, alone or combined, for pain relief in acute otitis media in children

    NARCIS (Netherlands)

    Sjoukes, Alies; Venekamp, Roderick P; van de Pol, Alma C; Hay, Alastair D; Little, Paul; Schilder, Anne GM; Damoiseaux, Roger Amj

    2016-01-01

    BACKGROUND: Acute otitis media (AOM) is one of the most common childhood infectious diseases and a significant reason for antibiotic prescriptions in children worldwide. Pain from middle ear infection and pressure behind the eardrum is the key symptom of AOM. Ear pain is central to children's and pa

  8. Reduced-Concentration Clavulanate for Young Children with Acute Otitis Media.

    Science.gov (United States)

    Hoberman, Alejandro; Paradise, Jack L; Rockette, Howard E; Jeong, Jong-Hyeon; Kearney, Diana H; Bhatnagar, Sonika; Shope, Timothy R; Muñiz, Gysella; Martin, Judith M; Kurs-Lasky, Marcia; Haralam, MaryAnn; Pope, Marcia A; Nagg, Jennifer P; Zhao, Wenchen; Miah, Mohammad Kowser; Beumer, Jan; Venkataramanan, Raman; Shaikh, Nader

    2017-07-01

    Amoxicillin-clavulanate (A/C) is currently the most effective oral antimicrobial in treating children with acute otitis media (AOM), but the standard dosage of 90 mg amoxicillin/6.4 mg clavulanate/kg of body weight/day commonly causes diarrhea. We examined whether an A/C formulation containing lower concentrations of clavulanate would result in less diarrhea while maintaining plasma levels of amoxicillin and clavulanate adequate to eradicate middle-ear pathogens and to achieve clinical success. We conducted an open-label study in children with AOM who were 6 to 23 months of age. In phase 1, we treated 40 children with a reduced-clavulanate A/C formulation providing 90 mg amoxicillin/3.2 mg clavulanate/kg/day for 10 days. In phase 2, we treated 72 children with the same formulation at a dosage of 80 mg amoxicillin/2.85 mg clavulanate/kg/day for 10 days. We compared the rates of protocol-defined diarrhea (PDD), diaper dermatitis, and AOM clinical response in these children with rates we had reported in children who received the standard A/C regimen, and we obtained plasma levels of amoxicillin and clavulanate at various time points. Outcomes in phase 1 children and in children who had received the standard regimen did not differ significantly. Rates of PDD in children receiving phase 2 and standard regimens were 17% and 26%, respectively (P = 0.10). The corresponding rates of diaper dermatitis were 21% and 33% (P = 0.04) and of AOM treatment failure were 12% and 16% (P = 0.44). Symptomatic responses did not differ significantly between regimens; both gave clavulanate levels sufficient to inhibit β-lactamase activity. In young children with AOM, clavulanate dosages lower than those currently used may be associated with fewer side effects without reducing clinical efficacy. (This study has been registered at ClinicalTrials.gov under registration no. NCT02630992.). Copyright © 2017 American Society for Microbiology.

  9. Characteristics and outcomes of acute otitis media in children carrying streptococcus pneumoniae or haemophilus influenzae in their nasopharynx as a single otopathogen after introduction of the heptavalent pneumococcal conjugate vaccine.

    Science.gov (United States)

    Caeymaex, Laurence; Varon, Emmanuelle; Levy, Corinne; Béchet, Stéphane; Derkx, Véronique; Desvignes, Véronique; Doit, Catherine; Cohen, Robert

    2014-05-01

    After PCV7 implementation, clinical characteristics were investigated in 832 young children with acute otitis media, carrying a single S. pneumoniae or H. influenzae in their nasopharynx. As compared with H. influenzae, S. pneumoniae-associated acute otitis media was less frequently associated with treatment failure (odds ratio = 0.5; 95% confidence interval: 0.36-0.83) and recurrence (odds ratio = 0.4; 95% confidence interval: 0.22-0.75). Post-PCV7 serotype replacement seemed not to affect the acute otitis media characteristics in these children.

  10. [Investigation of viral nucleic acids in middle-ear effusion specimens from children with acute otitis media].

    Science.gov (United States)

    Abu Sitteh, Muhammed H; Sener, Kenan; Yapar, Mehmet; Kiliç, Abdullah; Güney, Cakir; Kubar, Ayhan

    2008-07-01

    Acute otitis media with effusion (OME) is one of the major causes of antibiotic use, indication for operation and hearing loss in children. In two third of the cases the etiologic agents are bacteria. Nonetheless, increasing numbers of reports have implicated viruses as etiologic agents that may have some effect on prognosis of OME. The aim of this study was to investigate the presence of nucleic acids of respiratory syncytial virus (RSV) type A and B, influenza type A virus, adenovirus, cytomegalovirus (CMV), herpes simplex virus type-1 (HSV-1), and enteroviruses in the middle ear effusion specimens from children with otitis media by TaqMan real-time PCR. As a result, 18 of 30 (60%) OME samples were found positive in terms of viral nucleic acids by real-time PCR. RSV-A was detected in nine samples (30%), CMV in 3 (10%) samples and HSV-1 in 1 (3.3%) sample. In five of the samples two viruses were detected in the same sample (three were positive for adenovirus and RSV-A, and two were positive for CMV and RSV-A). Our data have supported the importance of viruses as etiologic agents of OME. Additionally, it was thought that TaqMan real-time PCR may be used as a reliable and rapid method for the detection of viruses in the middle ear effusion samples.

  11. Genome-wide association study for acute otitis media in children identifies FNDC1 as disease contributing gene

    Science.gov (United States)

    van Ingen, Gijs; Li, Jin; Goedegebure, André; Pandey, Rahul; Li, Yun Rose; March, Michael E.; Jaddoe, Vincent W. V.; Bakay, Marina; Mentch, Frank D.; Thomas, Kelly; Wei, Zhi; Chang, Xiao; Hain, Heather S.; Uitterlinden, André G.; Moll, Henriette A.; van Duijn, Cornelia M.; Rivadeneira, Fernando; Raat, Hein; Baatenburg de Jong, Robert J.; Sleiman, Patrick M.; van der Schroeff, Marc P.; Hakonarson, Hakon

    2016-01-01

    Acute otitis media (AOM) is among the most common pediatric diseases, and the most frequent reason for antibiotic treatment in children. Risk of AOM is dependent on environmental and host factors, as well as a significant genetic component. We identify genome-wide significance at a locus on 6q25.3 (rs2932989, Pmeta=2.15 × 10−09), and show that the associated variants are correlated with the methylation status of the FNDC1 gene (cg05678571, P=1.43 × 10−06), and further show it is an eQTL for FNDC1 (P=9.3 × 10−05). The mouse homologue, Fndc1, is expressed in middle ear tissue and its expression is upregulated upon lipopolysaccharide treatment. In this first GWAS of AOM and the largest OM genetic study to date, we identify the first genome-wide significant locus associated with AOM. PMID:27677580

  12. The critical role of myeloperoxidase in Streptococcus pneumoniae clearance and tissue damage during mouse acute otitis media.

    Science.gov (United States)

    Xiang, Yun; Jin, Chunfang; Wang, Wei; Wang, Zimeng; Huang, Yifei; Fan, Fangmei; Ma, Yurong; Zhang, Xuemei; Xu, Wenchun; Yin, Yibing; He, Yujuan

    2017-04-01

    We have recently reported that neutrophils play a pivotal role in innate defense against Streptococcus pneumoniae ( Spn) during mouse acute otitis media (AOM). However, the underlying mechanism remains unclear. By constructing models of pneumococcal AOM in C57BL/6 mice and using a specific inhibitor in vivo, we investigated the role of myeloperoxidase (MPO), one of the most important protein components of neutrophils. Experiment results showed a significant increase in MPO production of the recruited neutrophils in Spn-infected mice. Neutrophils killed Spn in a MPO-dependent manner. MPO facilitated the generation of reactive oxygen species (ROS), and consequently promoted Spn clearance at an early stage and exacerbated tissue damage. Moreover, MPO induced neutrophil apoptosis and necrosis, which, in turn, worsened tissue damage. In summary, our study demonstrates that neutrophil MPO plays a paradoxical role in bacterial clearance and tissue damage in pneumococcal AOM.

  13. Multiple Complications Due to Subacute Suppurative Otitis Media

    OpenAIRE

    Qirjazi, Brikena; Bardhyli, Dolores; Hoxhallari, Xhevair

    2014-01-01

    Subacute otitis media is a well-known pathology of ENT practice which is easily diagnosed and subsequently treated in the outpatient clinic. The rate of complications in acute otitis media is lower than in chronic otitis media. We present here the history of a young patient with subacute otitis media who developed both localized labyrinthitis and facial palsy requiring surgical treatment. We conclude that the treatment of subacute otitis media should be carefully monitored because complicatio...

  14. Otitis media: conceptos actuales

    Directory of Open Access Journals (Sweden)

    Hernán Sierra Fernández

    2004-09-01

    Full Text Available La otitis media aguda es uno de los motivos más frecuentes de consulta en la edad pediátrica. Los gérmenes que con mayor frecuencia se aíslan en el oído medio de estos pacientes son el Streptococcus pneumoniae, el Haemophilus influenzae, la Moraxella catarrhalis y el Streptococcus pyogenes. El patrón de resistencia antibiótica de estas bacterias varía dependiendo de la región geográfica. y es la base fundamental para establecer recomendaciones terapéuticas. El análisis en Costa Rica. de la microbiología de la otitis media aguda, otitis media recurrente y otitis media catalogada como falla terapéutica, sugiere que la amoxicilina en una dosis de 50 mg/Kg/día por 10 días, debe ser considerada el antibiótico de primera línea en los casos de otitis media aguda. En los pacientes con otitis media recurrente, falla antimicrobiana o cuando se sospeche la presencia de un Streptococcus pneumoniae resistente a la penicilina, se debe considerar el uso de amoxicilina en dosis más elevadas, amoxicilina con ácido clavulánico, macrólidos o ceftrlaxona.Otitis media is one of the most common causes of consultation among the pediatric population. The pathogens most frequently isolated from middle ear fluid are Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pyogenes. Antimicrobial resistance patterns vary by region and their knowledge is considered important in order to achieve proper antimicrobial selection. In Costa Rica the microbiology of patients with acute, recurrent and tteattnent failure otitis media has been recently analyzed. The results of these studies indicate that amoxicillin at 50 mg/kg/day for 10 days should be considered first line of therapy for patients with acute otitis media. In patients with recurrent otitis media, therapeutic failures or in patients at risk of having a penicillin non-susceptible Streptococcus pneumoniae, one of the second line agents should be considered.

  15. [Comparison of culture and real-time PCR methods in the detection of Streptococcus pneumoniae and Haemophilus influenzae in acute otitis media effusion specimens].

    Science.gov (United States)

    Eser, Ozgen Köseoğlu; Alp, Sehnaz; Ergin, Alper; Ipçi, Kaan; Alp, Alpaslan; Gür, Deniz; Hasçelik, Gülşen

    2012-10-01

    Streptococcus pneumoniae and Haemophilus influenzae are the major etiologic agents of acute otitis media. This study was aimed to compare the detection rate of S.pneumoniae and H.influenzae by culture and real-time polymerase chain reaction (Rt-PCR) in the middle ear effusions of patients diagnosed as acute otitis media. A total of 60 middle ear effusion samples collected from children with acute otitis media were included in the study. The samples were inoculated and incubated in BACTEC Ped Plus blood culture bottles and BACTEC 9120 system (BD Diagnostic Systems, MD), respectively, and the isolates were identified by conventional methods. For the molecular diagnosis of H.influenzae and S.pneumoniae, ply pneumolysin gene and HIB capsule region, respectively were amplified by Rt-PCR (LightCycler, Roche Diagnostics, Germany). H.influenzae and S.pneumoniae were isolated from 5 (8.3%) and 3 (5%) of the patient samples with conventional culture methods, respectively. In addition in 11.6% of the samples other microorganisms (Staphylococcus epidermidis, Streptococcus intermedius, Streptococcus sanguinis, Moraxella catarrhalis, Pseudomonas aeruginosa, Candida albicans) were also isolated. On the other hand H.influenzae and S.pneumoniae were detected in 38 (63.3%) and 24 (40%) of the samples with Rt-PCR, respectively. There was about eight fold increase in the detection frequency of H.influenzae and S.pneumoniae with Rt-PCR compared to culture methods. When culture was accepted as the gold standard method, the sensitivity, specificity and positive predictive value of Rt-PCR in the detection of H.influenzae and S.pneumoniae were estimated as 80%, 51% and 98.2%, respectively. As a result, Rt-PCR was shown to be a sensitive method and could be preferred for the rapid diagnosis of H.influenzae and S.pneumoniae in the etiological diagnosis of acute otitis media, especially in culture negative cases.

  16. Effect of administration of Streptococcus salivarius K12 on the occurrence of streptococcal pharyngo-tonsillitis, scarlet fever and acute otitis media in 3 years old children.

    Science.gov (United States)

    Di Pierro, F; Colombo, M; Giuliani, M G; Danza, M L; Basile, I; Bollani, T; Conti, A M; Zanvit, A; Rottoli, A S

    2016-11-01

    Streptococcus salivarius K12 (BLIS K12) is a probiotic strain strongly antagonistic to the growth of Streptococcus pyogenes, the most important bacterial cause of pharyngeal infections in humans. Shown to colonize the oral cavity and to be safe for human use, BLIS K12 has previously been reported to reduce pharyngo-tonsillitis episodes in children or adults known to have experienced recurrent streptococcal infection. The present study was focussed upon evaluating the role of BLIS K12 in the control of streptococcal disease and acute otitis media in children attending the first year of kindergarten. By randomization, 222 enrolled children attending the first year of kindergarten were divided into a treated group (N = 111) receiving for 6 months a daily treatment with BLIS K12 (Bactoblis®) and a control group (N = 111) who were monitored as untreated controls. During the 6 months of treatment and 3 months of follow-up, the children were evaluated for treatment tolerance, and for episodes of streptococcal pharyngo-tonsillitis, scarlet fever and acute otitis media. During the 6-month trial (N = 111 per group) the incidence of streptococcal pharyngo-tonsillitis, scarlet fever and acute otitis media was approximately 16%, 9% and 44% respectively in the treated group and 48%, 4% and 80% in the control group. During the 3-months follow-up (N = 29 per group) the corresponding rates of infection were 15%, 0% and 12% in the treated group and 26%, 6% and 36% in the controls. No apparent side effects were detected in the treated group either during treatment or follow-up. All of the enrolled children completed the study. The daily administration of BLIS K12 to children attending their first year of kindergarten was associated with a significant reduction in episodes of streptococcal pharyngitis and acute otitis media. No protection against scarlet fever was detected.

  17. Mucosal immunization with PsaA protein, using chitosan as a delivery system, increases protection against acute otitis media and invasive infection by Streptococcus pneumoniae.

    Science.gov (United States)

    Xu, J-H; Dai, W-J; Chen, B; Fan, X-Y

    2015-03-01

    As infection with Streptococcus pneumoniae (mainly via the mucosal route) is a leading cause of acute otitis media, sinus and bacterial pneumonia, the mucosal immunity plays an important role in the prevention of pneumococcal diseases. Therefore, intranasal vaccination may be an effective immunization strategy, but requires appropriate mucosal vaccine delivery systems. In this work, chitosan was used as a mucosal delivery system to form chitosan-PsaA nanoparticles based on ionotropic gelation methods and used to immunize BALB/c mice intranasally. Compared to mice immunized with naked PsaA, levels of IFN-γ, IL-17A and IL-4 in spleen lymphocytes, the systemic (IgG in serum) and mucosal (IgA in mucosal lavage) specific antibodies were enhanced significantly in mice inoculated with chitosan-PsaA. Furthermore, increased protection against acute otitis media following middle ear challenge with pneumococcus serotype 14, and improved survival following intraperitoneal challenge with pneumococcus serotype 3 or serotype 14, was found in the mice immunized with chitosan-PsaA nanoparticles. Thus, intranasal immunization with chitosan-PsaA can successfully induce mucosal and systemic immune responses and increase protection against pneumococcal acute otitis media and invasive infections. Hence, intranasal immunization with PsaA protein, based on chitosan as a delivery system, is an efficient immunization strategy for preventing pneumococcal infections.

  18. A mouse modle of acute otitis media%小鼠急性中耳炎模型的建立

    Institute of Scientific and Technical Information of China (English)

    周爱娥; 王维; 项云; 黄益飞; 董姗姗; 何於娟

    2013-01-01

    目的:建立小鼠急性中耳炎模型并初步探讨其病理机制。方法:不同菌量肺炎链球菌TIGR4经鼓膜穿刺接种于C57BL/6小鼠中耳腔内,观察小鼠体重变化及发病情况,于接种后不同时间点取小鼠头部进行组织切片HE染色,取心脏血及中耳灌洗液,中耳灌洗液进行细胞计数、细菌铺板计数和细胞涂片瑞氏染色,并测定其上清和血清中细胞因子含量。结果:小鼠接种肺炎链球菌后,体重下降,呈剂量依赖方式。中耳粘膜增厚,上皮细胞坏死脱落,中耳腔内大量炎症细胞浸润。中耳腔内中性粒细胞的募集时相与细菌的清除时相呈相关性,中耳灌洗液中IL-6和TNF-α显著升高。结论:本研究成功构建了小鼠急性中耳炎模型,为进一步研究急性中耳炎发病机制奠定了实验基础。%Objective :To establish a mouse model of acute otitis media and explore its pathological mechanism .Methods A total of 97 healthy ,female C57BL/6 mice were used .Under anesthetized ,5μl Streptococcus pneumoniae TIGR4 suspension (104 ,106 and 108 CFU) and equivalent phosphate buffer were puncture inoculation in the middle ear cavity through tympanic membrane .After inoculation ,the mouse weight and the incidence were observed daily .Four mice from each group were taken heart blood and middle ear lavage fluid (MELF) at 1 ,3 ,5 days after inoculation .Cell count ,cell classification ,bacteria loads and cytokines were determinated .HE staining of tissue sections with 106CFU treated mouse was monitored at 1 ,3 ,5 ,7 days after inoculation .Results After inoculated with Streptococcus pneumoniae ,mouse weight lost in a dose -dependent manner .Along with time ,middle ear mucosa epithelial cell necrosis ,mucosal thickening , inflammatory cell infiltration in the middle ear cavity and middle ear bone wall bone destruction were seen .Neutrophil recruitment phase was related with bacterial clearance phase .IL -6 and

  19. High detection rates of nucleic acids of a wide range of respiratory viruses in the nasopharynx and the middle ear of children with a history of recurrent acute otitis media.

    Science.gov (United States)

    Wiertsema, Selma P; Chidlow, Glenys R; Kirkham, Lea-Ann S; Corscadden, Karli J; Mowe, Eva N; Vijayasekaran, Shyan; Coates, Harvey L; Harnett, Gerald B; Richmond, Peter C

    2011-11-01

    Both bacteria and viruses play a role in the development of acute otitis media, however, the importance of specific viruses is unclear. In this study molecular methods were used to determine the presence of nucleic acids of human rhinoviruses (HRV; types A, B, and C), respiratory syncytial viruses (RSV; types A and B), bocavirus (HBoV), adenovirus, enterovirus, coronaviruses (229E, HKU1, NL63, and OC43), influenza viruses (types A, B, and C), parainfluenza viruses (types 1, 2, 3, 4A, and 4B), human metapneumovirus, and polyomaviruses (KI and WU) in the nasopharynx of children between 6 and 36 months of age either with (n = 180) or without (n = 66) a history of recurrent acute otitis media and in 238 middle ear effusion samples collected from 143 children with recurrent acute otitis media. The co-detection of these viruses with Streptococcus pneumoniae, nontypeable Haemophilus influenzae, and Moraxella catarrhalis was analyzed. HRV (58.3% vs. 42.4%), HBoV (52.2% vs. 19.7%), polyomaviruses (36.1% vs. 15.2%), parainfluenza viruses (29.4% vs. 9.1%), adenovirus (25.0% vs. 6.1%), and RSV (27.8% vs. 9.1%) were detected significantly more often in the nasopharynx of children with a history of recurrent acute otitis media compared to healthy children. HRV was predominant in the middle ear and detected in middle ear effusion of 46% of children. Since respiratory viruses were detected frequently in the nasopharynx of both children with and without a history of recurrent acute otitis media, the etiological role of specific viruses in recurrent acute otitis media remains uncertain, however, anti-viral therapies may be beneficial in future treatment and prevention strategies for acute otitis media.

  20. Bacteriotherapy with Streptococcus salivarius 24SMB and Streptococcus oralis 89a nasal spray for preventing recurrent acute otitis media in children: a real-life clinical experience

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    La Mantia I

    2017-06-01

    Full Text Available Ignazio La Mantia, Attilio Varricchio, Giorgio Ciprandi Associazione Italiana Vie Aeree Superiori, Naples, Italy Abstract: Recurrence of acute otitis media (RAOM is a relevant issue in the clinical practice. “Bacteriotherapy” has been proposed as an option in children with RAOM. Streptococcus salivarius 24SMB nasal spray has been previously demonstrated to reduce the risk of acute otitis media (AOM in otitis-prone children. The current retrospective and observational study aimed to confirm this outcome in a real-life setting, such as the common pediatric practice. Group A (108 children served as control; group B (159 children was treated with S. salivarius 24SMB and Streptococcus oralis 89a nasal spray after the first AOM episode. Active treatment consisted of 3 monthly courses: 2 puffs per nostril twice/day for a week. Group B showed a significant reduction of AOM episodes in comparison with group A (p<0.0001. Notably, all actively treated children with the highest AOM recurrence had a reduction of recurrence, whereas only 50% of the control group children had reduced RAOM (p<0.0001. Also, severity grade of AOM significantly diminished after the preventive bacteriotherapy (p<0.0001. In conclusion, the current retrospective and observational study demonstrated that S. salivarius 24SMB and S. oralis 89a nasal spray could be effective in the prevention of RAOM in a real-life setting. Keywords: recurrent acute otitis media, bacteriotherapy, Streptococcus salivarius 24SMB, Streptococcus oralis 89a, nasal spray, children

  1. Otoscopic diagnosis of otitis media.

    Science.gov (United States)

    Isaacson, Glenn

    2016-12-01

    Accurate diagnosis of otitis media is important to prevent suffering and complications when infection is present, and unnecessary antibiotic use when infection is absent. The usual signs and symptoms of acute otitis media are unreliable guides in infants and young children. Similarly, middle ear effusions may present with little discomfort in older children. We therefore depend on examination of the tympanic membrane with an otoscope to make most diagnoses. This article aims to improve the accuracy of middle ear diagnosis by pneumatic otoscopy. It includes descriptions and photographs of the normal ear drum and illustrates the pathologic changes seen in acute otitis media, long-standing eustachian tube dysfunction and otitis media with effusion.

  2. beta-Lactamase-producing Moraxella catarrhalis may prevent the emergence of penicillin-resistant Streptococcus pneumoniae in children with recurrent acute otitis media.

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    Joki-Erkkilä, Veli-Pekka; Aittoniemi, Janne; Vuento, Risto; Puhakka, Heikki

    2002-05-15

    We studied the effect of concomitant nasopharyngeal carriage of beta-lactamase producing Moraxella catarrhalis and Haemophilus influenzae on the occurrence of penicillin resistance of Streptococcus pneumoniae. We took nasopharyngeal samples from 306 children with recurrent otitis media and a history of several antibiotic treatments. We could isolate at least one of the pathogens in 89 subjects. Of these children 13% carried more than one pathogen. Of the isolated M. catarrhalis and H. influenzae strains 93% and 43% produced beta-lactamase, respectively. Of the S. pneumoniae strains 25% were non-susceptible (I/R) to penicillin. However, in patients carrying beta-lactamase-producing M. catarrhalis together with pneumococci all strains were susceptible to penicillin (P=0.0353). This finding suggests that beta-lactamase producing M. catarrhalis may hinder the emergence of penicillin resistance of S. pneumoniae in children with recurrent acute otitis media.

  3. [The swimmer's otitis. An up to date and prevention options].

    Science.gov (United States)

    Caramia, G; Serafini, V; Loggi, A

    2013-01-01

    The swimmer's otitis or acute otitis externa, is a pathology that often occurs in those who practice swimming at a competitive level. The same problem often occurs in the summer with the attendance of swimming pools and bathing areas. A survey made in the United States in 2007 confirms the dynamics of the onset of this pathology, because the contamination of fungi and bacteria in the waters of the swimming pools and the sea cause the inflammation of the epithelium of the auditory canal. To face this issue, in addition to a correct diagnosis, and the necessary and appropriate therapies, it may follow the use of these medicinal preparations. The first one (A) is protective-acting, the second one (B) is characterized as a preventive, hygroscopic, moistening, antiseptic and antimycotic-acting solution. Swimmers who have been using the two (pre-and post) preparations daily for about a year have reported sporadic episodes of otitis. However, there is no doubt that these two compounds deserve a meticulous clinical trial in order to confirm their preventive and therapeutic potentials in external acute otitis.

  4. The swimmer's otitis. An up to date and prevention options

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    G. Caramia

    2013-08-01

    Full Text Available The swimmer’s otitis or acute otitis externa, is a pathology that often occurs in those who practice swimming at a competitive level. The same problem often occurs in the summer with the attendance of swimming pools and bathing areas. A survey made in the United States in 2007 confirms the dynamics of the onset of this pathology, because the contamination of fungi and bacteria in the waters of the swimming pools and the sea cause the inflammation of the epithelium of the auditory canal. To face this issue, in addition to a correct diagnosis, and the necessary and appropriate therapies, it may follow the use of these medicinal preparations. The first one (A is protective-acting, the second one (B is characterized as a preventive, hygroscopic, moistening, antiseptic and antimycotic-acting solution. Swimmers who have been using the two (pre-and post preparations daily for about a year have reported sporadic episodes of otitis. However, there is no doubt that these two compounds deserve a meticulous clinical trial in order to confirm their preventive and therapeutic potentials in external acute otitis.

  5. [Chronic otitis mediaChronic Otitis Media].

    Science.gov (United States)

    Kohles, N; Schulz, T; Eßer, D

    2015-11-01

    There are 2 different kinds of chronic otitis media: Otitis media chronica mesotympanalis and otitis media chronica epitympanalis (cholesteatoma). The incidence of chronic otitis media as reported in literature differs in a wide range. The incidence rates vary between 0.45 and 46%. Both, otitis media chronica mesotympanalis and cholesteatoma, lead to eardrum perforation due to lengthy and recurring inflammations. Furthermore, chronic otitis media is characterized by frequently recurring otorrhea and conductive hearing loss. Georg Thieme Verlag KG Stuttgart · New York.

  6. Have Guidelines Affected Ear, Nose, and Throat Specialists’ Diagnoses and the Prescription of Antibiotics for Acute Otitis Media?

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    2011-01-01

    Full Text Available Introduction: The Ministry of Health and Medical Education of Iran, and similar institutions in many other countries, advises physicians to use current guidelines for the diagnosis and treatment of acute otitis media (AOM. However, there has been no evaluation of the effectiveness of such guidelines or whether physicians in Iran adhere to them. Thus, as laryngologists are the most important group of people who interact with patients with AOM, the aim of this study was to evaluate the attitude of laryngologists to the established guidelines.  Materials and Methods: A total of 120 anonymous surveys were mailed to 120 otolaryngologists in Tehran, Iran, to evaluate the patterns of diagnosis and treatment of AOM used by these physicians. The survey included questions regarding the otolaryngologists’ age, gender, place of work, and attitude towards diagnosis and treatment of AOM.  Results: Sixty-two completed surveys were received, for a response rate of 51%. There was no significant difference between respondents to these surveys according to sex, age, practice setting, graduation year, or the number of patients with AOM seen each month.  Conclusion: Our study adds new insights to the previous literature on the use of guidelines in the management of AOM. We can now assess the impact of guidelines on the usual practice of physicians in evidenced-based management of AOM.

  7. The Effect of Acute Otitis Media on Transient Otoacoustic Emissions A Clinical Guide to Successful Treatment Course

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    Arash Bayat

    2011-09-01

    Full Text Available Introduction & Objective: Acute otitis media (AOM is the most common causes of acquired hearing loss in children with increasing incidence. In young children the diagnosis is restricted to otoscopy and tympanometry whereas evaluation of the auditory function is impossible due to noncompliance during pure tone audiometry. For this purpose, measurement of otoacoustic emissions, especially transient evoked ones (TEOAEs, can be applied. The aim of this study was to evaluate the effect of AOM on TEOAEs in young children before and after treatment course. Material & Methods: In an analytic, cross-sectional design, 42 young children with AOM, both sexes, aged 2 to 4.5 years were evaluated through tympanometry and transient otoacoustic emissions (TEOAEs. TEOAEs signal to noise ratio (SNR and reproducibility of AOM patients were compared before, two weeks and six weeks after the treatment course. Then AOM responses were compared with an age-matched control group. The results were analyzed using SPSS 16. Results: Our findings revealed that TEOAE parameters in AOM subjects were the most affected on highest frequencies. Significant changes of TEOAE parameters were found 2 weeks after the treatment with further improvement 6 weeks after the treatment course (P 0.05. Conclusion: The results of this study suggest that there was an improvement in TEOAE SNR and band reproducibility in serial TEOAEs measurements. Thus,application of TEOAEs is a beneficial method to follow up medical treatment in young children with AOM.

  8. Impact of acute otitis media pathogen shifts on the clinical efficacy of several antibiotics: a therapeutic outcomes model.

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    Canut, A; Martin-Herrero, J E; Maortua, H; Labora, A; Isla, A; Rodriguez-Gascon, A

    2009-08-01

    The aim of this study was to predict the clinical efficacy of different antimicrobials in the treatment of patients with acute otitis media (AOM), before and after the change in the proportion of middle ear pathogens observed after the introduction of the new conjugated heptavalent penumococcal vaccine (pPCV-7). The therapeutic Outcomes model was used to predict the likelihood of clinical success. According to this mathematical model the obtained rank order of predicted clinical efficacy was similar in the pre-PVC7 period and the post-PVC period. The results suggest that ceftriaxone and amoxicillin/clavulanate are the antibiotics with the highest predicted clinical efficacy, whereas cefaclor, azithromycin, erythromycin and clarithromycin are those with the lowest predicted clinical efficacy. The differences between antibiotics with good and those with low antibacterial activity were greater when only cases of bacterial AOM were considered. Antibiotics for which the highest clinical efficacy was predicted should maximize the likelihood of cure in outpatient antibiotic treatment of AOM.

  9. The Effect of Acute Otitis Media on Transient Otoacoustic Emissions A Clinical Guide to Successful Treatment Course

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    A. Bayat

    Full Text Available Introduction & Objective: Acute otitis media (AOM is the most common causes of acquired hearing loss in children with increasing incidence. In young children the diagnosis is restricted to otoscopy and tympanometry whereas evaluation of the auditory function is impossible due to noncompliance during pure tone audiometry. For this purpose, measurement of otoacoustic emissions, especially transient evoked ones (TEOAEs, can be applied. The aim of this study was to evaluate the effect of AOM on TEOAEs in young children before and after treatment course.Material & Methods: In an analytic, cross-sectional design, 42 young children with AOM, both sexes, aged 2 to 4.5 years were evaluated through tympanometry and transient otoacoustic emissions (TEOAEs. TEOAEs signal to noise ratio (SNR and reproducibility of AOM patients were compared before, two weeks and six weeks after the treatment course. Then AOM responses were compared with an age-matched control group. The results were analyzed using SPSS 16.Results: Our findings revealed that TEOAE parameters in AOM subjects were the most affected on highest frequencies. Significant changes of TEOAE parameters were found 2 weeks after the treatment with further improvement 6 weeks after the treatment course (P 0.05.Conclusion: The results of this study suggest that there was an improvement in TEOAE SNR and band reproducibility in serial TEOAEs measurements. Thus,application of TEOAEs is a beneficial method to follow up medical treatment in young children with AOM. (Sci J Hamadan Univ Med Sci 2011;18(3:17-21

  10. Seasonality of antibiotic-resistant streptococcus pneumoniae that causes acute otitis media: a clue for an antibiotic-restriction policy?

    Science.gov (United States)

    Dagan, Ron; Barkai, Galia; Givon-Lavi, Noga; Sharf, Amir Z; Vardy, Daniel; Cohen, Ted; Lipsitch, Marc; Greenberg, David

    2008-04-15

    It is unclear whether reducing antibiotic prescriptions can reduce rates of resistance once resistance becomes prevalent. We attempted to determine whether reduced antibiotic consumption, which is observed yearly in children during the warm season, is associated with a reduction in antibiotic resistance in pneumococcal acute otitis media (AOM). Antibiotic prescriptions and resistance were measured prospectively during 1999-2003 in 2 demographically distinct populations: Jewish and Bedouin children (aged <5 years) in southern Israel. Associations were assessed using seasonally clustered logistic regression models. The study included 236,466 prescriptions and 3609 pneumococcal isolates. Prescription rates decreased during the warm months by 36% and 15% in Jewish and Bedouin children, respectively (P < .001 for the season). Among Jewish children, higher resistance rates were observed during the cold than the warm months (P < .001 for each antibiotic). This difference remained significant after adjustment for age, ethnic group, study year, history of antibiotic use, and serotype. The difference was not observed in Bedouin children. Rapid seasonal decline in resistant AOM-causing pneumococci occurred only in Jewish children, among whom a marked prescribing seasonality was noted, and not in Bedouin children, among whom prescription was less seasonal. The rapid seasonal decrease in resistance associated with markedly reduced antibiotic use suggests that drug-resistant pneumococci may pay a fitness cost.

  11. Primer reporte de aislamiento de Staphylococcus schleiferi subespecie coagulans en perros con pioderma y otitis externa en Chile First report of isolation of Staphylococcus schleiferi subspecies coagulans from dogs with pyoderma and external otitis in Chile

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    L Muñoz

    2012-01-01

    Full Text Available Staphylococcus schleiferi subesp. coagulans fue identificado y descrito por primera vez por Igimi y col (1990 en perros con otitis. El objetivo de este reporte fue determinar la frecuencia de aislamiento de S. schleiferi subesp. coagulans en muestras de perros con pioderma y/u otitis externa en Chile y establecer los perfiles de resistencia frente a antimicrobianos de uso habitual y caracterizar molecularmente la resistencia a quinolonas. Se obtuvieron muestras de 237 caninos adultos diagnosticados con pioderma y/u otitis externa, en el Hospital Veterinario de la Universidad de Chile. La identificación de Staphylococcus schleiferi subesp. coagulans se realizó con BBL™ Crystal GP. La concentración mínima inhibitoria se determinó mediante el método de dilución en agar. El panel de antimicrobianos utilizado fue oxacilina, amoxicilina, cefradina, mupirocina, clindamicina, enrofloxacino, doxiciclina, tetraciclina, kanamicina y sulfametoxazol / trimetoprim. De 237 muestras analizadas, 135 fueron aisladas de pioderma y 102 de otitis. Staphylococcus spp. se identificó en 117 y 52 de las muestras respectivamente. S. schleiferi subesp. coagulans se identificó en 8 cepas aisladas desde pioderma (6,8% y en 11 cepas de otitis (21,2%. Todas las cepas de S. schleiferi subesp. coagulans de pioderma y el 54,5% de otitis resultaron sensibles a todos los antimicrobianos. La susceptibilidad fue de un 90,9% mupirocina, enrofloxacino y sulfametoxazol/trimetoprim; 81,8% a amoxicilina y kanamicina y el 72,7% a clindamicina. Solo una cepa aislada de otitis presentó multirresistencia. La cepa de Staphylococcus schleiferi subesp. coagulans que evidenció resistencia fenotípica a quinolonas presentó mutación en los genes gyrA y grlA.Staphylococcus schleiferi subsp. coagulans was identified and described for the first time in 1990 by Igimi et al (1990 in dogs with otitis. The objective of this report was to determine the frequency of isolation of S

  12. A Treatment Protocol for Management of Bacterial and Fungal Malignant External Otitis: A Large Cohort in Tehran, Iran.

    Science.gov (United States)

    Hasibi, Mehrdad; Ashtiani, Mohammadtaghi Khorsandi; Motassadi Zarandi, Masoud; Yazdani, Nasrin; Borghei, Pedram; Kuhi, Ali; Dabiri, Sasan; Hosseini, Reza; Sardashti, Sara

    2017-07-01

    High rates of negative microbiologic test results highlight the potential role of empiric antimicrobial agents in management of malignant otitis externa (MOE). This study investigates the clinical presentation, laboratory findings, and response to empiric treatment in a large group of patients admitted to a tertiary academic hospital in Tehran, Iran. We recruited 224 patients diagnosed with MOE in a prospective observation from 2009 through 2015. All patients received a 2-agent antibacterial regimen at baseline (phase I). Patients with no improvement within 10 days and/or nonresponders to a second course of antibacterials were switched to antifungals (phase II). Response to treatment was observed and documented in both groups. All patients had physical symptoms for more than 12 weeks before admission. In total, 127 patients responded well to antibacterials. Eighty-seven out of 97 patients who were switched to antifungals had complete response to treatment; patients in the latter group had significantly higher A1C levels at baseline. Our findings provide evidence to develop clinical guidelines that accelerate diagnosis and treatment of MOE to improve patient outcomes.

  13. Genetic alteration of penicillin non-susceptible Streptococcus pneumoniae observed throughout recurrence of acute otitis media detected by amplified fragment length polymorphism analysis.

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    Sugata K

    2001-06-01

    Full Text Available The prevalence of penicillin non-susceptible Streptococcus pneumoniae (PNSSP is increasing among isolates from acute otitis media (AOM. Repeated episodes of antibiotic exposure are a well-known risk factor for the isolation of PNSSP although otitis-prone or recurrent AOM cases frequently require repeated courses of antibiotic treatment. In order to evaluate the chronological alteration of S. pneumoniae during recurrences of AOM, strains of S. pneumoniae were isolated from 11 patients, each of whom had experienced 2-4 episodes of AOM, were examined. Every bacterial specimen obtained from a single episode of recurrent AOM was examined by PCR-based penicillin-binding protein (PBP assay, serotyping, and amplified fragment length polymorphism (AFLP, then compared to other samples from the same case. Two cases (18.2% showed strain diversity during repeated antibiotic treatments by serotyping or PBP-assay. By AFLP analysis, 6 cases (54.5% demonstrated heterogeneous strains during recurrent AOM. Clonal survivors of previous episodes of AOM were not always the cause of subsequent episodes of AOM, even in otitis-prone cases.

  14. Malignant otitis externa: An unusual presentation

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    Rejee Ebenezer

    2011-01-01

    Full Text Available Destruction of condyle of mandible is an extremely rare complication of malignant otitis externa. Here we describe such a rare instance in a patient with malignant otitis externa. It is very important to diagnose this category of patients and treat them accordingly. The available data indicate the need for external drainage. We report a case with malignant otitis externa with temporomandibular involvement treated successfully with radical mastoidectomy and drainage of the joint through the external auditory canal and an external incision was avoided.

  15. Pneumococcal conjugate vaccines for preventing otitis media

    NARCIS (Netherlands)

    Jansen, Angelique G S C; Hak, Eelko; Veenhoven, Reinier H; Damoiseaux, Roger A M J; Schilder, Anne G M; Sanders, Elisabeth A M

    2009-01-01

    BACKGROUND: Acute otitis media (AOM) is a very common early infancy and childhood disease. The marginal benefits of antibiotics on AOM, the increasing problem of bacterial resistance to antibiotics, and the huge estimated direct and indirect annual costs associated with otitis media (OM) have prompt

  16. The clinical course of acute otitis media in high-risk Australian Aboriginal children: a longitudinal study

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    Skull Susan A

    2005-06-01

    Full Text Available Abstract Background It is unclear why some children with acute otitis media (AOM have poor outcomes. Our aim was to describe the clinical course of AOM and the associated bacterial nasopharyngeal colonisation in a high-risk population of Australian Aboriginal children. Methods We examined Aboriginal children younger than eight years who had a clinical diagnosis of AOM. Pneumatic otoscopy and video-otoscopy of the tympanic membrane (TM and tympanometry was done every weekday if possible. We followed children for either two weeks (AOM without perforation, or three weeks (AOM with perforation, or for longer periods if the infection persisted. Nasopharyngeal swabs were taken at study entry and then weekly. Results We enrolled 31 children and conducted a total of 219 assessments. Most children had bulging of the TM or recent middle ear discharge at diagnosis. Persistent signs of suppurative OM (without ear pain were present in most children 7 days (23/30, 77%, and 14 days (20/26, 77% later. Episodes of AOM did not usually have a sudden onset or short duration. Six of the 14 children with fresh discharge in their ear canal had an intact or functionally intact TM. Perforation size generally remained very small (Streptococcus pneumoniae (82%, Haemophilus influenzae (71%, and Moraxella catarrhalis (95%; 63% of swabs cultured all three pathogens. Conclusion In this high-risk population, AOM was generally painless and persistent. These infections were associated with persistent bacterial colonisation of the nasopharynx and any benefits of antibiotics were modest at best. Systematic follow up with careful examination and review of treatment are required and clinical resolution cannot be assumed.

  17. Effect of osteopathic manipulative treatment on middle ear effusion following acute otitis media in young children: a pilot study.

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    Steele, Karen M; Carreiro, Jane E; Viola, Judith Haug; Conte, Josephine A; Ridpath, Lance C

    2014-06-01

    Childhood acute otitis media (AOM) is highly prevalent. Its usual sequela of middle ear effusion (MEE) can lead to conductive hearing loss, for which surgery is commonly used. To evaluate the efficacy of an osteopathic manipulative treatment (OMT) protocol on MEE resolution following an episode of AOM. The authors hypothesized that OMT provided adjunctively to standard care for young children with AOM would reduce the duration of MEE following the onset of AOM. We compared standard care only (SCO) and standard care plus OMT (SC+OMT) for the duration of MEE following AOM. Patients were aged 6 months to 2 years. The SC+OMT group received OMT during 3 weekly visits. Weekly tympanometric and acoustic reflectometer (AR) readings were obtained from all patients. There were 52 patients enrolled, with 43 completing the study and 9 dropping out. No demographic differences were noted. Only ears from each patient with abnormal tympanograms at entry were included. There were 76 ears in the tympanogram analysis (38 from SCO; 38 from SC+OMT) and 61 ears in the AR data analysis (31 from SCO; 30 from SC+OMT). Dependence of bilateral ear disease noted in AR readings was accounted for in statistical analysis. Tympanogram data demonstrated a statistically significant improvement in MEE at visit 3 in patients in the SC+OMT group (odds ratio, 2.98; 95% confidence interval, 1.16, 7.62; χ(2) test for independence, P=.02). The AR data analysis showed statistically significant improvement at visit 3 for the SC+OMT group (z=2.05; P=.02). There was no statistically significant change in MEE before or immediately after the OMT protocol. A standardized OMT protocol administered adjunctively with standard care for patients with AOM may result in faster resolution of MEE following AOM than standard treatment alone. (ClinicalTrials.gov number NCT00520039.). © 2014 The American Osteopathic Association.

  18. Non-capsulated and capsulated Haemophilus influenzae in children with acute otitis media in Venezuela: a prospective epidemiological study

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    Naranjo Laura

    2012-02-01

    Full Text Available Abstract Background Non-typeable Haemophilus influenzae (NTHi and Streptococcus pneumoniae are major causes of bacterial acute otitis media (AOM. Data regarding AOM are limited in Latin America. This is the first active surveillance in a private setting in Venezuela to characterize the bacterial etiology of AOM in children Methods Between December 2008 and December 2009, 91 AOM episodes (including sporadic, recurrent and treatment failures were studied in 87 children enrolled into a medical center in Caracas, Venezuela. Middle ear fluid samples were collected either by tympanocentesis or spontaneous otorrhea swab sampling method. Standard laboratory and microbiological techniques were used to identify bacteria and test for antimicrobial resistance. The results were interpreted according to Clinical Laboratory Standards Institute (CLSI 2009 for non-meningitis isolates. All statistical analyses were performed using SAS 9.1 and Microsoft Excel (for graphical purposes. Results Overall, bacteria were cultured from 69.2% (63 of the 91 episodes; at least one pathogen (S. pneumoniae, H. influenzae, S. pyogenes or M. catarrhalis was cultured from 65.9% (60/91 of episodes. H. influenzae (55.5%; 35/63 episodes and S. pneumoniae (34.9%; 22/63 episodes were the most frequently reported bacteria. Among H. influenzae isolates, 62.9% (22/35 episodes were non-capsulated (NTHi and 31.4% (11/35 episodes were capsulated including types d, a, c and f, across all age groups. Low antibiotic resistance for H. influenzae was observed to amoxicillin/ampicillin (5.7%; 2/35 samples. NTHi was isolated in four of the six H. influenzae positive samples (66.7% from recurrent episodes. Conclusions We found H. influenzae and S. pneumoniae to be the main pathogens causing AOM in Venezuela. Pneumococcal conjugate vaccines with efficacy against these bacterial pathogens may have the potential to maximize protection against AOM.

  19. Suture restriction of the temporal bone as a risk factor for acute otitis media in children: cohort study

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    Morin Chantal

    2012-11-01

    Full Text Available Abstract Background Eustachian tube (ET dysfunction plays an important role in the pathogenesis of acute otitis media (AOM. Unfortunately, there is a lack of knowledge about the exact role of the ET’s bony support, the temporal bone, on occurrence of AOM. This study investigates whether severe suture restriction of the temporal bone is a risk factor for development of AOM in young children. Methods Using a prospective cohort design, 64 children aged 6 to 18 months without prior history of AOM were followed during the cold season (September 2009 to April 2010. Temporal bone status (categorized as with or without severe suture restriction was evaluated using palpation and a cranial bone mobility test. Information about potential baseline confounders and risk factors for AOM (gender, age, birth weight, gestational age, use of pacifier, daycare attendance, presence of siblings, low socioeconomic status, breastfeeding ≥ 6 months, parental smoking and history of upper respiratory tract infection were also collected. Occurrence of AOM diagnosed by physicians blinded to temporal bone status was the main outcome. Data were analyzed using hierarchical linear and nonlinear (multilevel models. Results Severe suture restriction of the temporal bone was identified in 23 children (35.9%. At least one AOM episode was diagnosed in 14 (48.3% of the ears associated with temporal bones previously identified as having severe suture restriction and in 28 (28.3% of those without severe suture restriction. Higher risk for AOM was explained by severe suture restriction of the temporal bone (adjusted relative risk (RR, 2.26, 95% CI 1.43 to 2.91, p Conclusions The study results indicate that severe suture restriction of the temporal bone is a risk factor for AOM in young children. Subsequent intervention studies are needed to determine if this mechanical risk factor can be modified in young children.

  20. Compared to placebo, long-term antibiotics resolve otitis media with effusion (OME and prevent acute otitis media with perforation (AOMwiP in a high-risk population: A randomized controlled trial

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    Morris Peter S

    2008-06-01

    Full Text Available Abstract Background For children at high risk of chronic suppurative otitis media (CSOM, strategies to prevent acute otitis media with perforation (AOMwiP may reduce progression to CSOM. Methods In a double blind study in northern Australia, 103 Aboriginal infants with first detection of OME were randomised to receive either amoxicillin (50 mg/kg/d BD or placebo for 24 weeks, or until bilateral aerated middle ears were diagnosed at two successive monthly examinations (success. Standardised clinical assessments and international standards for microbiology were used. Results Five of 52 infants in the amoxicillin group and none of 51 infants in the placebo group achieved success at the end of therapy (Risk Difference = 9.6% [95% confidence interval 1.6,17.6]. Amoxicillin significantly reduced the proportion of children with i perforation at the end of therapy (27% to 12% RD = -16% [-31,-1], ii recurrent perforation during therapy (18% to 4% RD = -14% [-25,-2], and iii reduced the proportion of examinations with a diagnosis of perforation during therapy (20% to 8% adjusted risk ratio 0.36 [0.15,0.83] p = 0.017. During therapy, the proportion of examinations with penicillin non-susceptible (MIC > 0.1 microg/ml pneumococci was not significantly different between the amoxicillin group (34% and the placebo group (40%. Beta-lactamase positive non-capsular H. influenzae (NCHi were uncommon during therapy but more frequent in the amoxicillin group (10% than placebo (5%. Conclusion Aboriginal infants receiving continuous amoxicillin had more normal ears, fewer perforations, and less pneumococcal carriage. There was no statistically significant increase in resistant pneumococci or NCHi in amoxicillin children compared to placebo children who received regular paediatric care and antibiotic treatment for symptomatic illnesses.

  1. Otitis media

    NARCIS (Netherlands)

    Rovers, MM; Schilder, AGM; Zielhuis, GA; Rosenfeld, RM

    2004-01-01

    Otitis media (OM) continues to be one of the most common childhood infections and is a major cause of morbidity in children. The pathogenesis of OM is multifactorial, involving the adaptive and native immune system, Eustachian-tube dysfunction, viral and bacterial load, and genetic and environmental

  2. Caracterización clínico-epidemiológica de la otitis media aguda en pacientes pediátricos Clinicoepidemiological characterization of the acute otitis media in children

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    Ileana Álvarez Lam

    2011-09-01

    de determinados factores socioeconómicos, ambientales y genéticos que pueden estar presentes en la población infantil.Introduction: the acute otitis media is one of the infectious diseases more frequent in childhood and it is one of the more important causes of medical consultations and prescription of antibiotic agents in cases under five years old. Objective: to determine the clinical-epidemiological behavior of disease. Methods: a prospective, longitudinal and descriptive study was conducted in 60 patients aged between 1 month and 14 years diagnosed with purulent acute otitis media seen in the "William Soler" Teaching Children Hospital during one year. Clinical data were obtained by means of patient's family and tutor survey. All underwent tympanocentesis with culture and nasopharyngeal exudates. Strains isolated (S. pneumoniae and H. influenzae were sent to Reference National Laboratory of the "Pedro Kourí" Tropical Medicine Institute to microbiological characterization and susceptibility antimicrobial assessment. Results: disease predominates in the group between 12 and 23 years months (55 % with a great involvement in the male sex (52 %. Fever and local manifestations related to middle ear (irritability, otalgia, and night cry were the more frequent clinical elements. The outside home care, the to tobacco smoke exposition and the early wean were the more frequent risk factors. S. pneumoniae, non-typing H. influenzae and S. epidermidis were the germs more isolated. The 25 % of strains of S. pneumoniae had an average resistance to penicillin but there was not report of resistance to third-generation cephalosporin. The 98,4 % of patients evolved satisfactorily. The disease complications were present in the 1,6 % of cases. Conclusions: the acute otitis media is frequent in children under 36 months of age and it is highly related to presence of determined socioeconomic, environmental and genetic factors that may to be present in children.

  3. The Clinical Potential of Semisynthetic Penicillins in Acute Bacterial Otitis Media and Acute Bacterial Tonsillitis in Children in the Practice of ENT Doctor: Focus on Ospamox and Amoxsiclav®

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    V.I. Popovych

    2015-10-01

    Full Text Available The wide prevalence of bacterial infections of upper respiratory tract, especially in childhood, the presence of complications that threaten the health and lives of patients necessitate the prescription of a rational systemic antibiotic therapy. Given the fact that in most cases the characteristics of the bacterial spectrum as an etiologic agent of these diseases is known, penicillin antibiotics are the first line in this pathology. On the example of two clinical cases, we have considered the use of suspension Ospamox (amoxicillin and Amoxiclav® (amoxicillin clavulanate in children with acute tonsillitis and acute otitis media, which demonstrated high efficacy and safety of treatment.

  4. Natural history, definitions, risk factors and burden of otitis media.

    Science.gov (United States)

    Kong, Kelvin; Coates, Harvey L C

    2009-11-02

    Otitis media remains a major health problem in Australia, with an unacceptably great dichotomy of incidence and severity of otitis media and its complications between Indigenous and non-Indigenous Australians. Among most children with acute otitis media, infection resolves rapidly with or without antibiotics, with ongoing middle ear effusion the only sequela. Overcrowding, poor living conditions, exposure to cigarette smoke, and lack of access to medical care are all major risk factors for otitis media. Estimates of the number of cases of otitis media in 2008 vary between 992,000 and 2,430,000 Australians, with a total estimated cost of $100 - $400 million.

  5. Otitis media with effusion:diagnosis and treatment

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    Ozgur Surmelioglu

    2013-04-01

    Full Text Available Otitis media with effusion (serous otitis media is characterised by an accumulation of fluid in the middle ear behind an intact tympanic membrane, without the symptoms or signs of acute infection. Serous otitis media is the most common cause of hearing loss in children in the developed world. Hearing loss may be affected speech, cognitive, and psychological development of the childeren. In addition, otitis media with effusion is not only seen in children, this sign may present with signs of nasopharyngeal diseases. For this reason, especially in childhood otitis media with effusion should be treated by early diagnosis. [Archives Medical Review Journal 2013; 22(2.000: 194-208

  6. Nasopharyngeal flora in children with acute otitis media before and after implementation of 7 valent pneumococcal conjugate vaccine in France

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    Cohen Robert

    2012-03-01

    Full Text Available Abstract Background Several studies have investigated the impact of 7-valent pneumococcal conjugate vaccine (PCV7 on pneumococcal (Sp and staphylococcal (Sa nasopharyngeal (NP carriage. Few have investigated the impact on Haemophilus influenzae (Hi and Moraxella catarrhalis (Mc carriage. We aimed to compare the NP carriage rates in young children with acute otitis media (AOM before and after PCV7 implementation in France. Methods Prior to PCV7 implementation, we performed 4 successive randomized trials with NP samples. These studies compared several antibiotic regimens for treating AOM in young children (6 to 30 months. After PCV7 implementation, to assess the impact of the vaccination program on NP flora, young children with AOM were enrolled in a prospective surveillance study. In each study, we obtained an NP sample to analyze the carriage rates of Sp, Hi, Mc and Sa and the factors influencing the carriage. Standardized history and physical examination findings were recorded; the methods used for NP swabs (sampling and cultures were the same in all studies. Results We enrolled 4,405 children (mean age 13.9 months, median 12.8. Among the 2,598 children enrolled after PCV7 implementation, 98.3% were vaccinated with PCV7. In comparing the pre- and post-PCV7 periods, we found a slight but non-significant decrease in carriage rates of pneumococcus (AOR = 0.85 [0.69;1.05], H. influenzae (AOR = 0.89 [0.73;1.09] and S. aureus (AOR = 0.92 [0.70;1.19]. By contrast, the carriage rate of M. catarrhalis increased slightly but not significantly between the 2 periods (AOR = 1.08 [0.95;1.2]. Among Sp carriers, the proportion of PCV7 vaccine types decreased from 66.6% to 10.7% (P Conclusion The carriage rates of otopathogen species (Sp, Hi, Mc and Sa did not significantly change in children with AOM after PCV7 implementation in France. However, we observed significant changes in carriage rates of PCV7 vaccine serotypes and penicillin non-susceptible Sp.

  7. Burden of acute otitis media in primary care pediatrics in Italy: a secondary data analysis from the Pedianet database

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    Marchisio Paola

    2012-11-01

    Full Text Available Abstract Background The incidence of acute otitis media (AOM vary from country to country. Geographical variations together with differences in study designs, reporting and settings play a role. We assessed the incidence of AOM in Italian children seen by primary care paediatricians (PCPs, and described the methods used to diagnose the disease. Methods This secondary data analysis from the Pedianet database considered children aged 0 – 6 years between 01/2003 and 12/2007. The AOM episodes were identified and validated by means of patient diaries. Incidence rates/100 person-years (PY were calculated for total AOM and for single or recurrent AOM. Results The 92,373 children (52.1% males were followed up for a total of 227,361 PY: 23,039 (24.9% presented 38,241 episodes of AOM (94.6% single episodes and 5.4% recurrent episodes. The total incidence rate of AOM in the 5-year period was 16.8 episodes per 100 PY (95% CI: 16.7-16.9, including single AOM (15.9 episodes per 100 PY; 95% CI: 15.7-16.1 and recurrent AOM (0.9 episodes per 100 PY; 95% CI: 0.9-0.9. There was a slight and continuously negative trend decrease over time (annual percent change −4.6%; 95%CI: -5.3, -3.9%. The AOM incidence rate varied with age, peaking in children aged 3 to 4 years (22.2 episodes per 100 PY; 95% CI 21.8-22.7. The vast majority of the AOM episodes (36,842/38,241, 96.3% were diagnosed using a static otoscope; a pneumatic otoscope was used in only 3.7%. Conclusions Our data fill a gap in our knowledge of the incidence of AOM in Italy, and indicate that AOM represents a considerable burden for the Italian PCP system. Educational programmes concerning the diagnosis of AOM are needed, as are further studies to monitor the incidence in relation to the introduction of wider pneumococcal conjugate vaccines.

  8. Effects of recurrent acute otitis media on cortical speech-sound processing in 2-year old children.

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    Haapala, Sini; Niemitalo-Haapola, Elina; Raappana, Antti; Kujala, Tiia; Suominen, Kalervo; Kujala, Teija; Jansson-Verkasalo, Eira

    2014-01-01

    To investigate at the age of 2 years the effects of childhood recurrent acute otitis media (RAOM) on central auditory processing by using cortical event-related potentials elicited by syllable stimuli. During a 1-year period, 22- to 26-month-old children fulfilling the criteria for tympanostomy tube insertion in Oulu University Hospital, Oulu, Finland, were recruited to the RAOM group (N = 20). The control group (N = 19) was matched by age, sex, and mother's educational level. In both groups, children were typically developing and had no family history of language disorder or developmental language problems. Finnish syllables /ke:/ and /pi:/ as standards and their variants with changes in frequency, intensity, vowel, consonant, and vowel duration as deviants were used to record P1, N2, and mismatch negativity (MMN) responses in the multifeature paradigm. The clinically healthy ears at the time of registration were a prerequisite for the participation. Children with RAOM and their controls showed the age-typical P1 and N2 responses with no differences in the amplitudes or latencies between the groups, which suggests unaffected basic encoding of sound features and sound representation formation. However, the groups showed different auditory discrimination profiles. In children with RAOM, frequency and vowel MMN amplitudes were increased. Furthermore, the MMN latency for the frequency change was shorter and the frequency MMN amplitude lateralized to the left hemisphere in the RAOM group instead of an adult-like right-hemispheric lateralization observed in the controls. The children with RAOM had a more anterior MMN amplitude scalp distribution for the intensity change than control children. In addition, the MMN amplitude elicited by consonant change was evenly distributed unlike in controls, who had a left-side preponderant lateralization. Taken together, these results suggest an elevated responsiveness for frequency, vowel, and intensity changes, and an immature

  9. Prevalence of otitis externa in stray cats in northern Italy.

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    Perego, Roberta; Proverbio, Daniela; Bagnagatti De Giorgi, Giada; Della Pepa, Alessandra; Spada, Eva

    2014-06-01

    Feline otitis externa is a dermatological disorder that has not been evaluated much in stray cats. One hundred and eighty-seven stray cats were randomly selected during a trap-neuter-release programme to investigate the prevalence of otitis externa in stray cat colonies in northern Italy. Swabs for cytological examination were obtained from the external ear canal of each cat. A direct otoscopic assessment of the external ear canal was made in 86/187 cats. Cytological evidence of otitis externa was present in 55.1% of cats. The influence on otitis of age, gender, habitat and season of sampling was tested, but no risk factors were found. Otodectes cynotis (as a sole agent or in combination) was the primary cause of otitis in 53.3% of cats. Cocci and rods, either alone or in combination with other agents, were perpetuating factors in 71.8% and 29.1% of cats, respectively. Pregnancy status was a risk factor for otitis caused by coccal infections. Malassezia species, alone or in combination, was the perpetuating factor in 50.5% of cats with otitis. Urban habitat and winter season were risk factors for otitis associated with Malassezia species. Demodex cati was identified as an incidental finding in two cats. There was good agreement between otoscopy and cytology with regard to the diagnosis of otitis externa. The results of this study show a high prevalence of otitis externa in stray colony cats and provide information on causal factors for feline otitis externa.

  10. Ascertainment of aurin ear drops antimicrobial and healing effect in dog otitis

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    Borisov Ivan

    2004-01-01

    Full Text Available Microbiological and clinical examinations have been made, related to the effect of Aurin ear drops - the solution "Primavet - Sofia" on dogs with acute and chronic conditions of external and media otitis. The pharmaceutical compatibility of the active substances and solution stability were examined. The inhibitory effects in vitro of Acidum boricum, Acidwn salicylicum Ethanolum and Aurin - solution on laboratory referents and clinically isolated strains of microorganisms were studied. The dosage and manner of application were specified and was considered the effect on different clinical forms of otitis were specified. In the course of the one-year examination period, it was ascertained that Aurin-solution possesses the necessary stability. The active Aurin-solution substances (Acidum boricum Acidum salicylicum, Novocainum secure optimal composition of supporting substances, and high inhibitory activity in vitro on microbial strains in the examined agents of dog otitis. A dosage of 10 to 20 drops and touching the earconch with 5-10 drops twice a day, in the course of 5-7 days, has local antiseptic, anti-inflammatory, antimycotic and pain soothing effects. The healing effect of Aurin is due to selective antibacterial and antimycotic effects of the active substances used. The effectiveness against otitis is due to synergism of the effects of active and supporting substances. The obtained clinical results present grounds for recommending Aurin - ear drops as an effective method of healing dog otitis.

  11. Neutrophil extracellular traps and bacterial biofilms in middle ear effusion of children with recurrent acute otitis media--a potential treatment target.

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    Ruth B Thornton

    Full Text Available BACKGROUND: Bacteria persist within biofilms on the middle ear mucosa of children with recurrent and chronic otitis media however the mechanisms by which these develop remain to be elucidated. Biopsies can be difficult to obtain from children and their small size limits analysis. METHODS: In this study we aimed to investigate biofilm presence in middle ear effusion (MEE from children with recurrent acute otitis media (rAOM and to determine if these may represent infectious reservoirs similarly to those on the mucosa. We examined this through culture, viability staining and fluorescent in situ hybridisation (FISH to determine bacterial species present. Most MEEs had live bacteria present using viability staining (32/36 and all effusions had bacteria present using the universal FISH probe (26/26. Of these, 70% contained 2 or more otopathogenic species. Extensive DNA stranding was also present. This DNA was largely host derived, representing neutrophil extracellular traps (NETs within which live bacteria in biofilm formations were present. When treated with the recombinant human deoxyribonuclease 1, Dornase alfa, these strands were observed to fragment. CONCLUSIONS: Bacterial biofilms, composed of multiple live otopathogenic species can be demonstrated in the MEEs of children with rAOM and that these contain extensive DNA stranding from NETs. The NETs contribute to the viscosity of the effusion, potentially contributing to its failure to clear as well as biofilm development. Our data indicates that Dornase alfa can fragment these strands and may play a role in future chronic OM treatment.

  12. Otite externa necrotizante com paralisia facial periférica bilateral: relato de caso e revisão da literatura Necrotizing external otitis with periferic bilateral facial palsy: case report and literature review

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    Antonio Antunes

    2004-01-01

    Full Text Available A otite externa necrotizante (OEN, conhecida no passado como otite externa maligna, é uma infecção potencialmente letal que começa usualmente no conduto auditivo externo e se estende à base do crânio ocorrendo, principalmente, em pacientes diabéticos idosos e que a despeito de antibioticoterapia prolongada está associada à morbidade elevada e mortalidade significante. Os autores apresentam o caso de um paciente adulto, diabético, com OEN e paralisia facial periférica bilateral que evoluiu com cura da infecção, porém sem melhora da paralisia.Necrotizing external otitis (NEO, known in the past as malignant external otitis, is a potencial letal infection which begins usually in the external ear canal and spreads to the base of the skull. It occurs mainly in diabetic elderly patients who despite prolonged antibioticotherapy is associated to high morbidity and significant mortality. The authors present a case of an adult diabetic patient who developed NOE associated with bilateral periferic facial palsy evoluting with cure of the infection but without facial improvement.

  13. Complicated necrotizing otitis externa.

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    Nawas, Mariam T; Daruwalla, Vistasp J; Spirer, David; Micco, Alan G; Nemeth, Alexander J

    2013-01-01

    Necrotizing (malignant) otitis externa (NOE) is a rare and invasive infection originating in the external acoustic meatus seen most commonly in diabetes and other immunocompromised states. After a protracted course, disease can smolder and extend into the mastoid, skull base, dural sinuses, and intracranially. We present a case of NOE complicated by mastoiditis, dural sinus thrombosis, and Bezold's abscess in an uncontrolled diabetic presenting with a prolonged course of facial nerve palsy. We stress the importance of maintaining a high index of clinical suspicion for NOE in diabetic patients and offering timely, aggressive treatment to mitigate its complications.

  14. Otitis media with effusion

    Science.gov (United States)

    OME; Secretory otitis media; Serous otitis media; Silent otitis media; Silent ear infection; Glue ear ... Kerschner JE, Preciado D. Otitis media. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: ...

  15. Otitis media: viruses, bacteria, biofilms and vaccines.

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    Massa, Helen M; Cripps, Allan W; Lehmann, Deborah

    2009-11-01

    Otitis media typically presents as either acute otitis media (AOM), with symptoms including fever, otalgia, otorrhoea or irritability and short duration; or as otitis media with effusion (OME), which is often asymptomatic and characterised by accumulation of fluid in the middle ear. Diagnostic certainty of otitis media is challenging, given the young age of patients and variability of symptoms. Otitis media predominantly occurs as coincident to viral upper respiratory tract infections and/or bacterial infections. Common viruses that cause upper respiratory tract infection are frequently associated with AOM and new-onset OME. These include respiratory syncytial virus, rhinovirus, adenovirus, parainfluenza and coronavirus. Predominant bacteria that cause otitis media are Streptococcus pneumoniae, Moraxella catarrhalis, and non-typeable Haemophilus influenzae. Antibiotic therapy does not significantly benefit most patients with AOM, but long-term prophylactic antibiotic therapy can reduce the risk of otitis media recurrence among children at high risk. In Australia, 84% of AOM is treated with antibiotic therapy, which contributes to development of antibiotic resistance. Vaccine development is a key future direction for reducing the world burden of otitis media, but requires polymicrobial formulation and ongoing monitoring and modification to ensure sustained reduction in disease burden.

  16. Malassezia pachydermatis e outros agentes infecciosos nas otites externas e dermatites em cães Malassezia pachydermatis and other infectious agents in external otitis and dermatitis in dogs

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    Márcia Nobre

    1998-09-01

    purpose of this work was to evaluate the prevalence of M. pachydermatis infection and other infectious agents in external otitis and dog dermatitis as well. We also examined 78 samples of dogs suffering from otitis, 36 samples of dogs having normal auditive tube and 24 having dermatitis. All samples were submitted to direct microscopic examination. They were cultured in blood agar, also in Sabouraud agar dextrose with cloranfenicol and cicloheximide. By direct examination showed that 50% of the samples on dogs with otitis and dermatitis 16.6% showed several cels resembling M. pachydermatis. However from healthy ear sample 83.3% did not present cells with this form. M. pachydermatis was isolated on 80.7% of otitis samples, on 25% of normal auditive tube samples and finally, 37.5% of dog dermatitis samples. It was isolated Staphylococcus intermedius, S. aureus, S. epidermidis, Pseudomonas aeruginosa, Proteus sp, Streptococcus sp and Otodectes cynotis from samples of animals with otitis. Cases of dermatites allowed also the isolation of Staphylococcus intermedius, S. aureus, S. epidermidis, Microsporum canis, M. gypseum, Trychophyton mentagophytes and Demodex canis. M. pachydermatis was the most prevalent agent in cases of external otitis and dermatitis, being an opportunistic agent, that cause otitis and dermatitis when thereis a change in the microenvironment

  17. Prospects for a vaccine against otitis media.

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    Cripps, Allan W; Otczyk, Diana C

    2006-08-01

    Otitis media is a major cause of morbidity in 80% of all children less than 3 years of age and often goes undiagnosed in the general population. There is evidence to suggest that the incidence of otitis media is increasing. The major cause of otitis media is infection of the middle ear with microbes from the nasopharynx. The anatomical orientation of the eustachian tube, in association with a number of risk factors, predisposes infants and young children to the infection. Bacteria are responsible for approximately 70% of cases of acute otitis media, with Streptococcus pneumoniae, nontypeable Haemophilus influenzae and Moraxella catarrhalis predominating as the causative agents. The respiratory viruses, respiratory syncytial virus, rhinovirus, parainfluenza and influenza, account for 30% of acute otitis media cases. Over the past decade, there has been a profound increase in the reported resistance to antibiotics, which, with increased disease burden, has focussed attention on vaccine development for otitis media. A polymicrobial formulation containing antigens from all major pathogens would have the greatest potential to deliver a sustained reduction in the disease burden globally. The disappointing outcomes for otitis media seen with the polysaccharide pneumococcal conjugate vaccine have raised major challenges for the vaccination strategy. Clearly, more knowledge is required concerning immune mechanisms in the middle ear, as well as vaccine formulations containing antigens that are more representative of the polymicrobial nature of the disease. Antigens that have been extensively tested in animal models are now available for testing in human subjects.

  18. Etiology of acute otitis media and serotype distribution of Streptococcus pneumoniae and Haemophilus influenzae in Chilean children <5 years of age

    Science.gov (United States)

    Rosenblut, Andres; Napolitano, Carla; Pereira, Angelica; Moreno, Camilo; Kolhe, Devayani; Lepetic, Alejandro; Ortega-Barria, Eduardo

    2017-01-01

    Abstract The impact of bacterial conjugate vaccines on acute otitis media (AOM) is affected by several factors including population characteristics, bacterial etiology and vaccine conjugation method, carrier, and coverage. This study estimated the baseline etiology, distribution, and antibiotic susceptibility of bacterial serotypes that causes AOM in children aged Streptococcus pneumoniae (41.7% [58/139]) and Haemophilus influenzae (40.3% [56/139]) were predominant among the cultures that showed bacterial growth (85% [139/164]). All Streptococcus pneumoniae positive episodes were serotyped, 19F (21%) and 14 (17%) were the predominant serotypes; all Haemophilus influenzae strains were nontypeable. Streptococcus pneumoniae were resistant to penicillin (5%) and erythromycin (33%); Haemophilus influenzae were resistant to ampicillin (14%) and cefuroxime and cefotaxime (2% each). AOM in Chilean children is predominantly caused by Streptococcus pneumoniae and nontypeable Haemophilus influenzae. Use of a broad spectrum vaccine against these pathogens might aid the reduction of AOM in Chile. PMID:28178138

  19. Etiology of acute otitis media and serotype distribution of Streptococcus pneumoniae and Haemophilus influenzae in Chilean children <5 years of age.

    Science.gov (United States)

    Rosenblut, Andres; Napolitano, Carla; Pereira, Angelica; Moreno, Camilo; Kolhe, Devayani; Lepetic, Alejandro; Ortega-Barria, Eduardo

    2017-02-01

    The impact of bacterial conjugate vaccines on acute otitis media (AOM) is affected by several factors including population characteristics, bacterial etiology and vaccine conjugation method, carrier, and coverage. This study estimated the baseline etiology, distribution, and antibiotic susceptibility of bacterial serotypes that causes AOM in children aged Haemophilus influenzae (40.3% [56/139]) were predominant among the cultures that showed bacterial growth (85% [139/164]). All Streptococcus pneumoniae positive episodes were serotyped, 19F (21%) and 14 (17%) were the predominant serotypes; all Haemophilus influenzae strains were nontypeable. Streptococcus pneumoniae were resistant to penicillin (5%) and erythromycin (33%); Haemophilus influenzae were resistant to ampicillin (14%) and cefuroxime and cefotaxime (2% each).AOM in Chilean children is predominantly caused by Streptococcus pneumoniae and nontypeable Haemophilus influenzae. Use of a broad spectrum vaccine against these pathogens might aid the reduction of AOM in Chile.

  20. Minimal biofilm eradication concentration of antimicrobial agents against nontypeable Haemophilus influenzae isolated from middle ear fluids of intractable acute otitis media.

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    Takei, Shin; Hotomi, Muneki; Yamanaka, Noboru

    2013-06-01

    Nontypeable Haemophilus influenzae (NTHi) makes the clinical course of acute otitis media (AOM) intractable by forming a biofilm that may hamper the clearance of the bacteria from middle ear cavity. In this study, we evaluated the minimum biofilm eradication concentration (MBEC) of antimicrobial agents against biofilm-forming NTHi strains. Twelve NTHi strains isolated from middle ear fluids of Japanese children with intractable AOM before antimicrobial treatment were evaluated for MBEC of fluoroquinolones in comparison with those of β-lactams and macrolides. AMPC and CDTR required much higher concentration, i.e., high MBECs, to suppress the biofilm formation of NTHi. In contrast, fluoroquinolones followed by macrolides showed lower MBECs. MBEC would be a good parameter to infer the efficacies of antimicrobials against NTHi in biofilm.

  1. Automated Diagnosis of Otitis Media: Vocabulary and Grammar

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    Kuruvilla, Anupama; Hoberman, Alejandro; Kovačević, Jelena

    2013-01-01

    We propose a novel automated algorithm for classifying diagnostic categories of otitis media: acute otitis media, otitis media with effusion, and no effusion. Acute otitis media represents a bacterial superinfection of the middle ear fluid, while otitis media with effusion represents a sterile effusion that tends to subside spontaneously. Diagnosing children with acute otitis media is difficult, often leading to overprescription of antibiotics as they are beneficial only for children with acute otitis media. This underscores the need for an accurate and automated diagnostic algorithm. To that end, we design a feature set understood by both otoscopists and engineers based on the actual visual cues used by otoscopists; we term this the otitis media vocabulary. We also design a process to combine the vocabulary terms based on the decision process used by otoscopists; we term this the otitis media grammar. The algorithm achieves 89.9% classification accuracy, outperforming both clinicians who did not receive special training and state-of-the-art classifiers. PMID:23997759

  2. Automated Diagnosis of Otitis Media: Vocabulary and Grammar

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    Anupama Kuruvilla

    2013-01-01

    Full Text Available We propose a novel automated algorithm for classifying diagnostic categories of otitis media: acute otitis media, otitis media with effusion, and no effusion. Acute otitis media represents a bacterial superinfection of the middle ear fluid, while otitis media with effusion represents a sterile effusion that tends to subside spontaneously. Diagnosing children with acute otitis media is difficult, often leading to overprescription of antibiotics as they are beneficial only for children with acute otitis media. This underscores the need for an accurate and automated diagnostic algorithm. To that end, we design a feature set understood by both otoscopists and engineers based on the actual visual cues used by otoscopists; we term this the otitis media vocabulary. We also design a process to combine the vocabulary terms based on the decision process used by otoscopists; we term this the otitis media grammar. The algorithm achieves 89.9% classification accuracy, outperforming both clinicians who did not receive special training and state-of-the-art classifiers.

  3. Emprego da vídeo-otoscopia no diagnóstico de otites externas de cães Video-otoscopy use in the diagnosis of external otitis in dogs

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    Cíntia Lúcia Maniscalco

    2009-11-01

    Full Text Available O objetivo deste trabalho foi estudar a utilização da vídeo-otoscopia como método diagnóstico para otites externas de cães. Para tanto, foram utilizados 20 cães adultos. O grupo A foi formado por 10 animais (cinco machos e cinco fêmeas provenientes do canil da Universidade Estadual Paulista, Campus de Jaboticabal, sem sinais clínicos aparentes de otite externa, e o grupo B foi formado por 10 animais (cinco machos e cinco fêmeas encaminhados pelo setor de Clínica Médica do Hospital Veterinário da faculdade de Ciências Agrárias e Veterinárias, Universidade Estadual Paulista, Campus de Jaboticabal, apresentando sinais clínicos de otite. Para realização dos exames, todos os animais foram submetidos ao mesmo protocolo anestésico (acepromazina na dose de 0,1mg kg-1 e tiletamina-zolazepan na dose de 10mg kg-1. Foram diagnosticadas três otites unilaterais e 13 bilaterais, e dentro dos achados estão secreção purulenta; epitélio ulcerado, hiperêmico ou hiperplásico; estenose do meato e alterações da membrana timpânica. A vídeo-otoscopia mostrou ser um método efetivo e um procedimento fundamental no auxílio diagnóstico e prognóstico das desordens auriculares.The objective of this study was the use of video-otoscopy as a method to diagnose external otitis in dogs. Hence 20 adult dogs were used. The group A was formed by 10 animals (5 males and 5 females with no apparent symptoms of the external otitis and the group B, formed by 10 animals (5 males and 5 females sent by the Medical Clinics section of the Veterinary Hospital at the Universidade Estadual Paulista - Câmpus Jaboticabal, with otitis symptoms. All the animals tested have undergone the same anesthesic protocol (acepromazine in a dosis of 0,1mg kg-1 and tiletamine-zolazepan in a dosis of 10mg kg-1. Three unilateral and 13 bi-lateral otitis were diagnosed and the findings include purulent secretion; ulcerated, hyperemic or hyperplasic epithelium; meathus stenosis

  4. Deletion of the complement C5a receptor alleviates the severity of acute pneumococcal otitis media following influenza A virus infection in mice.

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    Hua Hua Tong

    Full Text Available There is considerable evidence that influenza A virus (IAV promotes adherence, colonization, and superinfection by S. pneumoniae (Spn and contributes to the pathogenesis of otitis media (OM. The complement system is a critical innate immune defense against both pathogens. To assess the role of the complement system in the host defense and the pathogenesis of acute pneumococcal OM following IAV infection, we employed a well-established transtympanically-induced mouse model of acute pneumococcal OM. We found that antecedent IAV infection enhanced the severity of acute pneumococcal OM. Mice deficient in complement C1qa (C1qa-/- or factor B (Bf -/- exhibited delayed viral and bacterial clearance from the middle ear and developed significant mucosal damage in the eustachian tube and middle ear. This indicates that both the classical and alternative complement pathways are critical for the oto-immune defense against acute pneumococcal OM following influenza infection. We also found that Spn increased complement activation following IAV infection. This was characterized by sustained increased levels of anaphylatoxins C3a and C5a in serum and middle ear lavage samples. In contrast, mice deficient in the complement C5a receptor (C5aR demonstrated enhanced bacterial clearance and reduced severity of OM. Our data support the concept that C5a-C5aR interactions play a significant role in the pathogenesis of acute pneumococcal OM following IAV infection. It is possible that targeting the C5a-C5aR axis might prove useful in attenuating acute pneumococcal OM in patients with influenza infection.

  5. Clinical analysis of infant respiratory infection combined with acute otitis media%婴儿呼吸道感染并发急性中耳炎临床分析

    Institute of Scientific and Technical Information of China (English)

    贾西燕; 林秀珍; 刘彦民; 张慧娟

    2013-01-01

    Objective To analyze the related factors of infant respiratory infection combined with acute otitis media.Methods Five hundred and fifty-six cases of respiratory infection infants (including acute upper respiratory infection,bronchitis,pneumonia)admitted from March 2010 to March 2012 in Puyang maternal and child health-care hospital were randomly selected,they were divided into four time periods (0-3 month old,3-6 month old,6-9 month old,9-12 month old) according to the age,and divided into two time periods (less than three days,more than three days) according to the infection time,and then the situation of actue otitis media in infants was analyzed.Results Among the acute upper respiratory tract infection,acute bronchitis and pneumonia,the incidence of acute otitis media in infants had no significant difference (X2 =0.23,P =0.89).Actue otitis media incidence were negatively correlated with age (r =-0.99).With the infection time extension,the incidence of acute otitis media increased significantly(X2 =15.74,P < 0.01),the application of anti-infective drugs in infants with acute otitis media had significantly reduced (X2 =14.02,P < 0.01).Conclusions Respiratory infection combined with acute otitis media in infants is irrelevant to the site of infection,but it' s relevant to the age and infection time,application of anti-infective drugs can reduce the incidence of acute otitis media.%目的 分析婴儿呼吸道感染并发急性中耳炎的相关因素.方法 随机选取2010年3月至2012年3月濮阳市妇幼保健院收治的呼吸道感染(包括急性上呼吸道感染、急性支气管炎、肺炎)患儿556例,按患儿年龄将其分为4个时间段(0~3个月、3~6个月、6~9个月、9~12个月),按感染时间分为2个时间段(3d以内、3d以上),针对并发急性中耳炎情况进行分析.结果 在急性上呼吸道感染、急性支气管炎、肺炎患儿中,急性中耳炎发生率比较差异无统计学意义(X2=0.23,P=0.89);急

  6. Quantitative PCR of ear discharge from Indigenous Australian children with acute otitis media with perforation supports a role for Alloiococcus otitidis as a secondary pathogen

    Directory of Open Access Journals (Sweden)

    Marsh Robyn L

    2012-10-01

    Full Text Available Abstract Background Otitis media is endemic in remote Indigenous communities of Australia’s Northern Territory. Alloiococcus otitidis is an outer ear commensal and putative middle ear pathogen that has not previously been described in acute otitis media (AOM in this population. The aims of this study were to determine the presence, antibiotic susceptibility and bacterial load of A. otitidis in nasopharyngeal and ear discharge swabs collected from Indigenous Australian children with AOM with perforation. Methods Paired nasopharyngeal and ear discharge swabs from 27 children with AOM with perforation were tested by A. otitidis quantitative PCR (qPCR. Positive swabs were cultured for 21 days. Total and respiratory pathogen bacterial loads in A. otitidis-positive swabs were determined by qPCR. Results A. otitidis was detected by qPCR in 11 ear discharge swabs from 10 of 27 (37% children, but was not detected in paired nasopharyngeal swabs. A. otitidis was cultured from 5 of 11 qPCR-positive swabs from four children. All A. otitidis isolates had minimum inhibitory concentrations consistent with macrolide resistance. All A. otitidis qPCR-positive swabs were culture-positive for other bacteria. A. otitidis bacterial load ranged from 2.2 × 104-1.1 × 108 cells/swab (median 1.8 × 105 cells/swab. The relative abundance of A. otitidis ranged from 0.01% to 34% of the total bacterial load (median 0.7%. In 6 of 11 qPCR-positive swabs the A. otitidis relative abundance was A. otitidis bacterial load and relative abundance measures were comparable to that of Haemophilus influenzae. Conclusions A. otitidis can be a dominant species in the bacterial communities present in the ear discharge of Indigenous children with AOM with perforation. The absence of A. otitidis in nasopharyngeal swabs suggests the ear canal as the likely primary reservoir. The significance of A. otitidis at low relative abundance is unclear; however, at higher relative

  7. [Validation of the Otitis Media-6 Questionnaire for European Portuguese].

    Science.gov (United States)

    Lameiras, Ana Rita; Silva, Deodato; O'Neill, Assunção; Escada, Pedro

    2017-05-31

    Otitis media is one of the most prevalent childhood diseases. The impact of otitis media on quality of life of Portuguese children is unknown, because of the unavailability of a tool validated in European Portuguese to assess this consequence of otitis media. The Otitis Media-6 questionnaire (Otitis Media-6) is the most frequently used tool to assess health-related quality of life in children with otitis media. This study aims to create a version in the Portuguese language and culturally adapted to Portugal of the otitis media-6 questionnaire. The Otitis Media-6 questionnaire was translated and culturally adapted to the Portuguese language and population. Then, to assess the instrument psychometric properties, it was applied to a sample of Portuguese children with chronic otitis media with effusion or recurrent acute otitis media. The Portuguese version of Otitis Media-6 questionnaire demonstrated the following psychometric properties: construct validity for baseline (rs = 0.98) and change scores (rs = 0.97), internal consistency (α = 0.780), test-retest reliability (rs = 0.89) and responsiveness to clinical change (t(59) = 10.104). The simplicity and brevity of application of the instrument make it ideal for use in research and in clinical practice, enabling a more objective assessment of the extension of the otitis media impact in children quality of life and a more targeted therapeutic decision. The Portuguese version of the Otitis Media-6 questionnaire is a valid, reliable and sensitive instrument to evaluate the health-related quality of life in Portuguese children with otitis media.

  8. Otitis Media and Related Complications among Children with Autism Spectrum Disorders

    Science.gov (United States)

    Adams, Daniel J.; Susi, Apryl; Erdie-Lalena, Christine R.; Gorman, Gregory; Hisle-Gorman, Elizabeth; Rajnik, Michael; Elrod, Marilisa; Nylund, Cade M.

    2016-01-01

    Acute otitis media (AOM) symptoms can be masked by communication deficits, common to children with autism spectrum disorders (ASD). We sought to evaluate the association between ASD and otitis media. Using ICD-9-CM diagnostic codes, we performed a retrospective case-cohort study comparing AOM, and otitis-related diagnoses among children with and…

  9. A Modified Prophylactic Regimen for the Prevention of Otitis Externa in Saturation Divers

    Science.gov (United States)

    2013-10-01

    Prophylactic Regimen for the Prevention of Otitis Externa in Saturation Divers Authors: DISTRIBUTION STATEMENT A. Paul C. Algra, LT, MC...May 2012 – May 2013 4. TITLE AND SUBTITLE A Modified Prophylactic Regimen for the Prevention of Otitis Externa in Saturation Divers...SUPPLEMENTARY NOTES 14. ABSTRACT To prevent acute otitis externa (AOE) in the saturation setting and to decrease the side effects

  10. Otitis Media and Related Complications among Children with Autism Spectrum Disorders

    Science.gov (United States)

    Adams, Daniel J.; Susi, Apryl; Erdie-Lalena, Christine R.; Gorman, Gregory; Hisle-Gorman, Elizabeth; Rajnik, Michael; Elrod, Marilisa; Nylund, Cade M.

    2016-01-01

    Acute otitis media (AOM) symptoms can be masked by communication deficits, common to children with autism spectrum disorders (ASD). We sought to evaluate the association between ASD and otitis media. Using ICD-9-CM diagnostic codes, we performed a retrospective case-cohort study comparing AOM, and otitis-related diagnoses among children with and…

  11. Next-Generation Sequencing Combined with Specific PCR Assays To Determine the Bacterial 16S rRNA Gene Profiles of Middle Ear Fluid Collected from Children with Acute Otitis Media

    Science.gov (United States)

    Kramna, Lenka; Oikarinen, Sami; Sipilä, Markku; Rautiainen, Markus; Aittoniemi, Janne; Laranne, Jussi; Hyöty, Heikki; Cinek, Ondrej

    2017-01-01

    ABSTRACT The aim of the study was to analyze the bacteriome of acute otitis media with a novel modification of next-generation sequencing techniques. Outpatient children with acute otitis media were enrolled in the study, and middle ear fluids were collected during 90 episodes from 79 subjects aged 5 to 42 months (median age, 19 months). The bacteriome profiles of middle ear fluid samples were determined by a nested-PCR amplification of the 16S rRNA gene (V4 region), followed by mass sequencing. The profiling results were compared to the results of specific PCR assays targeting selected prevalent pathogens. Bacteriome profiling using nested amplification of low-volume samples was aided by a bioinformatic subtraction of signal contaminants from the recombinant polymerase, achieving a sensitivity slightly lower than that of specific PCR detection. Streptococcus pneumoniae was detected in 28 (31%) samples, Haemophilus influenzae in 24 (27%), Moraxella catarrhalis in 18 (20%), Staphylococcus spp. in 21 (23%), Turicella otitidis in 5 (5.6%), Alloiococcus otitidis in 3 (3.3%), and other bacteria in 14 (16%) using bacteriome profiling. S. pneumoniae was the dominant pathogen in 14 (16%) samples, H. influenzae in 15 (17%), M. catarrhalis in 5 (5.6%), T. otitidis in 2, and Staphylococcus auricularis in 2. Weaker signals of Prevotella melaninogenica, Veillonella dispar, and Veillonella montpellierensis were noted in several samples. Fourteen samples (16%) were not explainable by bacterial pathogens; novel causative agents were not detected. In conclusion, unbiased bacteriome profiling helped in depicting the true mutual quantitative ratios of ear bacteria, but at present, its complicated protocol impedes its routine clinical use. IMPORTANCE Although S. pneumoniae, H. influenzae, and M. catarrhalis have been long established as the most important pathogens in acute otitis media using culture and specific PCR assays, the knowledge of their mutual quantitative relations

  12. Next-Generation Sequencing Combined with Specific PCR Assays To Determine the Bacterial 16S rRNA Gene Profiles of Middle Ear Fluid Collected from Children with Acute Otitis Media.

    Science.gov (United States)

    Sillanpää, Saara; Kramna, Lenka; Oikarinen, Sami; Sipilä, Markku; Rautiainen, Markus; Aittoniemi, Janne; Laranne, Jussi; Hyöty, Heikki; Cinek, Ondrej

    2017-01-01

    The aim of the study was to analyze the bacteriome of acute otitis media with a novel modification of next-generation sequencing techniques. Outpatient children with acute otitis media were enrolled in the study, and middle ear fluids were collected during 90 episodes from 79 subjects aged 5 to 42 months (median age, 19 months). The bacteriome profiles of middle ear fluid samples were determined by a nested-PCR amplification of the 16S rRNA gene (V4 region), followed by mass sequencing. The profiling results were compared to the results of specific PCR assays targeting selected prevalent pathogens. Bacteriome profiling using nested amplification of low-volume samples was aided by a bioinformatic subtraction of signal contaminants from the recombinant polymerase, achieving a sensitivity slightly lower than that of specific PCR detection. Streptococcus pneumoniae was detected in 28 (31%) samples, Haemophilus influenzae in 24 (27%), Moraxella catarrhalis in 18 (20%), Staphylococcus spp. in 21 (23%), Turicella otitidis in 5 (5.6%), Alloiococcus otitidis in 3 (3.3%), and other bacteria in 14 (16%) using bacteriome profiling. S. pneumoniae was the dominant pathogen in 14 (16%) samples, H. influenzae in 15 (17%), M. catarrhalis in 5 (5.6%), T. otitidis in 2, and Staphylococcus auricularis in 2. Weaker signals of Prevotella melaninogenica, Veillonella dispar, and Veillonella montpellierensis were noted in several samples. Fourteen samples (16%) were not explainable by bacterial pathogens; novel causative agents were not detected. In conclusion, unbiased bacteriome profiling helped in depicting the true mutual quantitative ratios of ear bacteria, but at present, its complicated protocol impedes its routine clinical use. IMPORTANCE Although S. pneumoniae, H. influenzae, and M. catarrhalis have been long established as the most important pathogens in acute otitis media using culture and specific PCR assays, the knowledge of their mutual quantitative relations and

  13. Preliminary pediatric clinical evaluation of the oral probiotic Streptococcus salivarius K12 in preventing recurrent pharyngitis and/or tonsillitis caused by Streptococcus pyogenes and recurrent acute otitis media

    Science.gov (United States)

    Di Pierro, Francesco; Donato, Guido; Fomia, Federico; Adami, Teresa; Careddu, Domenico; Cassandro, Claudia; Albera, Roberto

    2012-01-01

    Background The oral probiotic Streptococcus salivarius K12 has been shown clearly to antagonize the growth of Streptococcus pyogenes, the most important bacterial cause of pharyngeal infections in humans, by releasing two bacteriocins named salivaricin A2 and salivaricin B. Unpublished observations indicate that it can also antagonize the growth of other bacteria involved in acute otitis media. Because of its ability to colonize the oral cavity and its safety profile, we have tested its efficacy in reducing the incidence of streptococcal pharyngitis and/or tonsillitis and episodes of acute otitis media. Methods We enrolled 82 children, including 65 with and 17 without a recent diagnosis of recurrent oral streptococcal pathology. Of those with recurrent pathology, 45 were treated daily for 90 days with an oral slow-release tablet containing five billion colony-forming units of S. salivarius K12 (Bactoblis®), and the remaining 20 served as an untreated control group. The 17 children without a recent diagnosis of recurrent oral pathology were used as an additional control group. After 90 days of treatment, a 6-month follow-up period without treatment was included to evaluate a possible persistent protective role for the previously administered product. Results The 41 children who completed the 90-day course of Bactoblis showed a reduction in their episodes of streptococcal pharyngeal infection (about 90%) and/or acute otitis media (about 40%), calculated by comparing infection rates in the previous year. The 90-day treatment also reduced the reported incidence of pharyngeal and ear infections by about 65% in the 6-month follow-up period during which the product was not administered. Subjects tolerated the product well, with no side effects or dropouts reported. Conclusion Prophylactic administration of S. salivarius K12 to children with a history of recurrent oral streptococcal pathology reduced episodes of streptococcal pharyngeal infections and/or tonsillitis as

  14. Preliminary pediatric clinical evaluation of the oral probiotic Streptococcus salivarius K12 in preventing recurrent pharyngitis and/or tonsillitis caused by Streptococcus pyogenes and recurrent acute otitis media.

    Science.gov (United States)

    Di Pierro, Francesco; Donato, Guido; Fomia, Federico; Adami, Teresa; Careddu, Domenico; Cassandro, Claudia; Albera, Roberto

    2012-01-01

    The oral probiotic Streptococcus salivarius K12 has been shown clearly to antagonize the growth of Streptococcus pyogenes, the most important bacterial cause of pharyngeal infections in humans, by releasing two bacteriocins named salivaricin A2 and salivaricin B. Unpublished observations indicate that it can also antagonize the growth of other bacteria involved in acute otitis media. Because of its ability to colonize the oral cavity and its safety profile, we have tested its efficacy in reducing the incidence of streptococcal pharyngitis and/or tonsillitis and episodes of acute otitis media. We enrolled 82 children, including 65 with and 17 without a recent diagnosis of recurrent oral streptococcal pathology. Of those with recurrent pathology, 45 were treated daily for 90 days with an oral slow-release tablet containing five billion colony-forming units of S. salivarius K12 (Bactoblis(®)), and the remaining 20 served as an untreated control group. The 17 children without a recent diagnosis of recurrent oral pathology were used as an additional control group. After 90 days of treatment, a 6-month follow-up period without treatment was included to evaluate a possible persistent protective role for the previously administered product. The 41 children who completed the 90-day course of Bactoblis showed a reduction in their episodes of streptococcal pharyngeal infection (about 90%) and/or acute otitis media (about 40%), calculated by comparing infection rates in the previous year. The 90-day treatment also reduced the reported incidence of pharyngeal and ear infections by about 65% in the 6-month follow-up period during which the product was not administered. Subjects tolerated the product well, with no side effects or dropouts reported. Prophylactic administration of S. salivarius K12 to children with a history of recurrent oral streptococcal pathology reduced episodes of streptococcal pharyngeal infections and/or tonsillitis as well as episodes of acute otitis media.

  15. Role of a proprietary propolis-based product on the wait-and-see approach in acute otitis media and in preventing evolution to tracheitis, bronchitis, or rhinosinusitis from nonstreptococcal pharyngitis

    OpenAIRE

    Di Pierro F.; Zanvit A; Colombo M

    2016-01-01

    Francesco Di Pierro,1 Alberto Zanvit,2 Maria Colombo3 1Scientific Department, Velleja Research, 2Biological Dentistry Department, Italian Stomatology Institute, 3ATS, District 5, Milan, Italy Abstract: Antipyretics and/or anti-inflammatory drugs along with a wait-and-see approach are the only treatments recommended in early acute otitis media (AOM) or viral pharyngitis. Propolis has been widely investigated for its antibacterial, antiviral, and anti-inflammatory properties and could perhaps b...

  16. Otalgia and eschar in the external auditory canal in scrub typhus complicated by acute respiratory distress syndrome and multiple organ failure

    Directory of Open Access Journals (Sweden)

    Hu Sung-Yuan

    2011-03-01

    Full Text Available Abstract Background Scrub typhus, a mite-transmitted zoonosis caused by Orientia tsutsugamushi, is an endemic disease in Taiwan and may be potentially fatal if diagnosis is delayed. Case presentations We encountered a 23-year-old previously healthy Taiwanese male soldier presenting with the right ear pain after training in the jungle and an eleven-day history of intermittent high fever up to 39°C. Amoxicillin/clavulanate was prescribed for otitis media at a local clinic. Skin rash over whole body and abdominal cramping pain with watery diarrhea appeared on the sixth day of fever. He was referred due to progressive dyspnea and cough for 4 days prior to admission in our institution. On physical examination, there were cardiopulmonary distress, icteric sclera, an eschar in the right external auditory canal and bilateral basal rales. Laboratory evaluation revealed thrombocytopenia, elevation of liver function and acute renal failure. Chest x-ray revealed bilateral diffuse infiltration. Doxycycline was prescribed for scrub typhus with acute respiratory distress syndrome and multiple organ failure. Fever subsided dramatically the next day and he was discharged on day 7 with oral tetracycline for 7 days. Conclusion Scrub typhus should be considered in acutely febrile patients with multiple organ involvement, particularly if there is an eschar or a history of environmental exposure in endemic areas. Rapid and accurate diagnosis, timely administration of antibiotics and intensive supportive care are necessary to decrease mortality of serious complications of scrub typhus.

  17. Analysis of the clinical treatment of acute otitis media with acute otitis media in Tangshan City%唐山市急性上呼吸道感染继发急性中耳炎患儿临床治疗分析

    Institute of Scientific and Technical Information of China (English)

    徐淑芳; 张全福; 刘俊英; 高晓宇; 李玲玲

    2016-01-01

    Objective: To investigate the clinical treatment of acute otitis media with acute otitis media in Tangshan City. Methods: 118 cases of acute upper respiratory tract infection secondary to acute otitis media were divided into two groups. All patients were given ceftriaxone treatment. The control group using chloramphenicol treatment. The observation group with budesonide inhalation on. The efficacy and clinical symptoms of the two groups were compared. Results: the total effective rate in the observation group was significantly higher than that in the control group (93.22% vs 77.97%). The difference was statisti-cally significant; observation group of pathogenic bacteria negative rate (89.43%), effectively reduce the rate of tympanic pres-sure (94.92%) was significantly higher than the control group (65.71% and 81.36%). The difference was statistically significant. The hearing improvement, the onset time and the length of hospital stay in the observation group were significantly better than those in the control group. Difference was statistically significant. The incidence of adverse reactions in observation group was compared with that of control group (6.78% vs 16.95%). There was no statistically significant difference.Conclusion: the cura-tive effect of budesonide inhalation of secondary acute otitis media combined with ceftriaxone in the treatment of children with acute upper respiratory tract infection significantly, can significantly improve the clinical symptoms, improve the hearing level, promote the recovery of eustachian tube function.%目的:探讨唐山市急性上呼吸道感染继发急性中耳炎患儿临床治疗分析。方法:将118例急性上呼吸道感染继发急性中耳炎患儿分为两组,全部患者给予头孢曲松钠治疗,对照组采用氯霉素滴耳液治疗,观察组采用布地奈德混悬液雾化吸入治疗,对比两组疗效及临床症状改善情况。结果:观察组总有效率显著高于对照组(93

  18. Heterotopic ossification in chronic fibrosing otitis externa

    Science.gov (United States)

    Maughan, Elizabeth F.; Bhutta, Mahmood F.; Lavy, Jeremy

    2015-01-01

    Acquired external auditory canal atresia is a rare complication of chronic inflammatory otitis, and is generally fibrous or soft tissue in nature. Here, we present the first reported case of heterotopic ossification within chronic fibrosing otitis externa in a 25-year-old male patient with a childhood history of granular myringitis and failed tympanoplasty. A calcified mass was demonstrated adjacent to the tympanic membrane on CT imaging, and surgical exploration revealed a cohesive bar of bone traversing the medial external auditory canal. Drill canaloplasty and split-thickness skin graft coverage of the lateral tympanic membrane resulted in an improvement in the pure tone average from 79 to 55 dB. As the treatment for chronic fibrosing otitis externa involves the surgical widening of the external auditory canal, we alert surgeons to the possibility of cohesive bone formation as a potential cause of navigational confusion and inadvertent over- or under-drilling of the canal stenosis. PMID:26429555

  19. Detection of respiratory pathogens in pediatric acute otitis media by PCR and comparison of findings in the middle ear and nasopharynx.

    Science.gov (United States)

    Yatsyshina, Svetlana; Mayanskiy, Nikolay; Shipulina, Olga; Kulichenko, Tatiana; Alyabieva, Natalia; Katosova, Lyubovj; Lazareva, Anna; Skachkova, Tatyana; Elkina, Maria; Matosova, Svetlana; Shipulin, German

    2016-05-01

    We conducted a series of polymerase chain reactions (PCRs) in order to detect bacteria (7 species) and viruses (17 species) in middle ear fluid (MEF) and nasopharynx (Nph) of children with acute otitis media (AOM; n=179). Bacterial and viral nucleic acids were detected in MEF of 78.8% and 14.5% patients, respectively. The prevalence was as follows: Streptococcus pneumoniae, 70.4%; Haemophilus influenzae, 17.9%; Staphylococcus aureus, 16.8%; Streptococcus pyogenes, 12.3%; Moraxella catarrhalis, 9.5%; rhinovirus, 9.5%; and adenovirus, 3.4%. The overall rate of PCR-positive specimens for bacterial pathogens was 2.6 times higher, compared to culture results. The rate of PCR-positive results and the distribution of pathogens in the Nph were similar to those in the MEF. Nph PCR results had variable positive predictive values and high negative predictive values in predicting MEF findings. Our results indicate that Nph PCR could be a practical tool for examining respiratory pathogens in children with acute infections.

  20. External validation of two tools for the clinical diagnosis of acute diverticulitis without imaging

    NARCIS (Netherlands)

    Kiewiet, J.J.S.; Andeweg, C.S.; Laurell, H.; Daniels, L.; Laméris, W.; Reitsma, J.B.; Hendriks, J.C.; Bleichrodt, R.; van Goor, H.; Boermeester, M.A.

    2014-01-01

    Aim External validation and comparison of the diagnostic accuracy of two predictive tools, the emergency department triad and the clinical scoring tool in diagnosing acute diverticulitis. Methods Two derivation datasets were used crosswise for external validation. In addition, both tools were valida

  1. Effect of Binghuang ear drop treatment on otitis externa in guinea pigs.

    Science.gov (United States)

    Zhai, Suo-qiang; Yu, Ning; Guo, Wei-Wei; Zhang, Yue

    2014-12-01

    To investigate the pharmacodynamic effects of Binghuang ear drop on acute suppurative otitis externa in guinea pig model. Thirty guinea pigs were randomly divided into three groups, with ten animals in each group. Group A animals had normal ear canal and Binghuang ear drops (two drops, B.I.D) were applied in both ears for 7 days; Group B animals had induced otitis externa and received identical prescription as group A; Group C had normal ear canal and were treated with normal saline (two drops, B.I.D) for 7 days. After the treatments, the external morphology of ear canals was observed and the paraffin sections of external auditory canal were prepared and examined under the microscope. The inflammatory manifestation and cell infiltration into the skin of group B was significantly attenuated after the Binghuang ear drops treatment. In contrast, no allergy or side effects were produced by Binghuang ear drops application in the animals with normal ear canals. Binghuang ear drops could be used to treat acute otitis externa by eliciting anti-bacterial effects.

  2. Preliminary pediatric clinical evaluation of the oral probiotic Streptococcus salivarius K12 in preventing recurrent pharyngitis and/or tonsillitis caused by Streptococcus pyogenes and recurrent acute otitis media

    Directory of Open Access Journals (Sweden)

    Di Pierro F

    2012-11-01

    Full Text Available Francesco Di Pierro,1 Guido Donato,2 Federico Fomia,3 Teresa Adami,4 Domenico Careddu,5 Claudia Cassandro,6 Roberto Albera61Scientific Department, Velleja Research, Milano, 2ASL 1, Cuneo, 3ASL 3, Brescia, 4Infective Diseases, Verona, 5ASL 13, Novara, 6Surgical Science Department, Università degli Studi, Torino, ItalyBackground: The oral probiotic Streptococcus salivarius K12 has been shown clearly to antagonize the growth of Streptococcus pyogenes, the most important bacterial cause of pharyngeal infections in humans, by releasing two bacteriocins named salivaricin A2 and salivaricin B. Unpublished observations indicate that it can also antagonize the growth of other bacteria involved in acute otitis media. Because of its ability to colonize the oral cavity and its safety profile, we have tested its efficacy in reducing the incidence of streptococcal pharyngitis and/or tonsillitis and episodes of acute otitis media.Methods: We enrolled 82 children, including 65 with and 17 without a recent diagnosis of recurrent oral streptococcal pathology. Of those with recurrent pathology, 45 were treated daily for 90 days with an oral slow-release tablet containing five billion colony-forming units of S. salivarius K12 (Bactoblis®, and the remaining 20 served as an untreated control group. The 17 children without a recent diagnosis of recurrent oral pathology were used as an additional control group. After 90 days of treatment, a 6-month follow-up period without treatment was included to evaluate a possible persistent protective role for the previously administered product.Results: The 41 children who completed the 90-day course of Bactoblis showed a reduction in their episodes of streptococcal pharyngeal infection (about 90% and/or acute otitis media (about 40%, calculated by comparing infection rates in the previous year. The 90-day treatment also reduced the reported incidence of pharyngeal and ear infections by about 65% in the 6-month follow-up period

  3. Identification and characterization of the bacterial etiology of clinically problematic acute otitis media after tympanocentesis or spontaneous otorrhea in German children

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    Grevers Gerhard

    2012-11-01

    Full Text Available Abstract Background Acute Otitis Media (AOM is an important and common disease of childhood. Bacteria isolated from cases of clinically problematic AOM in German children were identified and characterized. Methods In a prospective non-interventional study in German children between 3 months and less than 60 months of age with Ear, Nose and Throat Specialist –confirmed AOM, middle ear fluid was obtained by tympanocentesis (when clinically indicated or by careful sampling of otorrhea through/at an existing perforation. Results In 100 children with severe AOM, Haemophilus influenzae was identified in 21% (18/21, 85.7% were non-typeable [NTHi], Streptococcus pneumoniae in 10%, S. pyogenes in 13% and Moraxella catarrhalis in 1%. H. influenzae was the most frequently identified pathogen in children from 12 months of age. H. influenzae and S. pneumoniae were equally prevalent in children aged 3–11 months, but S. pyogenes was most frequently isolated in this age group. NTHi AOM disease appeared prevalent in all ages. Conclusions NTHi, S. pneumoniae and S. pyogenes are implicated as important causes of complicated AOM in children in Germany. NTHi disease appears prevalent in all ages. The impact of vaccination to prevent NTHi and S. pneumoniae AOM may be substantial in this population and is worth investigating.

  4. Non-typeable Haemophilus influenzae and Streptococcus pneumoniae as primary causes of acute otitis media in colombian children: a prospective study

    Directory of Open Access Journals (Sweden)

    Castrejon Maria M

    2011-01-01

    Full Text Available Abstract Background Acute otitis media (AOM is one of the most frequently encountered bacterial infections in children aged Streptococcus pneumoniae (S. pneumoniae and non-typeable Haemophilus influenzae (NTHi are historically identified as primary AOM causes. Nevertheless, recent data on bacterial pathogens causing AOM in Latin America are limited. This prospective study aimed to identify and characterize bacterial etiology and serotypes of AOM cases including antimicrobial susceptibility in Methods From February 2008 to January 2009, children ≥3 months and Results Of the 106 enrolled children, 99 were included in the analysis. Bacteria were cultured from 62/99 (63% of samples with S. pneumoniae, H. influenzae, or S. pyogenes. The most commonly isolated bacteria were H. influenzae in 31/99 (31% and S. pneumoniae in 30/99 (30% of samples. The majority of H. influenzae episodes were NTHi (27/31; 87%. 19F was the most frequently isolated pneumococcal serotype (10/30; 33%. Of the 30 S. pneumoniae positive samples, 8/30 (27% were resistant to tetracycline, 5/30 (17% to erythromycin and 8/30 (27% had intermediate resistance to penicillin. All H. influenzae isolates tested were negative to beta-lactamase. Conclusions NTHi and S. pneumoniae are the leading causes of AOM in Colombian children. A pneumococcal conjugate vaccine that prevents both pathogens could be useful in maximizing protection against AOM.

  5. Improved tympanic thermometer based on a fiber optic infrared radiometer and an otoscope and its use as a new diagnostic tool for acute otitis media

    Science.gov (United States)

    Fishman, Gadi; DeRowe, Ari; Ophir, Eyal; Scharf, Vered; Shabtai, Abraham; Ophir, Dov; Katzir, Abraham

    1999-06-01

    Clinical diagnosis of acute otitis media (AOM) in children is not easy. It was assumed that there is a difference ΔT between the Tympanic Membrane (TM) temperatures in the two ears in unilateral AOM and that an accurate measurement of ΔT may improve the diagnosis accuracy. An IR transmitting fiber, made of AgClBr, was coupled into a hand held otoscope and was used for the non-contact (radiometric) measurements of TT, the TM temperature. Experiments were carried out, first, on a laboratory model that simulated the human ear, including an artificial tympanic membrane and an artificial ear canal. Measurements carried out using commercially available tympanic thermometers shown that the temperature Tc of the ear canal affected the results. Tc did not affect the fiberoptic radiometer, and this device accurately measured the true temperature, TT of the tympanic membrane. A prospective blinded sampling of the TM temperature was then performed on 48 children with suspected AOM. The mean temperature difference between the ears, for children with unilateral AOM was ΔT = (0.68 +/- 0.27)°C. For children with bilateral AOM it was ΔT = (0.14+/-0.10)°C (p<0.001). It was demonstrated that afor unilateral AOM the difference ΔT was proportional to the systemic temperature. In conclusion, the fiberoptic interferometric measurements of the TM can be a useful non-invasive diagnostic tool for AOM, when combined with other data.

  6. Comparison of the effectiveness and safety of cefpodoxime and ciprofloxacin in acute exacerbation of chronic suppurative otitis media: A randomized, open-labeled, phase IV clinical trial

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    Arijit Ghosh

    2012-01-01

    Full Text Available Objective : To compare the effectiveness and safety of cefpodoxime and ciprofloxacin for the treatment of mild to moderate cases of acute exacerbation of chronic suppurative otitis media (AECSOM. Materials and Methods : Adult patients diagnosed with AECSOM were screened and patients fulfilling the inclusion criteria were randomized to receive either cefpodoxime 200 mg twice daily or ciprofloxacin 500 mg twice daily orally for 7 days. The primary outcome of this randomized, open-labeled, phase IV clinical trial (Registration Number - CTRI/2011/10/002079 was clinical success rate at day 14 visit and the secondary outcome was incidence of adverse events (AEs. Forty-six patients were enrolled: 23 in the cefpodoxime group and 23 in the ciprofloxacin group. Results : The clinical success rates were 95.6% in the cefpodoxime group versus 90.9% in the ciprofloxacin group. These rates are comparable, but no statistically significant difference was observed between the groups. Few mild and self-limiting AEs were observed and the tolerability of both the drugs was also good. Conclusion : The results of this randomized, open-labeled phase IV clinical trial showed that a 7-day course of cefpodoxime is therapeutically comparable to ciprofloxacin in terms of both clinical effectiveness and safety for the treatment of patients with AECSOM.

  7. Higher levels of mucosal antibody to pneumococcal vaccine candidate proteins are associated with reduced acute otitis media caused by Streptococcus pneumoniae in young children.

    Science.gov (United States)

    Xu, Q; Casey, J R; Pichichero, M E

    2015-09-01

    Mucosal immunity has a crucial role in controlling human respiratory tract infections. This study characterizes the naturally acquired mucosal antibody levels to three Streptococcus pneumoniae (Spn) protein antigens, pneumococcal histidine triad protein D (PhtD), pneumococcal choline binding protein A (PcpA), and pneumolysin (Ply), and assesses the association of the mucosal antibody levels with occurrence of acute otitis media (AOM) caused by Spn. Both nasopharyngeal (NP) immunoglobulin G (IgG) and IgA levels to all three proteins slightly decreased in children from 6 to 9 months of age and then gradually increased through 24 months of age. Spn NP colonization was associated with higher mucosal antibody levels to all three proteins. However, children with Spn AOM had 5-8-fold lower IgG and 3-6-fold lower IgA levels to the three proteins than children without AOM but asymptomatically colonized with Spn. Antigen-specific antibody levels in the middle ear fluid (MEF) were correlated with antibody levels in the NP. Children with AOM caused by Spn had lower antibody levels in both the MEF and NP than children with AOM caused by other pathogens. These results indicate that higher naturally acquired mucosal antibody levels to PhtD, PcpA and Ply are associated with reduced AOM caused by Spn.

  8. Pili play an important role in enhancing the bacterial clearance from the middle ear in a mouse model of acute otitis media with Moraxella catarrhalis.

    Science.gov (United States)

    Kawano, Toshiaki; Hirano, Takashi; Kodama, Satoru; Mitsui, Marcelo Takahiro; Ahmed, Kamruddin; Nishizono, Akira; Suzuki, Masashi

    2013-03-01

    Moraxella catarrhalis is a Gram-negative aerobic diplococcus that is currently the third most frequent cause of bacterial acute otitis media (AOM) in children. In this study, we developed an experimental murine AOM model by inoculating M. catarrhalis in the middle ear bulla and studied the local response to this inoculation, and modulation of its course by the pili of M. catarrhalis. The pili-positive and pili-negative M. catarrhalis showed differences in bacterial clearance and infiltration of inflammatory cells in the middle ear. Pili-negative M. catarrhalis induced a more delayed and prolonged immune response in the middle ear than that of pili-positive M. catarrhalis. TLR2, -4, -5 and -9 mRNA expression was upregulated in neutrophils that infiltrated the middle ear cavity during AOM caused by both pili-positive and pili-negative bacteria. TLR5 mRNA expression and TLR5 protein in the neutrophils were induced more robustly by pili-positive M. catarrhalis. This immune response is likely to be related to neutrophil function such as toll-like 5-dependent phagocytosis. Our results show that mice may provide a useful AOM model for studying the role of M. catarrhalis. Furthermore, we show that pili play an important role in enhancing M. catarrhalis clearance from the middle ear that is probably mediated through neutrophil-dependent TLR5 signaling.

  9. Clinical practice guidelines for the diagnosis and management of acute otitis media (AOM) in children in Japan - 2013 update.

    Science.gov (United States)

    Kitamura, Ken; Iino, Yukiko; Kamide, Yosuke; Kudo, Fumiyo; Nakayama, Takeo; Suzuki, Kenji; Taiji, Hidenobu; Takahashi, Haruo; Yamanaka, Noboru; Uno, Yoshifumi

    2015-04-01

    To (1) indicate methods of diagnosis and testing for childhood (otitis media (AOM) and (2) recommend methods of treatment in accordance with the evidence-based consensus reached by the Subcommittee of Clinical Practice Guideline for Diagnosis and Management of AOM in Children (Subcommittee of Clinical Practice Guideline), in light of the causative bacteria and their drug sensitivity of AOM in Japan. We investigated the most recently detected bacteria causing childhood AOM in Japan as well as antibacterial sensitivity and the worldwide distinct progress of vaccination, produced Clinical Questions concerning the diagnosis, testing methods, and treatment of AOM, searched literature published during 2000-2004, and issued the 2006 Guidelines. In the 2009 and 2013 Guidelines, we performed the same investigation with the addition of literature, which were not included in the 2006 Guidelines and published during 2005-2008 and during 2009-2012, respectively. We categorized AOM as mild, moderate, or severe on the basis of tympanic membrane findings and clinical symptoms, and presented recommended treatment for each degree of severity. Accurate assessment of tympanic membrane findings is important for judging the degree of severity and selecting a method of treatment. Some of new antimicrobial agents and pneumococcal vaccination are recommended as new treatment options. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. Bacterial otitis media: current vaccine development strategies.

    Science.gov (United States)

    Cripps, Allan W; Kyd, Jennelle

    2003-02-01

    Otitis media is the most common reason for children less than 5 years of age to visit a medical practitioner. Whilst the disease rarely results in death, there is significant associated morbidity. The most common complication is loss of hearing at a critical stage of the development of speech, language and cognitive abilities in children. The cause and pathogenesis of otitis media is multifactorial. Among the contributing factors, the single most important are viral and bacterial infections. Infection with respiratory syncytial virus, influenza viruses, para-influenza viruses, enteroviruses and adenovirus are most commonly associated with acute and chronic otitis media. Streptococcus pneumoniae, non-typeable Haemophilus influenzae and Moraxella catarrhalis are the most commonly isolated bacteria from the middle ears of children with otitis media. Treatment of otitis media has largely relied on the administration of antimicrobials and surgical intervention. However, attention has recently focused on the development of a vaccine. For a vaccine to be effective against bacterial otitis media, it must, at the very least, contain antigens that induce a protective immune response in the middle ear against the three most common infecting bacteria. Whilst over the past decade there has been significant progress in the development of vaccines against invasive S. pneumoniae disease, these vaccines are less efficacious for otitis media. The search for candidate vaccine antigens for non-typeable H. influenzae are well advanced whilst less progress has been made for M. catarrhalis. No human studies have been conducted for non-typeable H. influenzae or M. catarrhalis and the concept of a tribacterial vaccine remains to be tested in animal models. Only when vaccine antigens are determined and an understanding of the immune responses induced in the middle ear by infection and immunization is gained will the formulation of a tribacterial vaccine against otitis media be possible.

  11. Epidemiology of Intratemporal Complications of Otitis Media

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    Maranhão, André

    2014-01-01

    Full Text Available Introduction Despite the advent of antibiotics and immunizations in the last century, complications of otitis media remain quite frequent, have high morbidity and mortality rates, and pose a challenge to the otorhinolaryngologist. Objective To establish the annual incidence of intratemporal complications of otitis media and prospectively evaluate patients via an analysis of epidemiologic and clinical aspects. Methods Prospective, observational study. Between February 2010 and January 2011, patients admitted to a tertiary care, university-based otology practice with diagnosis of otitis media and an associated intratemporal complication (ITC were included in the study. The following data were evaluated: age, sex, type of ITC, treatment, imaging tests findings, type and degree of hearing loss, and clinical outcome. The overall incidence of all complications and of each complication individually was determined. Results A total of 1,816 patients were diagnosed with otitis media. For 592 (33% individuals, the diagnosis was chronic otitis media; for 1,224 (67%, the diagnosis was acute otitis media. ITCs of otitis media were diagnosed in 15 patients; thus, the annual incidence of intratemporal complications was 0.8%. We identified 19 ITC diagnoses in 15 patients (3 patients had more than one diagnosis. Labyrinthine fistulae were diagnosed in 7 (36.8% individuals, mastoiditis in 5 (26.3%, facial palsy in 4 (21.1%, and labyrinthitis in 3 (15.8%. Conclusion The incidence of intratemporal complications in Brazil remains significant when compared with developed countries. Chronic otitis media with cholesteatoma is the most frequent etiology of intratemporal complications. Labyrinthine fistula is the most common intratemporal complication.

  12. Atividade antimicrobiana in vitro de produtos vegetais em otite externa aguda In vitro antimicrobial activity of plants in Acute Otitis Externa

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    Janaina Cândida Rodrigues Nogueira

    2008-02-01

    Full Text Available Otite externa aguda é a inflamação do conduto auditivo externo, e plantas medicinais podem ser utilizadas, na cultura popular, para seu tratamento. OBJETIVO: Avaliar atividade antimicrobiana in vitro de Aleolanthus suaveolens, Caryophyllus aromaticus, Cymbopogon citratus, Matricaria chamomila, Pithecellobium avaremotemo, Plectranthus amboinicus e Ruta graveolens sobre agentes etiológicos de otite externa. CASUÍSTICA E MÉTODOS: A concentração inibitória mínima de extratos e óleos destas plantas foi obtida em amostras de otite externa. RESULTADOS: Staphylococcus aureus em 10 culturas, Pseudomonas aeruginosa em 8, Pseudomonas aeruginosa e Staphylococcus aureus, em associação, em 5 culturas e Candida albicans e Candida krusei em 4 culturas. P. aeruginosa foi resistente a todos os extratos e óleos essenciais testados; os extratos de A. suaveolens, P. avaremotemo e de R. graveolens foram inativos, o óleo essencial de C. aromaticus e M. chamomila foram ativos contra 3 cepas de S. aureus e as cepas de Candida; Sete das cepas de S. aureus foram sensíveis ao extrato de P. amboinicus, mas o óleo não mostrou atividade, 4 cepas de S.aureus e as cepas de Candida foram sensíveis ao óleo essencial de R. graveolens. CONCLUSÃO: Algumas plantas apresentaram resultados satisfatórios, dependendo do agente etiológico, porém se faz necessário estudos mais detalhados, para melhorar o aproveitamento destas plantas.Acute Otitis Externa is an inflammation of the outer auditory meatus, and according to popular saying, medicinal plant extracts can be used in its treatment. AIM: to assess the in vitro antimicrobial activity of the following plants: Aleolanthus suaveolens; Caryophyllus aromaticus; Cymbopogon citratus; Matricaria chamomila; Pithecellobium avaremotemo; Plectranthus amboinicus and Ruta graveolens on the germs that cause otitis externa. MATERIALS AND METHODS: the minimum inhibitory concentration of extracts and oils from these plants was

  13. Pneumococcal conjugate vaccines for preventing otitis media

    NARCIS (Netherlands)

    Fortanier, Alexandre C.; Venekamp, Roderick P.; Boonacker, Chantal W. B.; Hak, Eelko; Schilder, Anne G. M.; Sanders, Elisabeth A. M.; Damoiseaux, Roger A. M. J.

    2014-01-01

    BACKGROUND: Acute otitis media (AOM) is a very common respiratory infection in early infancy and childhood. The marginal benefits of antibiotics for AOM in low-risk populations in general, the increasing problem of bacterial resistance to antibiotics and the huge estimated direct and indirect annual

  14. Pneumococcal conjugate vaccines for preventing otitis media

    NARCIS (Netherlands)

    Fortanier, Alexandre C.; Venekamp, Roderick P.; Boonacker, Chantal W. B.; Hak, Eelko; Schilder, Anne G. M.; Sanders, Elisabeth A. M.; Damoiseaux, Roger A. M. J.

    2014-01-01

    BACKGROUND: Acute otitis media (AOM) is a very common respiratory infection in early infancy and childhood. The marginal benefits of antibiotics for AOM in low-risk populations in general, the increasing problem of bacterial resistance to antibiotics and the huge estimated direct and indirect annual

  15. Terapi pada Otitis Media Supuratif Akut

    OpenAIRE

    Aboet, Askaroellah

    2010-01-01

    Acute suppurative otitis media (ASOM) is an abrupt infection of the middle ear of short duration. The disease is one of the most common diseases world-wide. Treatment of ASOM consists of medical management, that is antibiotic based on empirical or bacterial culture for 10-14 days and surgical management, if failure of antibiotic treatment or mastoiditis stage of coalescent occurs.

  16. Perfil de isolamento microbiano em cães com otite média e externa associadas Profile of microorganisms isolated from dogs with associated media and extern otitis

    Directory of Open Access Journals (Sweden)

    L.C. Oliveira

    2006-12-01

    Full Text Available Comparou-se o perfil de isolamento microbiano de amostras coletadas de cães com otite média (OM e externa (OE associadas. Sessenta e quatro cães com otite média e externa foram avaliados durante 10 meses. Amostras dos condutos auditivos externos foram coletadas com auxílio de swabs estéreis e aquelas do ouvido médio pela técnica cirúrgica da osteotomia da bula timpânica. Os microrganismos foram cultivados e identificados de acordo com os métodos previamente descritos, e a susceptibilidade a antimicrobianos avaliada pelo método de difusão em ágar estabelecido pelo National Committee for Clinical Laboratory Standards. Bactérias anaeróbias estritas não foram isoladas em qualquer amostra. Todas as amostras de OE mostraram crescimento bacteriano e/ou fúngico. Na OM, a positividade nas culturas foi de 48%. Os microrganismos mais isolados na OE foram: Bacillus sp. (26,9%, M. pachydermatis (22,2% e S. intermedius (21,7%; na OM foram: S. intermedius (32,5%, S. aureus subsp. aureus (22,5% e bacilos Gram-negativos não fermentadores (10,0%. Observou-se alguma diferença no perfil de isolamento entre os quadros de OM e OE em 96,7% dos animais. Verificou-se elevada resistência de cepas de S. intermedius à penicilina G, ampicilina, eritromicina, tetraciclina e clindamicina.The isolation pattern of samples collected from dogs with both media (OM and extern otitis (OE was compared. Sixty-four dogs suffering from those conditions were studied over a 10-month period. Samples from the external ear were collected with sterile swabs while those from the middle ear were collected by osteotomy of the tympanic bulla. The microorganisms were cultured and identified according to methods previously described and to the susceptibility of antimicrobials according to the National Committee for Clinical Laboratory Standards agar diffusion test. Anaerobic bacteria were not isolated in any sample. All samples from OE showed bacterial and/or fungal growth

  17. Polymorphisms of Mannose-binding Lectin and Toll-like Receptors 2, 3, 4, 7 and 8 and the Risk of Respiratory Infections and Acute Otitis Media in Children.

    Science.gov (United States)

    Toivonen, Laura; Vuononvirta, Juho; Mertsola, Jussi; Waris, Matti; He, Qiushui; Peltola, Ville

    2017-05-01

    Mannose-binding lectin (MBL) and toll-like receptors (TLRs) are important components of the innate immune system. We assessed the susceptibility of children with genetic variants in these factors to respiratory infections, rhinovirus infections and acute otitis media. In a prospective cohort study, blood samples from 381 Finnish children were analyzed for polymorphisms in MBL2 at codons 52, 54 and 57, TLR2 Arg753Gln, TLR3 Leu412Phe, TLR4 Asp299Gly, TLR7 Gln11Leu and TLR8 Leu651Leu. Children were followed up for respiratory infections until 24 months of age with daily diaries. Polymerase chain reaction and antigen tests were used for detection of respiratory viruses from nasal swabs. Children with MBL variant genotype had a mean of 59 days with symptoms of respiratory infection per year, compared with 49 days in those with wild-type (P = 0.01). TLR8 polymorphisms were associated with an increased risk and TLR7 polymorphisms with a decreased risk of recurrent rhinovirus infections (P = 0.02 for both). TLR2 polymorphisms were associated with recurrent acute otitis media (P = 0.02). MBL polymorphisms were associated with an increased and TLR7 polymorphisms with a decreased risk of rhinovirus-associated acute otitis media (P = 0.03 and P = 0.006, respectively). Genetic polymorphisms in MBL and TLRs promote susceptibility to or protection against respiratory infections. In addition to environmental factors, genetic variations may explain why some children are more prone to respiratory infections.

  18. Septic arthritis of the temporomandibular joint as a complication of acute otitis media in a child: A rare case and the importance of real-time PCR for diagnosis.

    Science.gov (United States)

    Bast, F; Collier, S; Chadha, P; Collier, J

    2015-11-01

    We document the case of a 7-year-old boy who presented with pain in his left ear and trismus after a diagnosis of acute otitis media one week previously. His blood inflammatory markers were raised and magnetic resonance imaging (MRI) showed significant left temporomandibular joint effusion and partial attenuation of the left mastoid. A clinical diagnosis of septic arthritis of the TMJ was made and the patient was commenced on broad-spectrum antibiotics. Analysis using real time PCR enabled identification of the offending organism, confirmation of the diagnosis and antibiotic treatment to be specifically tailored for treatment.

  19. Impact of Pediatric Acute Otitis Media on Child and Parental Quality of Life and Associated Productivity Loss in Malaysia: A Prospective Observational Study.

    Science.gov (United States)

    Crawford, Bruce; Hashim, Siti Sabzah Mohd; Prepageran, Narayanan; See, Goh Bee; Meier, Genevieve; Wada, Keiko; Coon, Cheryl; Delgleize, Emmanuelle; DeRosa, Michael

    2017-03-01

    Acute otitis media (AOM) affects both child and parental quality of life (QoL). Data on QoL associated with AOM in Malaysia is sparse, and the burden of indirect costs have not been previously reported. To determine the effect of pediatric AOM on child and parental QoL in Malaysia and its economic impact (indirect costs). We utilized a set of QoL questionnaires (PAR-AOM-QOL, OM-6, and EQ-5D) combined with questions addressing work/productivity loss and financial costs associated with caring for a child during his or her illness in an observational, multicenter, prospective study. One hundred and ten AOM patients aged ≤5 years were included in the analysis. The majority of respondents were the patient's mother. Parental QoL was negatively affected for both emotional and daily disturbance scales, but the level of disturbance was low. Using OM-6, the greatest negative impact was on the child's QoL, followed by caregiver concerns, physical suffering, and emotional distress. Using EQ-5D, a moderately positive relationship between parents' emotional disturbance and daily disturbance, and a weak, negative correlation between parental emotional disturbance and parental health status was found. Parents with paid employment took an average of 21 h from work to care for their child, at an average cost of 321.8 Malaysian ringgit (US$97) in addition to their contribution to direct medical costs. Productivity losses whilst at work, uncompensated wage losses, and leisure time losses are also reported. This study found that AOM is associated with some negative impact on parental QoL and significant economic impact at both patient and societal levels. The findings provide useful data on healthcare resource utilization and disease burden of AOM in Malaysia.

  20. Three cases of tuberculous otitis media

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Jin Hwan; Sung, Ki Joon; Kim, Myung Soon; Kwon, Taek Sang; Yoon, Byoung Moon [Yonsei Univ. Wonju College of Medicine, Wonju (Korea, Republic of)

    1998-07-01

    We report the imaging features of three cases of tuberculous otitis media. All three patients underwent temporal bone CT scanning, and in two, additional MRI scanning was performed. The three cases showed soft tissue density in the external auditory canal, and in two, destruction of the trabeculation and internal cortex of the mastoid bone was noted. In two patients with facial palsy, erosion of the facial canal was seen. On MRI, abundant granulomatous tissue was noted in the middle ear cavity and mastoid air cells. In one case, abnormal enhancement of the cochlea, and of the facial and eighth cranial nerve in the internal acoustic canal was seen. Another case showed enhancement of the vestibule and lateral semicircular canal. If radiologic evaluation of chronic otitis media reveals destruction of the tegmen and trabeculation of the mastoid bone, together with abundant granulation tissue and enhancement of the internal ear, tuberculous otitis media may be included in the differential diagnosis.

  1. Eosinofiele otitis media

    NARCIS (Netherlands)

    de Jong, Monique A M; Smithuis, L O M J Otto; Stokroos, Robert J

    2014-01-01

    BACKGROUND: Eosinophilic otitis media (EOM) is a rare middle ear disease that may closely resemble therapy-resistant otitis media with effusion (OME). The diagnosis is made if eosinophil-rich fluid is present with two or more of the following minor criteria: (a) history of nasal polyps or, (b) bronc

  2. Evidence-based management of otitis media: a 5S model approach.

    Science.gov (United States)

    Wasson, J D; Yung, M W

    2015-02-01

    The 5S model proposes five hierarchical levels (systems, summaries, synopses, syntheses and studies) of pre-appraised evidence to guide evidence-based practice. This review aimed to identify and summarise pre-appraised evidence at the highest available 5S level for the management of different subsets of otitis media: acute otitis media, otitis media with effusion, chronic suppurative otitis media and cholesteatoma in both adults and children. Data sources were pre-appraised evidence resources. Evidence freely available from sources at the highest available level of the 5S model were summarised for this review. System level evidence exists for acute otitis media and otitis media with effusion. Summary level evidence exists for recurrent acute otitis media and medical management of chronic suppurative otitis media. There is an absence of randomised controlled trials to prove the efficacy of surgical management of chronic suppurative otitis media and cholesteatoma. Until randomised controlled trial data are generated, consensus publications on the surgical management of chronic suppurative otitis media and cholesteatoma should be used to guide best practice.

  3. 鼓膜穿刺术联合药物治疗急性分泌性中耳炎%Auripuncture combined with drug therapy in treatment of acute secretory otitis media

    Institute of Scientific and Technical Information of China (English)

    吴虹冰

    2015-01-01

    Objective To investigate auripuncture combined with drug therapy in treatment of acute secretory otitis me-dia. Methods Secretory otitis media was diagnosed in 146 cases through endoscopy, pure tone audiometry, and acoustic im-mittance examination. Auripuncture combined with drug treatment was applied in 114 cases, which Resulted in immediate hearing improvement with no relapses during the 3 months follow up. In the 32 cases treated with drugs alone, there was no noticeable hearing improvement. Conclusion Auripuncture combined with drugs is effective and safe in the treatment of acute secretory otitis media with low risks of complications.%目的:探讨鼓膜穿刺术联合药物治疗急性分泌性中耳炎的疗效。方法146例急性分泌性中耳炎患者均经过耳内镜及纯音测听、声导抗检查确诊为分泌性中耳炎,中耳腔积液,其中114例行鼓膜穿刺术联合药物治疗,32例单纯药物治疗,结果鼓膜穿刺术联合药物治疗患者听力当时即有明显提高,再经相应药物治疗,3月内无复发。而单纯药物治疗患者听力大多无明显改善,需再次复诊行鼓膜穿刺术才能治愈。结论鼓膜穿刺术联合药物治疗急性分泌性中耳炎疗效明显、安全无并发症。

  4. Computed tomography study of otitis media; A tomografia computadorizada no estudo das otites medias

    Energy Technology Data Exchange (ETDEWEB)

    Bahia, Paulo Roberto Valle; Marchiori, Edson [Universidade Federal, Rio de Janeiro, RJ (Brazil). Dept. de Radiologia

    1997-03-01

    The findings of computed tomography (CT) of 89 patients clinically suspected of having otitis media were studied in this work. Such results were compared to clinical diagnosis, otoscopy, surgical findings and previous data. Among the results of our analysis, we studied seven patients with acute otitis media and 83 patients with chronic otitis media. The patients with acute otitis media have undergone CT examinations to evaluate possible spread to central nervous system. The diagnosis of cholesteatoma, its extension and complications were the main indication. for chronic otitis media study. The main findings of the cholesteatomatous otitis were the occupation of the epitympanun, the bony wall destruction and the ossicular chain erosion. The CT demonstrated a great sensibility to diagnose the cholesteatoma. (author) 25 refs., 10 figs.

  5. Update on otitis media – prevention and treatment

    OpenAIRE

    Qureishi, Ali; Lee, Yan; Belfield, Katherine; Birchall, John P; Daniel, Matija

    2014-01-01

    Ali Qureishi,1 Yan Lee,2 Katherine Belfield,3 John P Birchall,4 Matija Daniel,21Otolaryngology Head and Neck Surgery, Northampton General Hospital, Northampton, UK; 2NIHR Nottingham Hearing Biomedical Research Unit, Nottingham, UK; 3Biomaterials Related Infection Group, 4Otorhinolaryngology Head and Neck Surgery, The University of Nottingham, Nottingham, UKAbstract: Acute otitis media and otitis media with effusion are common childhood disorders, a source of significant morbidity, and a leadi...

  6. Parental views on acute otitis media (AOM) and its therapy in children--results of an exploratory survey in German childcare facilities.

    Science.gov (United States)

    Kautz-Freimuth, Sibylle; Redaèlli, Marcus; Samel, Christina; Civello, Daniele; Altin, Sibel V; Stock, Stephanie

    2015-12-01

    Acute otitis media (AOM) is one of the main reasons for medical consultation and antibiotic use during childhood. Although 80% of AOM cases are self-limiting, antibiotic prescription is still high, either for physician- or for parent-related factors. This study aims to identify parental knowledge about, beliefs and attitudes towards, and experiences with AOM and its therapy and thus to gain insights into parents' perspectives within the German health care system. An exploratory survey was conducted among German-speaking parents of children aged 2 to 7 years who sent their children to a childcare facility. Childcare facilities were recruited by convenience sampling in different urban and rural sites in Germany, and all parents with children at those facilities were invited to participate. Data were evaluated using descriptive statistical analyses. One-hundred-thirty-eight parents participated. Of those, 75.4% (n = 104) were AOM-experienced and 75.4% (n = 104) had two or more children. Sixty-six percent generally agree that bacteria cause AOM. 20.2% generally agree that viruses cause AOM. 30.5% do not generally agree that viruses cause AOM. Eight percent generally agree that AOM resolves spontaneously, whereas 53.6% do not generally agree. 92.5% generally (45.7%) and partly (42.8%) agree that AOM needs antibiotic treatment. With respect to antibiotic effects, 56.6% generally agree that antibiotics rapidly relieve earache. 60.1% generally agree that antibiotics affect the gastrointestinal tract and 77.5% generally agree that antibiotics possibly become ineffective after frequent use. About 40% generally support and about 40% generally reject a "wait-and-see" strategy for AOM treatment. Parental-reported experiences reveal that antibiotics are by far more often prescribed (70.2%) than actively requested by parents (26.9%). Parental views on AOM, its therapy, and antibiotic effects reveal uncertainties especially with respect to causes, the natural course of the disease

  7. Probiotics and prebiotics in preventing episodes of acute otitis media in high-risk children: a randomized, double-blind, placebo-controlled study.

    Science.gov (United States)

    Cohen, Robert; Martin, Elvira; de La Rocque, France; Thollot, Franck; Pecquet, Sophie; Werner, Andreas; Boucherat, Michel; Varon, Emmanuelle; Bingen, Edouard; Levy, Corinne

    2013-08-01

    Several studies have suggested that probiotics (proB) and/or prebiotics (preB) could reduce the burden of infection in infants and toddlers. We aimed to determine whether follow-up formula supplemented with proB and preB could reduce the risk of acute otitis media (AOM). In this double-blind, placebo-controlled trial from November 2007 to April 2009, 37 pediatricians in France enrolled children 7 to 13 months of age with high risk of AOM who were randomly assigned to receive follow-up formula supplemented with proB (Streptococcus thermophilus NCC 2496, Streptococcus salivarius DSM 13084, Lactobacillus rhamnosus LPR CGMCC 1.3724) and preB (Raftilose/Raftiline) or follow-up formula alone (placebo). During 12 months, the 2 groups were compared for number of AOM episodes diagnosed (primary outcome) and secondary outcomes by the Poisson model (incidence rate ratio [IRR]) or logistic regression (odds ratio; and 95% confidence interval [95% CI]) after adjustment on covariates of interest. We enrolled 224 children (112 in each group). All children were vaccinated (4 doses) with the 7-valent pneumococcal conjugate vaccine; demographic characteristics were similar in the 2 groups. In total, 486 AOM episodes were reported, 249 and 237 in the treatment and control groups, respectively. The treatment and control groups did not differ in incidence of AOM (IRR 1.0, 95% CI: 0.8-1.2), lower respiratory tract infections (IRR 0.9, 0.7-1.2) or number of antibiotic treatment courses (IRR = 1.0, 95% CI: 0.8-1.2). Treatment was not associated with recurrent AOM (odds ratio 1.0, 95% CI: 0.5-1.7). With regard to gastrointestinal disorders, both formulas were well tolerated. The proB and preB included in follow-up formula given to children at 7 to 13 months of age did not reduce the risk of AOM, recurrent AOM, antibiotic use or lower respiratory tract infections at 1 year.

  8. HADOC: a computer code for calculation of external and inhalation doses from acute radionuclide releases

    Energy Technology Data Exchange (ETDEWEB)

    Strenge, D.L.; Peloquin, R.A.

    1981-04-01

    The computer code HADOC (Hanford Acute Dose Calculations) is described and instructions for its use are presented. The code calculates external dose from air submersion and inhalation doses following acute radionuclide releases. Atmospheric dispersion is calculated using the Hanford model with options to determine maximum conditions. Building wake effects and terrain variation may also be considered. Doses are calculated using dose conversion factor supplied in a data library. Doses are reported for one and fifty year dose commitment periods for the maximum individual and the regional population (within 50 miles). The fractional contribution to dose by radionuclide and exposure mode are also printed if requested.

  9. Otitis media: conceptos actuales

    Directory of Open Access Journals (Sweden)

    Hernán Sierra Fernández

    2004-09-01

    Full Text Available La otitis media aguda es uno de los motivos más frecuentes de consulta en la edad pediátrica. Los gérmenes que con mayor frecuencia se aíslan en el oído medio de estos pacientes son el Streptococcus pneumoniae, el Haemophilus influenzae, la Moraxella catarrhalis y el Streptococcus pyogenes. El patrón de resistencia antibiótica de estas bacterias varía dependiendo de la región geográfica. y es la base fundamental para establecer recomendaciones terapéuticas. El análisis en Costa Rica. de la microbiología de la otitis media aguda, otitis media recurrente y otitis media catalogada como falla terapéutica, sugiere que la amoxicilina en una dosis de 50 mg/Kg/día por 10 días, debe ser considerada el antibiótico de primera línea en los casos de otitis media aguda. En los pacientes con otitis media recurrente, falla antimicrobiana o cuando se sospeche la presencia de un Streptococcus pneumoniae resistente a la penicilina, se debe considerar el uso de amoxicilina en dosis más elevadas, amoxicilina con ácido clavulánico, macrólidos o ceftrlaxona.

  10. Acute mastoiditis in children

    DEFF Research Database (Denmark)

    Anthonsen, Kristian; Høstmark, Karianne; Hansen, Søren;

    2013-01-01

    Conservative treatment of acute otitis media may lead to more complications. This study evaluates changes in incidence, the clinical and microbiological findings, the complications and the outcome of acute mastoiditis in children in a country employing conservative guidelines in treating acute...... otitis media....

  11. Risk factors for otitis media in children with special emphasis on the role of colonization with bacterial airway pathogens: The Generation R study

    NARCIS (Netherlands)

    J.A.M. Labout (Joost); L. Duijts (Liesbeth); A. Lebon (Ankie); R. de Groot (Ronald); A. Hofman (Albert); V.W.V. Jaddoe (Vincent); H.A. Verbrugh (Henri); P.W.M. Hermans (Peter); H.A. Moll (Henriëtte)

    2011-01-01

    textabstractAcute otitis media is the most frequent diagnosis in children visiting physicians' offices. Risk factors for otitis media have been widely studied. Yet, the correlation between bacterial carriage and the development of otitis media is not entirely clear. Our aim was to study in a

  12. Risk factors for otitis media in children with special emphasis on the role of colonization with bacterial airway pathogens: the Generation R study

    NARCIS (Netherlands)

    Labout, J.A.; Duijts, L.; Lebon, A.; Groot, R. de; Hofman, A.; Jaddoe, V.V.; Verbrugh, H.A.; Hermans, P.W.M.; Moll, H.A.

    2011-01-01

    Acute otitis media is the most frequent diagnosis in children visiting physicians' offices. Risk factors for otitis media have been widely studied. Yet, the correlation between bacterial carriage and the development of otitis media is not entirely clear. Our aim was to study in a population-based

  13. OCCURRENCY OF MALASSEZIA PACHYDERMATIS AND OTHER INFECTIOUS AGENTS AS CAUSE OF EXTERNAL OTITIS IN DOGS FROM RIO GRANDE DO SUL STATE, BRAZIL (1996/1997 Ocorrência de Malassezia pachydermatis e de outros agentes etiológicos de otite externa em cães no estado do Rio Grande do Sul, BR (1996-1997

    Directory of Open Access Journals (Sweden)

    Márcia de Oliveira Nobre

    2001-10-01

    Full Text Available The purpose of this work was to evaluate the frequency of Malassezia pachydermatis infection and other infectious agents in dogs with external otitis and with healthy auditory tubes. Clinical manifestations of external otitis were evaluated. Samples from the auditory tube of 102 dogs with otitis and from 32 healthy dogs were submitted to direct microscopic examination and cultured in blood agar and Sabouraud dextrose agar with chloramphenicol and cycloheximide. Direct examination showed more than ten cells of M. pachydermatis in 52.0% of the samples from dogs with otitis, but in only 21.8% of the healthy auditory tube samples. M. pachydermatis was isolated in 37.5% of the samples from dogs with healthy auditory tube and 76.5% (p0.05. Infection by M. pachydermatis was prevalent in the following breeds: Cocker Spainel, German Shepherd and Brazilian Fila. No differences were found in frequency of the infection in relation to age, sex and ear anatomy of the dogs. Otomycosis were predominantly ceruminous and erythematous. M. pachydermatis was the most frequent agent in external otitis.Este trabalho teve como objetivos estudar a ocorrência da Malassezia pachydermatis e de outros agentes etiológicos em cães com otite externa e com conduto auditivo externo hígido; caracterizar a otomicose por M. pachydermatis. Foram analisadas 32 amostras de cães com o conduto auditivo hígido e 102 de otite externa. Todas as amostras foram submetidas ao exame direto, cultivo em ágar sangue e em ágar Sabouraud dextrose acrescido de cloranfenicol e cicloheximida. Ao exame direto 52.0% das amostras de otite apresentaram mais de dez células de M. pachydermatis. Somente 21.8% das amostras de orelhas hígidas apresentaram no exame direto células com esta morfologia (uma a dez células. M. pachydermatis foi isolada em 37.5% das amostras do conduto auditivo hígido e em 76.5% das amostras de otite (p0.05. A infecção por M. pachydermatis foi prevalente em cães da ra

  14. 生理海水辅助治疗儿童急性分泌性中耳炎的疗效分析%Adjuvant Treatment Efficacy Analysis of Children with Acute Physiological Seawater Secretory Otitis Media

    Institute of Scientific and Technical Information of China (English)

    乔晓丞; 王明辉

    2013-01-01

    Objective To observe the clinical ef ect of physiological sea water nasal douche therapy on children with acute secretory otitis media. Methods 2011 May -2012 August 100 cases (130 ears) were acute secretory otitis media in children, were randomly divided into physiological sea water nasal lavage combined treatment group (treatment group, 55 cases, 82 ears) and the control group (45 cases, 48 ears), two groups were given conventional systemic drug therapy. Compare the two groups at tenth and twentieth days of treatment ef ect. Results Treatment group 76 ears, 6 ears were inef ective, the total ef iciency of 92.7%; control group, 38 ears and 10 ears of ef ective, inef ective, the total ef iciency of 79.2%; there was significant dif erence between two groups (P < 0.05). Conclusions Physiological sea water therapy on children with acute secretory otitis media is bet er.%目的观察生理海水鼻腔冲洗辅助治疗儿童急性分泌性中耳炎的临床疗效。方法2011年5月~2012年8月收治100例(130耳)急性分泌性中耳炎的儿童,随机分为生理海水鼻腔冲洗联合治疗组(治疗组,55例,82耳)和对照组(45例,48耳),两组同时给予常规全身药物治疗。比较两组在第10d和第20d的治疗效果。结果治疗组有效76耳,无效6耳,总有效率92.7%;对照组有效38耳,无效10耳,总有效率79.2%;两组差异有统计学意义(P<0.05)。结论生理海水辅助治疗儿童急性分泌性中耳炎效果较好。

  15. Efficacy of Nasal Combination Therapy in Children with Acute Secretory Otitis Media%鼻部联合治疗儿童急性分泌性中耳炎的疗效分析

    Institute of Scientific and Technical Information of China (English)

    陈岚

    2012-01-01

    目的:观察鼻部联合治疗儿童急性分泌性中耳炎的临床疗效.方法:2010年5月-2011年12月收治100例(126耳)急性分泌性中耳炎的儿童,随机分为鼻部联合治疗组(治疗组,60例,76耳)和对照组(40例,50耳),两组同时给予常规全身药物治疗.分别于第7天和第14天复诊,比较两组的治疗效果.结果:治疗组有效72耳,无效4耳,总有效率94.7%;对照组有效35耳,无效1 5耳,总有效率70%;两组差异有统计学意义(P<0.05).结论:鼻部联合治疗儿童急性分泌性中耳炎效果较好.%Objective:To observe the efficacy of nasal combination therapy in children with acute secretory otitis media. Methods: A randomized controlled trial included 126 ears of 100 children (from May 2010 to December 2011) who had acute secretory otitis media. Seventy-six ears of 60 children who had nasal combination treatment were taken as study group,and 50 ears of 40 children who didn't undergo nasal combination treatment were taken as control group. All the children in the two groups were given conventional systemic drug therapy. The efficacy of treatment were evaluated and compared at 7 days and 14 days after treatment. Results: The treatment of 72 ears in the study group was effective, and the total effective rate was 94. 7%. The treatment of 35 ears in the control group was effective, and the total effective rate was 70. 0%. Difference between the two groups was significant (P<0. 05). Conclusions: The nasal combination therapy in children with acute secretory otitis media is effective.

  16. [Otitis media with effusion in children younger than 1 year].

    Science.gov (United States)

    Di Francesco, Renata Cantisani; Barros, Vivian Boschesi; Ramos, Rafael

    2016-06-01

    To determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors. Retrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber-gold color, fluid level, handle of malleus position), type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis. 25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2,500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score otitis media with effusion. Otitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  17. Otitis media with effusion in children younger than 1 year

    Directory of Open Access Journals (Sweden)

    Renata Cantisani Di Francesco

    2016-06-01

    Full Text Available Abstract Objective: To determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors. Methods: Retrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber-gold color, fluid level, handle of malleus position, type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis. Results: 25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score <7 and day care attendance. The multivariate analysis showed that artificial feeding is the factor most often associated to otitis media with effusion. Conclusions: Otitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding.

  18. Otitis media with effusion in children younger than 1 year

    Science.gov (United States)

    Di Francesco, Renata Cantisani; Barros, Vivian Boschesi; Ramos, Rafael

    2016-01-01

    Abstract Objective: To determine the prevalence of otitis media with effusion in children younger than 1 year and its association with the season of the year, artificial feeding, environmental and perinatal factors. Methods: Retrospective study of 184 randomly included medical records from a total of 982 healthy infants evaluated for hearing screening tests. Diagnosis of otitis media with effusion was based on otoscopy (amber-gold color, fluid level, handle of malleus position), type B tympanometric curves and absence of otoacoustic emissions. Incomplete medical records or those describing acute otitis media, upper respiratory tract infections on the assessment day or in the last 3 months, neuropathies and craniofacial anomalies were excluded. Data such as gestational age, birth weight, Apgar score, type of feeding and day care attendance were compared between children with and without otitis media with effusion through likelihood tests and multivariate analysis. Results: 25.3% of 184 infants had otitis media with bilateral effusion; 9.2% had unilateral. In infants with otitis media, the following were observed: chronological age of 9.6±1.7 months; gestational age >38 weeks in 43.4% and birth weight >2500g in 48.4%. Otitis media with effusion was associated with winter/fall, artificial feeding, Apgar score <7 and day care attendance. The multivariate analysis showed that artificial feeding is the factor most often associated to otitis media with effusion. Conclusions: Otitis media with effusion was found in about one third of children younger than 1 year and was mainly associated with artificial feeding. PMID:26559603

  19. Prevention of otitis media in children by pneumococcal vaccination.

    Science.gov (United States)

    Karma, P; Pukander, J; Sipilä, M; Timonen, M; Pöntynen, S; Herva, E; Grönroos, P; Mäkelä, H

    1985-01-01

    A total of 3,340 infants, 95 per cent of them 7 to 9 months old, were randomly vaccinated in a double-blind fashion with either the 14-valent pneumococcal (Pn) polysaccharide vaccine or a saline placebo in three urban areas in Finland. The second dose of the vaccine was given 5 months later. Age and sex distribution, recruitment of infants, and their otitis-related treatment and follow-up were similar in the study areas. Side effects after vaccination were mild and fewer than among older children. Antibody responses to vaccine polysaccharides varied from type to type, but were generally poor, especially to types most prevalent in otitis media. After the first dose of vaccine, the occurrence of otitis visits among the Pn-vaccinated, as compared with controls, showed inter-area differences, but ranged from not more than a 30 per cent reduction at its best to an increase in some areas and in some clinical categories. The respective figures for children with acute otitis media were similar between the vaccination groups and the study areas. The effect of the vaccine on acute otitis media caused by specific Pn types/groups represented in the vaccine was variable but generally poor. Group 6 attacks especially seemed to behave problematically. The second dose of the vaccine did not give additional benefit serologically or clinically. The efficacy of currently available pneumococcal vaccine against otitis media seemed poor in infants.

  20. Update on otitis media – prevention and treatment

    Directory of Open Access Journals (Sweden)

    Qureishi A

    2014-01-01

    Full Text Available Ali Qureishi,1 Yan Lee,2 Katherine Belfield,3 John P Birchall,4 Matija Daniel,21Otolaryngology Head and Neck Surgery, Northampton General Hospital, Northampton, UK; 2NIHR Nottingham Hearing Biomedical Research Unit, Nottingham, UK; 3Biomaterials Related Infection Group, 4Otorhinolaryngology Head and Neck Surgery, The University of Nottingham, Nottingham, UKAbstract: Acute otitis media and otitis media with effusion are common childhood disorders, a source of significant morbidity, and a leading cause of antibiotic prescription in primary health care. Although effective treatments are available, some shortcomings remain, and thus better treatments would be welcome. Recent discoveries within the field of otitis media research relating to its etiology and pathogenesis have led to further investigation aimed at developing novel treatments. This article provides a review of the latest evidence relating to the understanding of acute otitis media and otitis media with effusion, current treatment strategies, their limitations, new areas of research, and novel strategies for treatment.Keywords: otitis media, ear, hearing, infection, biofilm, antibiotics

  1. TUBERCULOUS OTITIS MEDIA – REVISITED WITH 3 INTERESTING CASE REPORTS

    Directory of Open Access Journals (Sweden)

    Akanksha A.

    2013-12-01

    Full Text Available ABSTRACT: Tuberculous otitis media is a ra re disease that is clinically variable and nonspecific. Tuberculous otitis media can be difficult to diagnose because it can easily be confused with other acute or chronic middle ear conditions. The signs and symptoms are variable and nonspecific and ofte n differ from classic descriptions. Furthermore, no two cases may not necessarily present itself clinically in the same manner. Cases of chronic otitis media that are unresponsive to the usual therapy or show unexpected postoperative evolution should be in vestigated for tuberculosis. Tuberculous otitis media should be suspected after failure of current antibiotics or persistent effusion after tympanoplasty or mastoidectomy. Because of these factors, the diagnosis is often made during surgery or postoperati vely. Late diagnosis delays the start of treatment, thereby increasing the risk of complications

  2. A case series of complicated infective otitis media requiring surgery in adults.

    Science.gov (United States)

    Heah, Harold; Soon, Sue Rene; Yuen, Heng-Wai

    2016-12-01

    With the advent of antibiotics, complications of otitis media have become less common. It is crucial for physicians to recognise otitis media and treat its complications early. Herein, we present our institution's experience with patients who required emergency surgical intervention for complications of otitis media. Data on patients who underwent emergency surgery for complications of otitis media from 2004 to 2011 was retrieved from the archives of the Department of Otolaryngology, Changi General Hospital, Singapore. A total of 12 patients (10 male, two female) underwent emergency surgery for complications of otitis media. The median age of the patients was 25 years. Otalgia, otorrhoea, headache and fever were the main presenting symptoms. Extracranial complications were observed in 11 patients, and six patients had associated intracranial complications. The primary otologic disease was acute otitis media in six patients, chronic otitis media without cholesteatoma in three patients and chronic otitis media with cholesteatoma in three patients. Mastoidectomy and drainage of abscess through the mastoid, with insertion of grommet tube, was the main surgical approach. Two patients required craniotomy. The mean length of hospital stay was 16.2 days and the mean follow-up period was 16.3 months. Five patients had residual conductive hearing loss; two patients with facial palsy had full recovery. Otitis media can still result in serious complications in the post-antibiotic era. Patients with otitis media should be monitored, and prompt surgical intervention should be performed when necessary to attain good outcomes.

  3. Quality-of-Life Differences among Diagnostic Subgroups of Children Receiving Ventilating Tubes for Otitis Media

    DEFF Research Database (Denmark)

    Heidemann, Christian Hamilton; Lauridsen, Henrik Hein; Kjeldsen, Anette Drøhse;

    2015-01-01

    completed questionnaires at 7 time points from before treatment to 18-month follow-up. Logistic regression analysis was used to investigate possible predictors for clinical success. RESULTS: Response rates ranged from 96% to 81%; diagnostic distribution: 15% recurrent acute otitis media (rAOM), 47% otitis...

  4. Magnetic resonance imaging findings in a red kangaroo (Macropus rufus) with otitis.

    Science.gov (United States)

    Okeson, Danelle M; Coke, Rob L; Kochunov, Peter; Davis, M Duff

    2008-12-01

    Magnetic resonance imaging (MRI) was performed on an adult, male Red kangaroo (Macropus rufus) with a history of nonspecific neurologic signs and acute discharge from the left ear. MRI revealed findings consistent with otitis and possible osteomyelitis of the temporal and mastoid bones. To the authors' knowledge, this is the first report of otitis and MRI findings in a kangaroo.

  5. Streptococcus pneumoniae serotypes isolated from the middle ear of Mexican children diagnosed with acute otitis media Serotipificación de Streptococcus pneumoniae aislados de líquido de oído medio en niños mexicanos con diagnóstico de otitis media aguda

    Directory of Open Access Journals (Sweden)

    Demóstenes Gómez-Barreto

    2011-06-01

    Full Text Available OBJECTIVE: The aim of this study was to identify the etiology and the serotypes of S. pneumoniae (Sp in Mexican children with acute otitis media (AOM. MATERIALS AND METHODS: The study includessamples frompatientsdiagnosed with AOM at the Federico Gomez Children's Hospital of Mexico (2002-2003,with positive culture for Sp bacteriologically confirmed in middle ear fluid obtained by tympanocentesis. All Sp were serotyped. A total of 138 samples from 135 children with AOM were included. RESULTS: Sp was isolated in 72 samples from 70 children. Sixty (85.7% were previously healthy and 10 (14.3% were immunocompromised. The most common serotypes were 6B and 19F (16.67%, and 6 A, 14 and 23F (15.27%. CONCLUSION: The distribution of serotypes among the children with AOM in the study is similar to that reported in developing cities, and 63.9% of the isolated serotypes are found to be included in the 7-Valent Pneumococcal Conjugate Vaccine (PCV, 68.1% in the 10-Valent PCV and 83.3% in 13-Valent PCV.OBJETIVO: Conocer la etiología y serotipos de S. pneumoniae (Sp en niños mexicanos, con otitis media aguda (OMA. MATERIAL Y MÉTODOS: Se incluyeron las muestras de pacientes con OMA del Hospital Infantil de México Federico Gómez (2002-2003, con cultivo positivo para Sp, (bacteriológicamente confirmados en el líquido del oído medio obtenido por timpanocentesis. Todos los Sp. fueron serotipificados. Se incluyeron 138 muestras de 135 niños con OMA. RESULTADOS: Sp. se aisló en 72 muestras de 70 niños: 60 (85.7% eran previamente sanos y 10 (14.3% eran inmunocomprometidos. Los serotipos más frecuentes fueron 6B y 19F (16.67%, y 6 A, 14 y 23F (15.27%. CONCLUSIONES: La distribución de los serotipos en niños con otitis media aguda fue similar a la reportada en ciudades en desarrollo y se observó que 63.9% de los serotipos aislados están incluidos en la vacuna conjugada 7-valente, 68.1% en la 10-valente y 83.3% en la 13-valente.

  6. Low-Cost Alternative External Rotation Shoulder Brace and Review of Treatment in Acute Shoulder Dislocations

    Directory of Open Access Journals (Sweden)

    Lacy, Kyle

    2015-01-01

    Full Text Available Traumatic dislocations of the shoulder commonly present to emergency departments (EDs. Immediate closed reduction of both anterior and posterior glenohumeral dislocations is recommended and is frequently performed in the ED. Recurrence of dislocation is common, as anteroinferior labral tears (Bankart lesions are present in many anterior shoulder dislocations.14,15,18,23 Immobilization of the shoulder following closed reduction is therefore recommended; previous studies support the use of immobilization with the shoulder in a position of external rotation, for both anterior and posterior shoulder dislocations.7-11,19 In this study, we present a technique for assembling a low-cost external rotation shoulder brace using materials found in most hospitals: cotton roll, stockinette, and shoulder immobilizers. This brace is particularly suited for the uninsured patient, who lacks the financial resources to pay for a pre-fabricated brace out of pocket. We also performed a cost analysis for our low-cost external rotation shoulder brace, and a cost comparison with pre-fabricated brand name braces. At our institution, the total materials cost for our brace was $19.15. The cost of a pre-fabricated shoulder brace at our institution is $150 with markup, which is reimbursed on average at $50.40 according to our hospital billing data. The low-cost external rotation shoulder brace is therefore a more affordable option for the uninsured patient presenting with acute shoulder dislocation. [West J Emerg Med. 2015;16(1:114–120.

  7. The management of otitis externa in UK general practice.

    Science.gov (United States)

    Pabla, L; Jindal, M; Latif, K

    2012-03-01

    Acute otitis externa is common and provides a heavy workload for general practitioners. We aim to determine the first-line treatment used by general practitioners in the management of otitis externa and subsequent second-line treatment in a hospital ENT clinic. In addition, this study aims to ascertain whether local and national guidelines are being followed appropriately. A prospective observational study on the management of otitis externa in consecutive patients referred to an ENT emergency clinic was undertaken. Data were collected and analysed on symptoms, initial management by general practitioners, findings and treatment in the ENT clinic. A total of 106 patients were studied. The mean duration of symptoms before presentation to clinic was 13 days; 42% of patients received no treatment by their GP prior to referral to the ENT emergency clinic. Only 14% of patients received topical antibiotics alone, whilst 44% received oral antibiotics, either alone or in conjunction with topical antibiotics by their GP. Of the 106 patients, 86% received topical antibiotics in the ENT emergency clinic and oral antibiotics were reserved for those presenting with complicated acute otitis externa. Topical antibiotics are associated with a decrease in disease persistence, whilst oral antibiotics are associated with an increase. However, general practitioners are prescribing oral antibiotics more often than required. There are few regional guidelines and no explicit national guidelines on the management of acute otitis externa for GPs to refer to. We suggest the implementation of national guidelines to aid clinical practice.

  8. Recurrent malignant otitis externa: management and outcome.

    Science.gov (United States)

    Omran, Ahmed Amin; El Garem, Hany Farouk; Al Alem, Reyad Khalil

    2012-03-01

    Necrotizing (malignant) external otitis (NEO) is an infection involving the temporal and the adjacent bones. It is a rare type of external otitis that occurs primarily in immunocompromised persons. The present study aimed to evaluate its management and outcome in recurrent cases. Ten patients attending the ENT Department, Alexandria University were included. They had recurrence of otitis externa over a period of 6 months after-cure, as well as severe night otalgia and high ESR level. Peri-auricular soft tissue swelling, cranial nerve paralysis and trismus were the main persistent or developing presentations in recurrent cases. Extensive surgical intervention was performed in four patients with unsatisfactory outcome. On the other hand, satisfactory results were obtained with those treated with specific medical therapy after culture and sensitivity test and those who underwent minimal surgical intervention. In conclusion, NEO is an aggressive disease that necessitates conservative management and local debridement of sequestrated tissues. The ESR is a good indicator of treatment response. It is recommended to be meticulous in treatment of cases with recurrent NEO and extensive surgical interventions are discouraged.

  9. Danish guidelines on management of otitis media in preschool children

    DEFF Research Database (Denmark)

    Heidemann, C. H.; Lous, J.; Berg, J.

    2016-01-01

    INTRODUCTION: Otitis media is one of the most common diseases in small children. This underlines the importance of optimizing diagnostics and treatment of the condition. Recent literature points toward a stricter approach to diagnosing acute otitis media (AOM). Moreover, ventilating tube treatment...... the Danish guidelines regarding the diagnostic criteria for acute otitis media and surgical treatment of RAOM and COME. METHODS: The GRADE system (The Grading of Recommendations Assessment, Development and Evaluation) was used in order to comply with current standards of evidence assessment in formulation...... of recommendations. An extensive literature search was conducted between July and December 2014. The quality of the existing literature was assessed using AGREE II (Appraisal of Guidelines for Research & Evaluation), AMSTAR (assessing the Methodological Quality of Systematic Reviews), QUADAS-2 (Quality of Diagnostic...

  10. Recurrent malignant otitis externa with multiple cranial nerve involvement: A case report

    Directory of Open Access Journals (Sweden)

    Đerić Dragoslava

    2016-01-01

    Full Text Available Introduction. Necrotizing otitis externa is a rare but conditionally fatal infection of external auditory canal with extension to deep soft tissue and bones, resulting in necrosis and osteomyelitis of the temporal bone and scull base. This condition is also known as malignant otitis due to an aggressive behavior and poor treatment response. Early diagnosis of malignant otitis is a difficult challenge. We present an illustrative case of necrotizing otitis externa and suggest some strategies to avoid diagnostic and treatment pitfalls. Case Outline. A 70-year-old patient presented with signs of malignant otitis externa, complicated by peripheral facial palsy. Adequate diagnostic and treatment procedures were performed with clinical signs of resolution. The recurrence of malignant infection had presented three months after previous infection with multiple cranial nerve neuropathies and signs of jugular vein and lateral sinus thrombosis. An aggressive antibiotic treatment and surgery were carried out, followed by substantial recovery of the patient and complete restoration of cranial nerves’ functions. Conclusion. Necrotizing otitis externa is a serious condition with uncertain prognosis. The suspicion of malignant external otitis should be raised in cases of resistance to topical treatment, especially in patient with predisposing factors. Evidence-based guideline for necrotizing otitis externa still doesn’t exist and treatment protocol should be adjusted to individual presentation of each patient.

  11. Reduced Serum IgG Responses to Pneumococcal Antigens in Otitis-Prone Children May Be Due to Poor Memory B-Cell Generation

    Science.gov (United States)

    Sharma, Sharad K.; Casey, Janet R.

    2012-01-01

    A low level of serum antibody to antigens expressed by Streptococcus pneumoniae has been proposed to explain the susceptibility of children to recurrent episodes of acute otitis media (hereafter, “otitis-prone children”). By use of enzyme-linked immunospot assays, the percentages of memory B cells to pneumococcal protein antigens PhtD, LytB, PcpA, PhtE, and Ply were compared between otitis-prone and non–otitis-prone children at the time of acute otitis media or nasopharyngeal colonization with S. pneumoniae. We found significantly lower percentages of memory B cells to 3 pneumococcal protein antigens (PhtD, PhtE, and Ply) and reduced antigen-specific immunoglobulin G concentrations in otitis-prone children, compared with non–otitis-prone children. PMID:22383675

  12. Paracetamol (acetaminophen) or non-steroidal anti-inflammatory drugs, alone or combined, for pain relief in acute otitis media in children.

    Science.gov (United States)

    Sjoukes, Alies; Venekamp, Roderick P; van de Pol, Alma C; Hay, Alastair D; Little, Paul; Schilder, Anne Gm; Damoiseaux, Roger Amj

    2016-12-15

    Acute otitis media (AOM) is one of the most common childhood infectious diseases and a significant reason for antibiotic prescriptions in children worldwide. Pain from middle ear infection and pressure behind the eardrum is the key symptom of AOM. Ear pain is central to children's and parents' experience of the illness. Because antibiotics provide only marginal benefits, analgesic treatment including paracetamol (acetaminophen) and non-steroidal anti-inflammatory drugs (NSAIDs) is regarded as the cornerstone of AOM management in children. Our primary objective was to assess the effectiveness of paracetamol (acetaminophen) or NSAIDs, alone or combined, compared with placebo or no treatment in relieving pain in children with AOM. Our secondary objective was to assess the effectiveness of NSAIDs compared with paracetamol in children with AOM. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), Issue 7, July 2016; MEDLINE (Ovid, from 1946 to August 2016), Embase (from 1947 to August 2016), CINAHL (from 1981 to August 2016), LILACS (from 1982 to August 2016) and Web of Science (from 1955 to August 2016) for published trials. We screened reference lists of included studies and relevant systematic reviews for additional trials. We searched WHO ICTRP, ClinicalTrials.gov, and the Netherlands Trial Registry (NTR) for completed and ongoing trials (search date 19 August 2016). We included randomised controlled trials (RCTs) comparing the effectiveness of paracetamol or NSAIDs, alone or combined, for pain relief in children with AOM. We also included trials of paracetamol or NSAIDs, alone or combined, for children with fever or upper respiratory tract infections (URTIs) if we were able to extract subgroup data on pain relief in children with AOM either directly or after obtaining additional data from study authors. Two review authors independently assessed methodological quality of the included trials and extracted data. We used the GRADE approach to rate

  13. The Otitis Media-6 questionnaire

    DEFF Research Database (Denmark)

    Heidemann, Christian Hamilton; Godballe, Christian; Kjeldsen, Anette Drøhse

    2013-01-01

    The Otitis Media-6 questionnaire (OM-6) is the most frequently used instrument to measure health related quality of life in children with otitis media. The main objectives of this study are 1) to translate and cross-culturally adapt the OM-6 into Danish, and 2) to assess important psychometric...... properties including structural validity and interpretability of the OM-6 in a Danish population of children suffering from otitis media....

  14. [Malignant otitis externa with disfunction of the temporomandibular articulation].

    Science.gov (United States)

    Rojas Casanova, P; Pila Pérez, R; Dieguez Tejada, R; Pila Peláez, M

    1993-01-01

    Here we present a case of a female patient 70 years old stricken with diabetes mellitud 40 years of evolution with manifestations of malignant external otitis accompanied by disfunction of the temporomandibular articulation. Here we will show the clinical characteristics and the diagnosis in our patient likewise its treatment. We will expound the most important aspects of the entity at this present time.

  15. Echinacea purpurea and osteopathic manipulative treatment in children with recurrent otitis media: a randomized controlled trial.

    Science.gov (United States)

    Wahl, Richard A; Aldous, Michael B; Worden, Katherine A; Grant, Kathryn L

    2008-10-02

    Recurrent otitis media is a common problem in young children. Echinacea and osteopathic manipulative treatment have been proposed as preventive measures, but have been inadequately studied. This study was designed to assess the efficacy of Echinacea purpurea and/or osteopathic manipulative treatment (OMT) for prevention of acute otitis media in otitis-prone children. A randomized, placebo-controlled, two-by-two factorial trial with 6-month follow-up, conducted 1999 - 2002 in Tucson, Arizona. Patients were aged 12-60 months with recurrent otitis media, defined as three or more separate episodes of acute otitis media within six months, or at least four episodes in one year. Ninety children (44% white non-Hispanic, 39% Hispanic, 57% male) were enrolled, of which 84 had follow-up for at least 3 months. Children were randomly assigned to one of four protocol groups: double placebo, echinacea plus sham OMT, true OMT (including cranial manipulation) plus placebo echinacea, or true echinacea plus OMT. An alcohol extract of Echinacea purpurea roots and seeds (or placebo) was administered for 10 days at the first sign of each common cold. Five OMT visits (or sham treatments) were offered over 3 months. No interaction was found between echinacea and OMT. Echinacea was associated with a borderline increased risk of having at least one episode of acute otitis media during 6-month follow-up compared to placebo (65% versus 41%; relative risk, 1.59, 95% CI 1.04, 2.42). OMT did not significantly affect risk compared to sham (44% versus 61%; relative risk, 0.72, 95% CI 0.48, 1.10). In otitis-prone young children, treating colds with this form of echinacea does not decrease the risk of acute otitis media, and may in fact increase risk. A regimen of up to five osteopathic manipulative treatments does not significantly decrease the risk of acute otitis media. ClinicalTrials.gov Identifier: NCT00010465.

  16. Otitis media and its consequences : beyond the earache

    NARCIS (Netherlands)

    Vergison, Anne; Dagan, Ron; Arguedas, Adriano; Bonhoeffer, Jan; Cohen, Robert; DHooge, Ingeborg; Haberman, Alejandro; Liese, Johannes; Marchisio, Paola; Palmu, Arto A.; Ray, G. Thomas; Sanders, Elisabeth A. M.; Simoes, Eric A. F.; Uhari, Matti; van Eldere, Johan; Pelton, Stephen I.

    2010-01-01

    An international group of multidisciplinary experts on middle-ear and paediatric infections met to explore where consensus exists on the management of acute otitis media. After informal discussions among several specialists of paediatric infectious disease, the group was expanded to include a larger

  17. Serotype distribution of pneumococci isolated from pediatric patients with acute otitis media and invasive infections, and potential coverage of pneumococcal conjugated vaccines Distribución de serotipos de neumococos aislados de pacientes pediátricos con otitis media aguda e infecciones invasivas y su cobertura potencial a través de vacunas conjugadas

    Directory of Open Access Journals (Sweden)

    Vanesa Reijtman

    2013-03-01

    Full Text Available A 16-month prospective, descriptive study was conducted on pneumococcal serotype distribution isolated from children with acute otitis media (AÜM and invasive infections (INV. Eighty-nine children with pneumococcal INV and 324 with a first episode of AOM were included. Bacterial pathogens (N = 326 were isolated from the middle-ear fluid of 250 patients. A total of 30 pneumococcal serotypes were identified. Prevalent serotypes were 14, 19A, 9V, 3, 19F, 6A, 23F, and 18C in AOM and 14, 1, 19A, 5, 12F, 6B, and 18C in INV. Potential coverage with PCV10 vaccine would be 46.5 % and 60.7 % for pneumococci involved in AOM and INV, respectively; it would be 71.7 % and 73 % with PCV13. PCV10, conjugated with a Haemophilus protein, would have an immunologic coverage of 39.9 % for AOM vs. 18.5 % with PCV13. However, differences in the prevention of INV were crucial for the decision to include the 13-valent vaccine in the national calendar for children less than two years old in Argentina.Se realizó un estudio prospectivo descriptivo sobre la distribución de serotipos de neumococos aislados de niños con otitis media aguda (OMA y con infecciones invasivas (INV en un período de 16 meses. Se incluyeron 89 niños con INV neumocócicas y 324 con un primer episodio de OMA. Trescientos cuarenta y seis patógenos se aislaron de las secreciones de oído medio obtenidas de 250 pacientes. Se identificaron 30 serotipos y los más prevalentes fueron el 14, 19A, 9V, 3, 19F, 6A, 23F y 18C en OMA y el 14, 1, 19A, 5, 12F, 6B y 18C en INV. La cobertura potencial con la vacuna PCV10 sería de 46,5 % y 60,7 % para neumococos involucrados en OMA y en INV, respectivamente; con la PCV13, esta sería de 71,7 % y 73 %. La PCV10 conjugada con una proteína de Haemophilus tendría una cobertura inmunológica del 39,9 % para OMA, contra una cobertura del 18,5 % de la PCV13. Sin embargo, las diferencias en la prevención de INV fueron determinantes a la hora de considerar

  18. Comprehensive Proteomic and Metabolomic Signatures of Nontypeable Haemophilus influenzae-Induced Acute Otitis Media Reveal Bacterial Aerobic Respiration in an Immunosuppressed Environment.

    Science.gov (United States)

    Harrison, Alistair; Dubois, Laura G; St John-Williams, Lisa; Moseley, M Arthur; Hardison, Rachael L; Heimlich, Derek R; Stoddard, Alexander; Kerschner, Joseph E; Justice, Sheryl S; Thompson, J Will; Mason, Kevin M

    2016-03-01

    A thorough understanding of the molecular details of the interactions between bacteria and host are critical to ultimately prevent disease. Recent technological advances allow simultaneous analysis of host and bacterial protein and metabolic profiles from a single small tissue sample to provide insight into pathogenesis. We used the chinchilla model of human otitis media to determine, for the first time, the most expansive delineation of global changes in protein and metabolite profiles during an experimentally induced disease. After 48 h of infection with nontypeable Haemophilus influenzae, middle ear tissue lysates were analyzed by high-resolution quantitative two-dimensional liquid chromatography-tandem mass spectrometry. Dynamic changes in 105 chinchilla proteins and 66 metabolites define the early proteomic and metabolomic signature of otitis media. Our studies indicate that establishment of disease coincides with actin morphogenesis, suppression of inflammatory mediators, and bacterial aerobic respiration. We validated the observed increase in the actin-remodeling complex, Arp2/3, and experimentally showed a role for Arp2/3 in nontypeable Haemophilus influenzae invasion. Direct inhibition of actin branch morphology altered bacterial invasion into host epithelial cells, and is supportive of our efforts to use the information gathered to modify outcomes of disease. The twenty-eight nontypeable Haemophilus influenzae proteins identified participate in carbohydrate and amino acid metabolism, redox homeostasis, and include cell wall-associated metabolic proteins. Quantitative characterization of the molecular signatures of infection will redefine our understanding of host response driven developmental changes during pathogenesis. These data represent the first comprehensive study of host protein and metabolite profiles in vivo in response to infection and show the feasibility of extensive characterization of host protein profiles during disease. Identification of

  19. 上呼吸道感染引发小儿急性外耳道炎的临床研究%Clinical study of children's acute otitis externa caused by upper respiratory tract infections

    Institute of Scientific and Technical Information of China (English)

    肖英; 冶娟; 马新春

    2013-01-01

    目的 研究上呼吸道感染引发小儿急性外耳道炎的临床治疗效果,从而找到有效的治疗方案.方法 随机选择80例上呼吸道感染引发小儿急性外耳道炎患儿,按照不同的治疗方法分为观察组和对照组进行研究,每组各40例;观察组采用炎琥宁注射液治疗,对照组采用阿奇霉素注射液治疗,观察比较两组患者的疗效.结果 观察组的总有效率达95.0%,高于对照组的77.5%,治疗后患儿体温观察组为37.1℃,对照组为37.75℃,观察组的疗效比对照组有明显提高,差异有统计学意义(P<0.05);在治疗后的3d,观察组退热率为85.0%明显好于对照组的52.5%,两组比较差异有统计学意义(P<0.05).结论 及时采用炎琥宁注射液治疗上呼吸道感染引发的小儿急性外耳道炎有很好的疗效,值得临床推广.%OBJECTIVE To study the effect of the clinical treatment of children with acute otitis externa caused by upper respiratory tract infections so as to find an effective treatment program.METHODS A total of 80 children suffering from acute otitis externa which was caused by upper respiratory tract infections were randomly selected as the study objects and were divided into the observation group and the control group according to the various treatment methods with 40 cases in each; the observation group was treated with Yanhuning injection,while the control group received azithromycin injection; there was no significant difference between the two groups in terms of disease progression and basic conditions,which were not comparable,the clinical efficacy was observed and compared between the two groups.RESULTS The total effective rate of the observation group reached up to 95.0%,completely higher than 77.5% of the control group; the body temperature after the treatment was 37.1℃ in the observation group,significantly lower than 37.75 ℃ of the control group,the difference between the two groups was significant(P<0

  20. Occurrence of otitis media in children and assessment of treatment options.

    Science.gov (United States)

    Nwokoye, N N; Egwari, L O; Olubi, O O

    2015-08-01

    Otitis media is a more frequent occurrence in children, and the disease may progress from an acute to chronic state if appropriate and timely intervention is not initiated. A total of 212 children aged 6 months to 10 years were examined and treated for otitis media, in a 13-month hospital-based study. Acute otitis media was diagnosed in 130 (61.3 per cent) of the patients. There were 82 (38.7 per cent) chronic suppurative otitis media cases. The incidence of acute otitis media and chronic suppurative otitis media in the first year of life was 54.6 per cent and 45.1 per cent respectively. Chronic suppurative otitis media patients were assigned to one of three treatment groups. Recovery occurred in 70.4 per cent of amoxicillin-treated patients, in 88.9 per cent of amoxicillin-clavulanic acid treated patients and in 96.4 per cent of culture and antibiotic sensitivity test patients. Relapses were seen only in the amoxicillin (five cases) and amoxicillin-clavulanic acid (two cases) groups. The success rate in patients treated with antibiotics makes this option mandatory for an established diagnosis.

  1. Prevalence and associated risk factors of otitis media and its subtypes in South Indian population

    Directory of Open Access Journals (Sweden)

    Manche Santoshi Kumari

    2016-07-01

    Full Text Available Background: Otitis media is a common inflammatory disorder caused by the effusion of fluids or pathological changes in the tympanic membrane of middle ear that leads to hearing loss in all age groups which may be either temporary or permanent. Objective: The present study aimed to identify the risk factors responsible for the onset and progression of otitis media and its subtypes as well as its associated co-morbidities in the South Indian population. Subjects and methods: The study constituted 2602 subjects including children and adults affected with OM and the diagnosis was confirmed by ENT specialists using all the required otorhinolaryngological tests. The study was carried out by the institutional ethical clearance. The data were coded and evaluations were performed using the Statistical Package for Social Sciences, PASW STATISTICS 18.0 software (SPSS Inc., Chicago, IL, USA. Results: squamous-chronic suppurative otitis media was highly prevalent (47.3% followed by mucosal-chronic suppurative otitis media (18.5%, acute suppurative otitis media (17.6%, and otitis media with effusion (16.6%. The multinomial logistic regression analysis showed significant association of tinnitus with squamous-chronic suppurative otitis media; bilaterality, tinnitus and vertigo with mucosal-chronic suppurative otitis media while bilaterality, adenoids, tinnitus and snoring with otitis media with effusion. Significant differences were observed in different forms of hearing loss at higher frequency within the subtypes of otitis media. Conclusions: The study has revealed that otitis media predominantly affects all age groups and has a serious health concern in cases affected with hearing loss and its associated co-morbidities.

  2. [Malignant externa otitis: the modern principles of diagnostics and treatment].

    Science.gov (United States)

    Nikiforova, G N; Svistushkin, V M; Shevchik, A E; Zolotova, A V

    The objective of the present study was to elucidate the specific features of the clinical course of malignant externa otitis in the context of the present-day concepts. A total of 5 patients presenting with the confirmed diagnosis of malignant external otitis were available for the examination. The analysis of the clinical observations provided the basis for the characteristic of pathogenesis of this condition, diagnostic principles, and treatment modalities for the management of the pathology in question. It is concluded that the patients suffering from malignant externa otitis must remain under medical care and observation during a long period and the strategy for the treatment of each concrete patient should be chosen on an individual basis taking into consideration the presence of concomitant pathologies and their adequate therapy.

  3. Korean Clinical Practice Guidelines: Otitis Media in Children

    Science.gov (United States)

    Lee, Hyo-Jeong; Park, Su-Kyoung; Choi, Kyu Young; Park, Su Eun; Chun, Young Myung; Kim, Kyu-Sung; Park, Shi-Nae; Cho, Yang-Sun; Kim, Young-Jae

    2012-01-01

    Acute otitis media (AOM) and otitis media with effusion (OME) are common infections in children, and their diagnosis and treatment have significant impacts on the health of children and the costs of providing national medical care. In 2009, the Korean Otologic Society organized a committee composed of experts in the field of otolaryngology, pediatrics, and family medicine to develop Korean clinical practice guidelines (CPG) for otitis media in children with the goal of meeting regional medical and social needs in Korea. For this purpose, the committee adapted existing guidelines. A comprehensive literature review was carried out primarily from 2004 to 2009 using medical search engines including data from Korea. A draft was written after a national questionnaire survey and several public audits, and it was editorially supervised by senior advisors before publication of the final report. These evidence-based guidelines for the management of otitis media in children provide recommendations to primary practitioners for the diagnosis and treatment of children younger than 15 yr old with uncomplicated AOM and OME. The guidelines include recommendations regarding diagnosis, treatment options, prevention and parent education, medical records, referral, and complementary/alternative medicine for treating pediatric otitis media. PMID:22876048

  4. Korean clinical practice guidelines: otitis media in children.

    Science.gov (United States)

    Lee, Hyo-Jeong; Park, Su-Kyoung; Choi, Kyu Young; Park, Su Eun; Chun, Young Myung; Kim, Kyu-Sung; Park, Shi-Nae; Cho, Yang-Sun; Kim, Young-Jae; Kim, Hyung-Jong; Korean Otologic Society

    2012-08-01

    Acute otitis media (AOM) and otitis media with effusion (OME) are common infections in children, and their diagnosis and treatment have significant impacts on the health of children and the costs of providing national medical care. In 2009, the Korean Otologic Society organized a committee composed of experts in the field of otolaryngology, pediatrics, and family medicine to develop Korean clinical practice guidelines (CPG) for otitis media in children with the goal of meeting regional medical and social needs in Korea. For this purpose, the committee adapted existing guidelines. A comprehensive literature review was carried out primarily from 2004 to 2009 using medical search engines including data from Korea. A draft was written after a national questionnaire survey and several public audits, and it was editorially supervised by senior advisors before publication of the final report. These evidence-based guidelines for the management of otitis media in children provide recommendations to primary practitioners for the diagnosis and treatment of children younger than 15 yr old with uncomplicated AOM and OME. The guidelines include recommendations regarding diagnosis, treatment options, prevention and parent education, medical records, referral, and complementary/alternative medicine for treating pediatric otitis media.

  5. PRIMARY TUBERCULOSIS OTITIS MEDIA: CASE PRESENTATION AND REVIEW OF LITERATURE

    Directory of Open Access Journals (Sweden)

    Shankar

    2014-12-01

    Full Text Available : INTRODUCTION: Tuberculous otitis media is a rare cause of chronic suppurative infection of the middle ear and mastoid. The incidence of tuberculosis in the middle ear is very low and accounts for only 0.04% of all cases of chronic Suppurative otitis media. Its diagnosis is often delayed because it can easily be confused with other acute or chronic middle ear conditions, still the treatment of tuberculous otitis media is medical treatment with anti -tuberculous drugs and mastoid exploration if the temporal bone is involved and also to clear the disease from the middle ear cavity to avoid further complications. CASE PRESENTATION: A 21 year male patient presented with ear discharge, deafness and headache, diagnosed as primary tuberculous otitis media, treated with mastoidectomy and anti-tuberculous treatment. DISCUSSION: Primary tuberculous otitis media is very rare condition in adults, it is commonly seen in children which is also secondary to pulmonary tuberculosis / extra pulmonary tuberculosis the treatment of choice is anti tuberculous treatment for 06 months, surgery indicated to clear the disease from middle ear, temporal bone and to avoid further complications. CONCLUSION: Even though primary tuberculosis in middle ear and mastoid is very rare, the diagnosis is possible only with histological findings. In our case there was no signs of pulmonary / extra pulmonary tuberculosis, treated with mastoidectomy followed by anti - tuberculous treatment.

  6. Development of Animal Models of Otitis Media

    OpenAIRE

    Park, Moo Kyun; Lee, Byung Don

    2013-01-01

    Otitis media is defined as inflammation of the middle ear, including the auditory ossicles and the Eustachian tube. Otitis media is a major health problem in many societies. The causes of otitis media includes infection and anatomic/physiologic, host, and environmental factors. In general, otitis media is a childhood disease, and anatomic and physiologic changes have great effects on its development. Thus, in vitro or human experimental studies of otitis media are difficult. Several experimen...

  7. Acute otitis media——a common disease needs to be recognized profoundly%急性中耳炎--一种需要加深认识的常见病

    Institute of Scientific and Technical Information of China (English)

    董永绥; 钟瑞胜

    2001-01-01

    @@ 去过美国的同道们,一定会注意到,在那里的儿科医师们常随身携带窥耳镜,遇到发热的小儿,必对其检查双侧耳道,以发现有无急性中耳炎(acute otitis media,AOM)存在.笔者认为,他们这样做至少有2个原因:(1)因为在美国,过去的20年中,因中耳炎就诊儿科的人数从1975年的990万例次升至1990年的2450万例次;AOM发生率很高,近乎2/3的3岁以前小儿至少患过1次AOM,50%的儿童患过2次或更多次;(2)AOM可有各种不同的并发症,以丧失听力最常见.幼小儿童可因此而影响认知、语言和情感的正常发育[1].

  8. Role of a proprietary propolis-based product on the wait-and-see approach in acute otitis media and in preventing evolution to tracheitis, bronchitis, or rhinosinusitis from nonstreptococcal pharyngitis

    Science.gov (United States)

    Di Pierro, Francesco; Zanvit, Alberto; Colombo, Maria

    2016-01-01

    Antipyretics and/or anti-inflammatory drugs along with a wait-and-see approach are the only treatments recommended in early acute otitis media (AOM) or viral pharyngitis. Propolis has been widely investigated for its antibacterial, antiviral, and anti-inflammatory properties and could perhaps be administered as an add-on therapy during watchful waiting in AOM or for better control of symptoms in nonstreptococcal pharyngitis. However, propolis has well-known problems of poor solubility and low oral bioavailability. We therefore analyzed a proprietary propolis-based product (Propolisina®) developed to overcome these limitations, in a retrospective, open-label, controlled study of Streptococcus pyogenes-negative children with a diagnosis of AOM or pharyngitis. Our results show that the use of propolis supplement for 72 hours lessens the severity of AOM and viral pharyngitis, reduces the use of antipyretics and anti-inflammatory drugs, and decreases the rate of evolution to tracheitis, bronchitis, and rhinosinusitis. Our study shows that propolis could be used as a safe add-on therapy in case of AOM and/or viral pharyngitis. PMID:27956842

  9. Role of a proprietary propolis-based product on the wait-and-see approach in acute otitis media and in preventing evolution to tracheitis, bronchitis, or rhinosinusitis from nonstreptococcal pharyngitis

    Directory of Open Access Journals (Sweden)

    Di Pierro F

    2016-11-01

    Full Text Available Francesco Di Pierro,1 Alberto Zanvit,2 Maria Colombo3 1Scientific Department, Velleja Research, 2Biological Dentistry Department, Italian Stomatology Institute, 3ATS, District 5, Milan, Italy Abstract: Antipyretics and/or anti-inflammatory drugs along with a wait-and-see approach are the only treatments recommended in early acute otitis media (AOM or viral pharyngitis. Propolis has been widely investigated for its antibacterial, antiviral, and anti-inflammatory properties and could perhaps be administered as an add-on therapy during watchful waiting in AOM or for better control of symptoms in nonstreptococcal pharyngitis. However, propolis has well-known problems of poor solubility and low oral bioavailability. We therefore analyzed a proprietary propolis-based product (Propolisina® developed to overcome these limitations, in a retrospective, open-label, controlled study of Streptococcus pyogenes-negative children with a diagnosis of AOM or pharyngitis. Our results show that the use of propolis supplement for 72 hours lessens the severity of AOM and viral pharyngitis, reduces the use of antipyretics and anti-inflammatory drugs, and decreases the rate of evolution to tracheitis, bronchitis, and rhinosinusitis. Our study shows that propolis could be used as a safe add-on therapy in case of AOM and/or viral pharyngitis. Keywords: pediatric infections, cogrinding, bioavailability, propolis

  10. Role of a proprietary propolis-based product on the wait-and-see approach in acute otitis media and in preventing evolution to tracheitis, bronchitis, or rhinosinusitis from nonstreptococcal pharyngitis.

    Science.gov (United States)

    Di Pierro, Francesco; Zanvit, Alberto; Colombo, Maria

    2016-01-01

    Antipyretics and/or anti-inflammatory drugs along with a wait-and-see approach are the only treatments recommended in early acute otitis media (AOM) or viral pharyngitis. Propolis has been widely investigated for its antibacterial, antiviral, and anti-inflammatory properties and could perhaps be administered as an add-on therapy during watchful waiting in AOM or for better control of symptoms in nonstreptococcal pharyngitis. However, propolis has well-known problems of poor solubility and low oral bioavailability. We therefore analyzed a proprietary propolis-based product (Propolisina(®)) developed to overcome these limitations, in a retrospective, open-label, controlled study of Streptococcus pyogenes-negative children with a diagnosis of AOM or pharyngitis. Our results show that the use of propolis supplement for 72 hours lessens the severity of AOM and viral pharyngitis, reduces the use of antipyretics and anti-inflammatory drugs, and decreases the rate of evolution to tracheitis, bronchitis, and rhinosinusitis. Our study shows that propolis could be used as a safe add-on therapy in case of AOM and/or viral pharyngitis.

  11. Acute tryptophan depletion attenuates brain-heart coupling following external feedback

    Directory of Open Access Journals (Sweden)

    Erik M Mueller

    2012-04-01

    Full Text Available External and internal performance feedback triggers neural and visceral modulations such as reactions in the medial prefrontal cortex and insulae or changes of heart period (HP. The functional coupling of neural and cardiac responses following feedback (cortico-cardiac connectivity is not well understood. While linear time-lagged within-subjects correlations of single-trial EEG and HP (cardio-electroencephalographic covariance-tracing, CECT indicate a robust negative coupling of EEG magnitude 300 ms after presentation of an external feedback stimulus with subsequent alterations of heart period (the so-called N300H phenomenon, the neurotransmitter systems underlying feedback-evoked cortico-cardiac connectivity are largely unknown. Because it has been shown that acute tryptophan depletion (ATD, attenuating brain serotonin (5-HT, decreases cardiac but not neural correlates of feedback processing, we hypothesized that 5-HT may be involved in feedback-evoked cortico-cardiac connectivity. In a placebo-controlled double-blind crossover design, twelve healthy participants received a tryptophan-free amino-acid drink at one session and a balanced amino-acid control-drink on another and twice performed a time-estimation task with feedback presented after each trial. N300H magnitude and plasma tryptophan levels were assessed. Results indicated a robust N300H after the control drink, which was significantly attenuated following ATD. Moreover, plasma tryptophan levels during the control session were correlated with N300H amplitude such that individuals with lower tryptophan levels showed reduced N300H. Together, these findings indicate that 5-HT is important for feedback-induced covariation of cortical and cardiac activity. Because individual differences in anxiety have previously been linked to 5-HT, cortico-cardiac coupling and feedback processing, the present findings may be particularly relevant for futures studies linking 5-HT to anxiety.

  12. Childhood otitis media is associated with dizziness in adulthood: the HUNT cohort study.

    Science.gov (United States)

    Aarhus, Lisa; Tambs, Kristian; Hoffman, Howard J; Engdahl, Bo

    2016-08-01

    The objective of the study was to examine the association between otitis media in childhood and dizziness in adulthood. Longitudinal, population-based cohort study of 21,962 adults (aged 20-59 years, mean 40) who completed a health questionnaire in the Nord-Trøndelag Hearing Loss Study was conducted. At 7, 10 and 13 years of age, the same individuals underwent screening audiometry in a longitudinal school hearing investigation. Children found with hearing loss underwent an ear, nose and throat specialist examination. Adults diagnosed with childhood chronic suppurative otitis media (n = 102) and childhood hearing loss after recurrent acute otitis media (n = 590) were significantly more likely to have increased risk of reported dizziness when compared to adults with normal hearing as children at the school investigation and also a negative history of recurrent otitis media (n = 21,270), p otitis media and childhood hearing loss after recurrent acute otitis media are associated with increased risk of dizziness in adulthood. This might reflect a permanent effect of inflammatory mediators or toxins on the vestibular system. The new finding stresses the importance of treatment and prevention of these otitis media conditions.

  13. Occurrence of Malassezia species in Persian and domestic short hair cats with and without otitis externa.

    Science.gov (United States)

    Shokri, Hojjatollah; Khosravi, Alireza; Rad, Mohammadali; Jamshidi, Shahram

    2010-03-01

    The yeasts of the Malassezia genus are opportunistic microorganisms in the skin and auricular canal of human and animals, mainly cats, and can cause otitis externa and dermatitis disorders. The aim of this study was to evaluate the occurrence of different species of Malassezia in the external ear canal of cats with and without otitis externa. Thirty-one normal cats and 82 animals with otitis externa were clinically examined. Sterile cotton swabs were used to collect specimens from the external ear canal and streaked onto the surface of Sabouraud dextrose agar (SDA) and modified Dixon agar. Malassezia yeasts were isolated from 95.1% and 48.4% of the cats with and without otitis externa, respectively. The rate of isolation in affected animals versus normals was highly significant (Potitis, 57.7% were identified as M. pachydermatis (with significant frequency; Potitis externa can be associated with lipid-dependent Malassezia species in addition to the non lipid- dependent species M. pachydermatis.

  14. Temporal bone CT findings of tuberculous otitis media : comparison with chronic otitis media

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Jeong A; Rho, Myung Ho; Kim, Young Min; Lee, Ho Seung; Choi, Pil Yeob; Seong, Young Soon; Kwon, Jae Soo; Lee, Sang Wook [Masan Samsung Hospital, Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of); Jung, Keon Sik [Pohang Sunrin Hospital, Pohang (Korea, Republic of)

    1999-06-01

    To compare the differential findings of tuberculous otitis media(TOM) with those of chronic sup purative otitis media with or without cholesteatoma, as seen on high resolution temporal bone CT. We retrospectively reviewed 14 cases of TOM, 30 cases of chronic suppurative otitis media(CSOM), and 30 cases of chronic otitis media with cholesteatoma(Chole). All had been pathologically confirmed. We evaluated the preservation of mastoid cells without sclerotic change, the location and extension of soft tissue to the external auditary canal, and erosion of ossicles, the tegmen tympani, scutum, bony labyrinth, facial nerve canal and sigmoid sinus, and the presence of intracranial complications. Soft tissue in the mastoid antrum was seen in all cases of TOM(100%), 29 cases of CSOM(96.7%), and 26 cases of Chole(86.7%). In contrast, the soft tissue in the entire middle ear cavity was noted in 13 cases of TOM(92.8%), 7 cases of CSOM(23.3%), and 12 cases of Chole(40%). Soft tissue extended to the superior aspect of the external auditory canal in 4 cases of TOM (28.6%) and 5 cases of Chole (16.7%). Mastoid air cells were seen in 9 cases of TOM (64.3%), 4 cases of CSOM (13.3%), and 3 cases of Chole(10%). Ossicular erosion was noted in 6 cases of TOM (42.9%), 12 cases of CSOM (40%), and 26 cases of Chole(86.7%), while in one case of TOM (7.1%), 5 cases of CSOM (16.7%), and 15 cases of Chole(50%) there was erosion of the scutum. In one case of TOM, follow-up CT study after 9 months of antituberculous medication without surgery revealed complete clearing of previously noted soft tissue in the middle ear cavity. Specific CT findings of TOM were not seen, but if there were findings of soft tissue in the entire middle ear cavity, soft tissue extension to the external auditory canal, preservation of mastoid air cells without sclerotic change, and intact scutum, TOM may be differentiated from other chronic otitis media.

  15. Otitis externa maligna

    OpenAIRE

    2014-01-01

    La otitis externa maligna es una enfermedad cuyo diagnóstico y tra- tamiento supone un reto para cualquier especialista. Es una infección severa que afecta al conducto auditivo externo (óseo/cartilaginoso) y a los tejidos blandos adyacentes. Suele afectar a pacientes inmuno- comprometidos y la diabetes mellitus es condición asociada hasta en 65% de los casos. En la mayoría de los casos el agente causal es la Pseudomonas aeruginosa. El diagnóstico debe basarse en historia clínica y exploración...

  16. Single photon emission computed tomography/computed tomography of the skull in malignant otitis externa.

    Science.gov (United States)

    Chakraborty, Dhritiman; Bhattacharya, Anish; Kamaleshwaran, Koramadai Karuppusamy; Agrawal, Kanhaiyalal; Gupta, Ashok Kumar; Mittal, Bhagwant Rai

    2012-01-01

    Malignant otitis externa is a severe, rare infective condition of the external auditory canal and skull base. The diagnosis is generally made from a range of clinical, laboratory, and imaging findings. Technetium 99m methylene diphosphonate bone scintigraphy is known to detect osteomyelitis earlier than computed tomography. The authors present a patient with bilateral malignant otitis externa where the extent of skull base involvement was determined on 3-phase bone scintigraphy with single photon emission computed tomography/computed tomography.

  17. Danish guidelines on management of otitis media in preschool children.

    Science.gov (United States)

    Heidemann, C H; Lous, J; Berg, J; Christensen, J J; Håkonsen, S J; Jakobsen, M; Johansen, C J; Nielsen, L H; Hansen, M P; Poulsen, A; Schousboe, L P; Skrubbeltrang, C; Vind, A B; Homøe, P

    2016-08-01

    Otitis media is one of the most common diseases in small children. This underlines the importance of optimizing diagnostics and treatment of the condition. Recent literature points toward a stricter approach to diagnosing acute otitis media (AOM). Moreover, ventilating tube treatment for recurrent AOM (RAOM) and chronic otitis media with effusion (COME) has become the most frequently performed surgical procedure in pre-school children. Therefore, the Danish Health and Medicines Authority and the Danish Society of Otorhinolaryngology, Head and Neck Surgery deemed it necessary to update the Danish guidelines regarding the diagnostic criteria for acute otitis media and surgical treatment of RAOM and COME. The GRADE system (The Grading of Recommendations Assessment, Development and Evaluation) was used in order to comply with current standards of evidence assessment in formulation of recommendations. An extensive literature search was conducted between July and December 2014. The quality of the existing literature was assessed using AGREE II (Appraisal of Guidelines for Research & Evaluation), AMSTAR (assessing the Methodological Quality of Systematic Reviews), QUADAS-2 (Quality of Diagnostic Accuracy Studies), Cochrane Risk of Bias Tool for randomized trials and ACROBAT-NRSI (A Cochrane Risk of Bias Assessment Tool for Non-Randomized Studies). The working group consisted of otolaryngologists, general practitioners, pediatricians, microbiologists and epidemiologists. Recommendations for AOM diagnosis, surgical management for RAOM and COME, including the role of adenoidectomy and treatment of ventilating tube otorrhea, are proposed in the guideline. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Otitis externa por Demodex cati

    OpenAIRE

    L. Real; Ortuñez, A.; Verde Arribas, Mª T.; Navarro, L.; Vilela, C

    2010-01-01

    La demodicosis por Demodex cati es una enfermedad parasitaria poco común que se presenta bajo tres formas clínicas: generalizada, localizada y otitis externa ceruminosa u otodemodicosis. El objetivo de esta comunicación es presentar dos casos clínicos de otitis ceruminosa causada por D.cati sin la presencia de otros síntomas cutáneos.

  19. Acute effects of dynamic stretching exercise on power output during concentric dynamic constant external resistance leg extension

    OpenAIRE

    YAMAGUCHI, TAICHI; Ishii, Kojiro; Yamanaka, Masanori; YASUDA, KAZUNORI

    2007-01-01

    AbstractThe purpose of the present study was to clarify the acute effect of dynamic stretching exercise on muscular performance during concentric dynamic constant external resistance (DCER, formally called isotonic) muscle actions under various loads. Concentric DCER leg extension power outputs were measured in 12 healthy male students after 2 types of pretreatment. The pre- treatments were: (a) dynamic stretching treatment including 2 types of dynamic stretching exercises of leg extensors an...

  20. Bacterial Interference in Nasopharyngeal Bacterial Flora of Otitis-prone and Non-otitis-prone Children

    NARCIS (Netherlands)

    J.M. Bernstein; S. Sagahtaheri-ALtaie; D.M. Dryja; J. Wactawski-Wende

    1994-01-01

    textabstractThe quantitative bacteriology of the adenoid was studied in 34 otitis-prone and 25 non-otitis prone children. Viridans streptococci appeared to be the predominant normal flora in children who are non-otitis prone. There was a significant decrease in viridans streptococci in the otitis-pr

  1. Otitis externa: a practical guide to treatment and prevention.

    Science.gov (United States)

    Sander, R

    2001-03-01

    Otitis externa is most commonly caused by infection (usually bacterial, although occasionally fungal), but it may also be associated with a variety of noninfectious systemic or local dermatologic processes. The most characteristic symptom is discomfort that is limited to the external auditory canal, while the most characteristic signs are erythema and swelling of the canal with variable discharge. Excessive moisture and trauma, both of which impair the canal's natural defenses, are the two most common precipitants of otitis externa, and avoidance of these precipitants is the cornerstone of prevention. Thorough cleansing of the canal is essential for diagnosis and treatment, but flushing should be avoided. Acidification with a topical solution of 2 percent acetic acid combined with hydrocortisone for inflammation is effective treatment in most cases and, when used after exposure to moisture, is an excellent prophylactic. Other prophylactic measures such as drying the ears with a hair dryer and avoiding manipulation of the external auditory canal may help prevent recurrence.

  2. Decline in antibiotic resistance and changes in the serotype distribution of Streptococcus pneumoniae isolates from children with acute otitis media; a 2001-2011 survey by the French Pneumococcal Network.

    Science.gov (United States)

    Kempf, M; Varon, E; Lepoutre, A; Gravet, A; Baraduc, R; Brun, M; Chardon, H; Cremniter, J; Croizé, J; Dalmay, F; Demachy, M-C; Fosse, T; Grelaud, C; Hadou, T; Hamdad, F; Koeck, J-L; Luce, S; Mermond, S; Patry, I; Péchinot, A; Raymond, J; Ros, A; Segonds, C; Soullié, B; Tandé, D; Vergnaud, M; Vernet-Garnier, V; Wallet, F; Gutmann, L; Ploy, M-C; Lanotte, P

    2015-01-01

    Streptococcus pneumoniae is an important cause of acute otitis media (AOM). The aim of this study was to evaluate trends in antibiotic resistance and circulating serotypes of pneumococci isolated from middle ear fluid of French children with AOM during the period 2001-2011, before and after the introduction of the PCV-7 (2003) and PCV-13 (2010) vaccines. Between 2001 and 2011 the French pneumococcal surveillance network analysed the antibiotic susceptibility of 6683 S. pneumoniae isolated from children with AOM, of which 1569 were serotyped. We observed a significant overall increase in antibiotic susceptibility. Respective resistance (I+R) rates in 2001 and 2011 were 76.9% and 57.3% for penicillin, 43.0% and 29.8% for amoxicillin, and 28.6% and 13.0% for cefotaxime. We also found a marked reduction in vaccine serotypes after PCV-7 implementation, from 63.0% in 2001 to 13.2% in 2011, while the incidence of the additional six serotypes included in PCV-13 increased during the same period, with a particularly high proportion of 19A isolates. The proportion of some non-PCV-13 serotypes also increased between 2001 and 2011, especially 15A and 23A. Before PCV-7 implementation, most (70.8%) penicillin non-susceptible pneumococci belonged to PCV-7 serotypes, whereas in 2011, 56.8% of penicillin non-susceptible pneumococci belonged to serotype 19A. Between 2001 and 2011, antibiotic resistance among pneumococci responsible for AOM in France fell markedly, and PCV-7 serotypes were replaced by non-PCV-7 serotypes, especially 19A. We are continuing to assess the impact of PCV-13, introduced in France in 2010, on pneumococcal serotype circulation and antibiotic resistance.

  3. Association of Dermatological Conditions of External Ear with the Use of Cotton Buds

    Directory of Open Access Journals (Sweden)

    Salahuddin Ahmed

    2014-09-01

    Full Text Available Background: The habit of cleaning the external auditory canal with cotton buds is a common practice of the masses. It has strong association with neurodermatitis and contact dermatitis of the external ear. It is also associated with acute otitis externa, rupture of tympanic membrane causing bleeding and temporary hearing loss in some cases. In many cases the injury will heal but damage to minuscule bones deep inside the ear can cause permanent deafness. Objective: The objective of this study was to determine the association of dermatological condition of external ear with the use of cotton buds. Materials and Methods: This case control study was done from January to October 2012 in the Ear Nose Throat Department of Pakistan Level III Hospital, Darfur, Sudan. Sixty seven patients with dermatological diseases of external ear were cases and 83 subjects without dermatological diseases of external ear were selected as controls. Results: Among 67 cases, 58 were cotton bud users and among 83 controls only 29 were cotton bud users. Different types of dermatological diseases were neurodermatitis (34.32%, otitis externa (28.36%, contact dermatitis (26.87% and wax impaction (8.95%. Ninety three percent of cotton bud users were ignorant of harmful effects of this bad habit. Conclusion: There is a strong association of dermatological diseases of external ear with the use of cotton bud which should be discouraged by fortifying the warning by manufacturers and health education at various educational levels.

  4. Malignant otitis externa with bilateral cranial nerve involvement: Report of a unique case

    Directory of Open Access Journals (Sweden)

    Somnath Saha

    2013-01-01

    Full Text Available Malignant otitis externa is an inflammatory condition caused by pseudomonas infection usually in the elderly diabetics, or an immunosuppressive condition that presents with diffuse otitis externa along with excruciating pain and granulations tissue in the external auditory meatus. Facial paralysis is common along with occasional involvement of other cranial nerves. Case report describing a patient of malignant otitis externa who presented to a tertiary referral hospital of eastern India. This patient had ipsilateral facial and tenth cranial nerve paralysis along with delayed-onset contralateral sixth and twelfth cranial nerve palsy. The patient was treated initially with intravenous anti-pseudomonal antibody followed by tympanic platectomy, facial nerve decompression and medialisation thyroplasty. The contralateral cranial nerve palsy was managed conservatively with partial recovery of function. Malignant otitis externa, though a common disease, may occasionally present with uncommon or unexplained presentations. The management of these cases should be prompt and aggressive and specifically address each of the debilitating complications.

  5. Racial and familial factors in otitis media. A point prevalence study on Easter Island.

    Science.gov (United States)

    Goycoolea, H G; Goycoolea, M V; Farfan, C R

    1988-02-01

    Of the 249 children aged 5 to 9 years who live on Easter Island, 220 underwent complete otolaryngological evaluation. Twenty children were found to have otitis media (acute, chronic, or both). Three of these children were genetically impure natives, nine were of mixed parentage, and eight were "continentals" (with a birth origin other than the island). None of the genetically pure natives had otitis media. Our data show that, in a population with all factors in common except for familial and racial background, the point prevalence of otitis media is higher in children of mixed or continental origin than in genetically pure native children. The high prevalence of otitis media in children of mixed parentage and in one particular family of European ancestry suggests the presence of intrinsic or pronicity factors that are seemingly transmissible.

  6. Prevention of otitis media: now a reality?

    Science.gov (United States)

    Schuerman, Lode; Borys, Dorota; Hoet, Bernard; Forsgren, Arne; Prymula, Roman

    2009-09-25

    Acute otitis media (AOM), one of the most common childhood diseases, is associated with a substantial medical, social and economic burden. Non-typeable Haemophilus influenzae (NTHi) and Streptococcus pneumoniae are the two main causes of bacterial OM. The 7-valent pneumococcal CRM(197)-conjugate vaccine (7vCRM, Prevnar/Prevenar, Wyeth) demonstrated efficacy against AOM caused by vaccine pneumococcal serotypes. Protection against overall AOM was also observed with an 11-valent pneumococcal protein D-conjugate vaccine (11Pn-PD) in the Pneumococcal Otitis Efficacy Trial (POET). Following POET, an optimized 10-valent pneumococcal non-typeable H. influenzae protein D-conjugate vaccine (PHiD-CV; Synflorix, GlaxoSmithKline Biologicals) was developed. This vaccine includes serotypes 1, 5, and 7F, in addition to those already included in 7vCRM, and was recently licensed in Europe for active immunization against invasive disease and AOM caused by S. pneumoniae in infants and children from 6 weeks up to 2 years of age. The use of protein D as carrier protein permits avoidance of possible interferences known to occur with some conjugate vaccines, and has the added potential benefit of providing protection against NTHi. This review seeks to highlight the recent advances in the field of OM vaccination, with a focus on data regarding the recently licensed PHiD-CV.

  7. Malignant otitis externa in a healthy non-diabetic patient.

    Science.gov (United States)

    Liu, Xiao-Long; Peng, Hong; Mo, Ting-Ting; Liang, Yong

    2016-08-01

    A healthy 60-year-old male was initially treated for external otitis, and subsequently received multiple surgeries including abscess drainage, temporal bone debridement, canaloplasty of the external auditory meatus, and fistula excision and was treated with numerous antibiotics at another hospital over a 1-year period. He was seen at our hospital on February 14, 2014 with a complaint of a non-healing wound behind the left ear and drainage of purulent fluid. He had no history of diabetes mellitus or compromised immune function. Computed tomography (CT) and magnetic resonance imaging (MRI) studies at our hospital showed osteomyelitis involving the left temporal, occipital, and sphenoid bones, the mandible, and an epidural abscess. Routine blood testing and tests of immune function were normal, and no evidence of other infectious processes was found. He was diagnosed with malignant otitis externa (MOE). Bone debridement and incision and drainage of the epidural abscess were performed, and vancomycin was administered because culture results revealed Corynebacterium jeikeium, Corynebacterium xerosis, and Enterococcus faecalis. MOE should be considered in healthy patients with external otitis who fail initial treatment.

  8. Frequent carriage of resistance mechanisms to beta-lactams and biofilm formation in Haemophilus influenzae causing treatment failure and recurrent otitis media in young children

    NARCIS (Netherlands)

    Garcia-Cobos, Silvia; Moscoso, Miriam; Pumarola, Felix; Arroyo, Margarita; Lara, Noelia; Perez-Vazquez, Maria; Aracil, Belen; Oteo, Jesus; Garcia, Ernesto; Campos, Jose

    2014-01-01

    Objectives: Non-typeable Haemophilus influenzae are a major cause of acute otitis media (AOM), including chronic and recurrent otitis in young children. The objective of this study was to determine whether non-typeable H. influenzae isolates causing these infections produce biofilms and carry resist

  9. Cefaclor in Children with Acute Otitis Media and Amoxicillin and Clavulanate Potassium Contrast Analysis%头孢克洛和阿莫西林克拉维酸钾用于儿童急性中耳炎治疗的对比分析

    Institute of Scientific and Technical Information of China (English)

    谢寒冰

    2014-01-01

    Objective Comparison of acute otitis media in children with application of cefaclor and amoxicil in and clavulanate potassium two kinds of the clinical ef icacy of drug treatment. Methods From March 2011 to February 2013 treated 120 cases of children with acute otitis media in this study, random grouping. Children with the control group given amoxicil in and clavulanate potassium therapy, cefaclor treatment group. compared with two groups of children always show the dif erences of ef iciency and adverse reactions. Results After treatment, we found that the experimental group after treatment with total total ef iciency was 93.33%, control group the total ef iciency of 88.33%, dif erences between groups have no statistical significance ( >0.05). Experimental group the incidence of adverse reactions was 0%, the control group, the incidence of adverse reactions was 10.0%between groups was statistical y significant dif erence ( 0.05)。实验组不良反应发生率为0%,对照组不良反应发生率为10.0%,组间差异有统计学意义(P<0.05)。结论采用头孢克洛和阿莫西林克拉维酸钾两种药物治疗儿童急性中耳炎,可将其在临床进行推广应用。

  10. Tuberculous otitis media: a resurgence?

    Science.gov (United States)

    Kameswaran, M; Natarajan, K; Parthiban, M; Krishnan, P V; Raghunandhan, S

    2017-09-01

    Tuberculosis is a global health problem that is especially prevalent in developing countries such as India. Recently, atypical presentation has become more common and a high index of suspicion is essential. This study analysed the various presenting symptoms and signs of tuberculous otitis media and the role of diagnostic tests, with the aim of formulating criteria for the diagnosis. A total of 502 patients underwent tympanomastoidectomy over a two-year period. Microbiological and histopathological examinations and polymerase chain reaction analysis of tissue taken during tympanomastoidectomy were performed. A total of 25 patients (5 per cent) were diagnosed with tuberculous otitis media. Severe mixed hearing loss, facial palsy, labyrinthine fistula, post-aural fistula, perichondritis and extradural abscess were noted. There seems to be a resurgence in tuberculous otitis media in India. Microbiological, histopathological and polymerase chain reaction tests for tuberculosis are helpful for its diagnosis.

  11. Pediatric otitis media in Fiji: Survey findings 2015.

    Science.gov (United States)

    Fang, Te-Yung; Rafai, Eric; Wang, Pa-Chun; Bai, Chiy-Huey; Jiang, Peng-Long; Huang, Shu-Nuan; Chen, You-Ju; Chao, Yi-Ting; Wang, Chen-Hsu; Chang, Chia-Hsiu

    2016-06-01

    Otitis media (OM), as a common infectious disease, is a major cause of hearing impairment among the general population. OM remains a major public health threat in the Pacific islands, but the risks of OM have not been thoroughly explored in this region. The objective of this study is to investigate the prevalence, clinical features, and quality-of-life impacts of OM in Fiji. In the medical service trip entitled "Healing and Hope - Taiwan Cathay Heart and Hearing Medical Mission to Fiji" (TCHHMMF), we conducted a cross-sectional OM survey study in Suva and Sigatoka areas (Korolevu, Cuvu, and Lomawai) in the summer of 2015. The otitis media - 6 (OM-6) was used to survey the OM-related quality of life. In the 467 pediatric patients (aged 0-18 years old) screened, 13 (2.78%) have acute otitis media (AOM), 37 (7.92%) have otitis media with effusion (OME), and 19 (4.1%) have chronic otitis media (COM). Age (OR 0.53, 95% CI: 0.36-0.77) is a significant predictor of AOM, whereas male gender (OR 2.46, 95% CI: 1.13-5.37), smoke exposure (OR 2.81, 95% CI: 1.01-7.82), and concomitant chronic sinusitis (OR 6.05, 95% CI: 2.31-15.88) are significant predictors of OME. The mean OM-6 item scores are highest in caregiver concerns (3.8), physical suffering (3.7), and hearing loss (3.4) domains. OM is an important primary care disease in Fiji that remains under-served. It is critical to educate professionals, parents, and patients to detect and to improve care for OM. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. Single photon emission computed tomography/computed tomography for malignant otitis externa: lesion not shown on planar image.

    Science.gov (United States)

    Chen, Yu-Hung; Hsieh, Hung-Jen

    2013-01-01

    Malignant otitis externa is a severe and rare infection of the external acoustic meatus. Triphasic bone and (67)Ga scintigraphies are used to initial detect and follow-up the response of therapy. With single photon emission computed tomography/computed tomography images, the diagnostic sensitivity is higher. We presented a case with malignant otitis externa with initial negative planar scintigraphic finding. The lesion was detected by photon emission computed tomography/computed tomography images. We concluded that the photon emission computed tomography/computed tomography should be performed routinely for patients with suspected malignant otitis externa, even without evidence of lesion on planar images.

  13. Echinacea purpurea and osteopathic manipulative treatment in children with recurrent otitis media: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Worden Katherine A

    2008-10-01

    Full Text Available Abstract Background Recurrent otitis media is a common problem in young children. Echinacea and osteopathic manipulative treatment have been proposed as preventive measures, but have been inadequately studied. This study was designed to assess the efficacy of Echinacea purpurea and/or osteopathic manipulative treatment (OMT for prevention of acute otitis media in otitis-prone children. Methods A randomized, placebo-controlled, two-by-two factorial trial with 6-month follow-up, conducted 1999 – 2002 in Tucson, Arizona. Patients were aged 12–60 months with recurrent otitis media, defined as three or more separate episodes of acute otitis media within six months, or at least four episodes in one year. Ninety children (44% white non-Hispanic, 39% Hispanic, 57% male were enrolled, of which 84 had follow-up for at least 3 months. Children were randomly assigned to one of four protocol groups: double placebo, echinacea plus sham OMT, true OMT (including cranial manipulation plus placebo echinacea, or true echinacea plus OMT. An alcohol extract of Echinacea purpurea roots and seeds (or placebo was administered for 10 days at the first sign of each common cold. Five OMT visits (or sham treatments were offered over 3 months. Results No interaction was found between echinacea and OMT. Echinacea was associated with a borderline increased risk of having at least one episode of acute otitis media during 6-month follow-up compared to placebo (65% versus 41%; relative risk, 1.59, 95% CI 1.04, 2.42. OMT did not significantly affect risk compared to sham (44% versus 61%; relative risk, 0.72, 95% CI 0.48, 1.10. Conclusion In otitis-prone young children, treating colds with this form of echinacea does not decrease the risk of acute otitis media, and may in fact increase risk. A regimen of up to five osteopathic manipulative treatments does not significantly decrease the risk of acute otitis media. Trial registration ClinicalTrials.gov Identifier: NCT00010465

  14. Epidemiology, natural history, and risk factors: panel report from the Ninth International Research Conference on Otitis Media

    DEFF Research Database (Denmark)

    Daly, Kathleen A; Hoffman, Howard J; Kvaerner, Kari Jorunn

    2010-01-01

    The 2007 Recent Advances in Otitis Media Research Conference Panel Report provides an update on otitis media (OM) research published from 2003 to 2007. This report summarizes important trends in disease incidence and prevalence, describes established and newly identified risk factors for acute an...... vaccine in infants. The panel report also recommends short and long term goals for current and future OM research.......The 2007 Recent Advances in Otitis Media Research Conference Panel Report provides an update on otitis media (OM) research published from 2003 to 2007. This report summarizes important trends in disease incidence and prevalence, describes established and newly identified risk factors for acute...... and chronic OM and OM with effusion, and conveys information on newly discovered genetic factors. In this report, researchers have described declining rates of OM diagnosis, antibiotic prescriptions, offices visits for OM, and middle ear surgery since the licensure and routine use of pneumococcal conjugate...

  15. Epidemiology, natural history, and risk factors: panel report from the Ninth International Research Conference on Otitis Media

    DEFF Research Database (Denmark)

    Daly, Kathleen A; Hoffman, Howard J; Kvaerner, Kari Jorunn

    2010-01-01

    The 2007 Recent Advances in Otitis Media Research Conference Panel Report provides an update on otitis media (OM) research published from 2003 to 2007. This report summarizes important trends in disease incidence and prevalence, describes established and newly identified risk factors for acute an...... vaccine in infants. The panel report also recommends short and long term goals for current and future OM research.......The 2007 Recent Advances in Otitis Media Research Conference Panel Report provides an update on otitis media (OM) research published from 2003 to 2007. This report summarizes important trends in disease incidence and prevalence, describes established and newly identified risk factors for acute...... and chronic OM and OM with effusion, and conveys information on newly discovered genetic factors. In this report, researchers have described declining rates of OM diagnosis, antibiotic prescriptions, offices visits for OM, and middle ear surgery since the licensure and routine use of pneumococcal conjugate...

  16. Clinical analysis of children with acute otitis media complicated with upper respiratory infection%儿童上呼吸道感染并发急性中耳炎96例临床分析

    Institute of Scientific and Technical Information of China (English)

    徐玉珍; 刘诗强; 庄丽宝; 阮善

    2004-01-01

    目的为了解目前儿童上呼吸道感染并发急性中耳炎(acute otitis media AOM)的情况,分析我院2002年诊治的上呼吸道感染并发急性中耳炎患儿的临床特点.方法采集2002年1月~2002年12月期间经我院诊治的上呼吸道感染,经耳镜检查确诊为急性中耳炎患儿(0~14岁)的临床资料,包括性别、年龄、体温、起病时间、发病情况、血象、听力检查、随访疗效.并予以统计分析.结果并发急性中耳炎96例,占上呼吸道感染患儿2.9%.男孩多于女孩(58:38).最小患儿年龄为10月,平均发病年龄为3.5岁.右耳:左耳:双耳发病比值为6:3:2.首次发病86例,复发10例.有明显耳部症状者占21.9%(21例).并发AOM患儿平均白细胞计数和中性粒细胞含量均明显高于正常水平.结论儿童急性中耳炎多发生于幼儿时期.AOM往往并发于急性上呼吸道感染,目前检出率不高,容易被忽视而漏诊.儿童AOM多存在细菌感染,抗生素治疗效果明显.

  17. Dynamics of Streptococcus pneumoniae serotypes causing acute otitis media isolated from children with spontaneous middle-ear drainage over a 12-year period (1999-2010 in a region of northern Spain.

    Directory of Open Access Journals (Sweden)

    Marta Alonso

    Full Text Available The aim of this study was to determine the serotype and clonal distribution of pneumococci causing acute otitis media (AOM and their relationship with recurrences and mixed infections with other microorganisms under the influence of the 7-valent pneumococcal conjugate vaccine (PCV7. To do this, all pneumococcal isolates collected from the spontaneous middle-ear drainage of children <5 years old diagnosed of AOM by their pediatrician or their general practitioner from 1999 to 2010 were phenotypically characterized and the most frequent serotypes were genotyped. In the 12-year study, 818 episodes of pneumococcal AOM were detected, mostly (70.5% in children younger than 2 years old. In 262 episodes (32%, the pneumococci were isolated with another bacterium, mainly (n=214 Haemophilus influenzae. Mixed infections were similar in children under or over 2 years old. The most frequent serotypes were 19A (n=227, 27.8%, 3 (n=92, 11.2% and 19F (n=74, 9%. Serotypes included in the PCV7 sharply decreased from 62.4% in the pre-vaccination (1999-2001 to 2.2% in the late post-vaccination period (2008-2010. Serotype diversity steadily increased after the introduction of the PCV7 but decreased from 2008-2010 due to the predominant role of serotype 19A isolates, mostly ST276 and ST320. The prevalence of serotype 3 doubled from 6.1% (20/326 in 1999-2004 to 14.6% (72/492 in 2005-2010. Relapses mainly occurred in male infants infected with isolates with diminished antimicrobial susceptibility. Reinfections caused by isolates with the same serotype but different genotype were frequent, highlighting the need for genetic studies to differentiate among similar strains. In conclusion, the main change in pneumococcal AOM observed after the introduction of the PCV7 was the sharp decrease in vaccine serotypes. Also notable was the high burden of serotype 19A in total pneumococcal AOM before and especially after the introduction of the PCV7, as well as in relapses and

  18. Infectious complications of pediatric cochlear implants are highly influenced by otitis media.

    Science.gov (United States)

    Vila, Peter M; Ghogomu, Nsangou T; Odom-John, Audrey R; Hullar, Timothy E; Hirose, Keiko

    2017-06-01

    Determine the incidence of ear infections in cochlear implant patients, evaluate the contribution of otitis media to complications, describe the bacteriology of otitis media in the cochlear implant population, the treatment provided at our center, and the long term outcome. Data collected included age at implantation, history of otitis media or ear tubes, etiology of hearing loss, inner ear anatomy, postoperative infections, time to infection, route of antibiotic administration, and interventions for infections. Categories of infection were acute otitis media, otitis media with effusion, tube otorrhea, meningitis, scalp cellulitis, and infection at the implant site. Middle ear infections were diagnosed in 37% of implanted ears. Extension of middle ear infections into the implant site occurred in 2.8% of all implants (n = 16). Of the 16 infected devices, 10 were successfully treated with antibiotic therapy and did not require explantation. The retained implant group and explanted group both included some middle ear microbes such as Haemophilus influenzae and Streptococcus pneumoniae, as well as skin flora such as Staphylococcus aureus. Otitis media in pediatric cochlear implant patients is a common event and usually does not lead to complications of the cochlear implant. However, when the ear infection spreads to the scalp and the implant site, it is still possible to eliminate the infection using antibiotic therapy, particularly when treatment is directed to the specific organism that is recovered from the infected space and the duration and route of antibiotic treatment is carefully considered. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Suppurative labyrinthitis associated with otitis media: 26 years' experience

    Directory of Open Access Journals (Sweden)

    André Souza de Albuquerque Maranhão

    2016-02-01

    Full Text Available ABSTRACT INTRODUCTION: Suppurative labyrinthitis continues to result in significant hearing impairment, despite scientific efforts to improve not only its diagnosis but also its treatment. The definitive diagnosis depends on imaging of the inner ear, but it is usually clinically presumed. OBJECTIVE: To analyze the clinical factors and hearing outcomes in patients with labyrinthitis secondary to middle ear infections and to discuss findings based on imaging test results. METHODS: Retrospective cohort study, based on the charts of patients admitted with middle ear infection-associated labyrinthitis. RESULTS: We identified 14 patients, eight (57% of whom were females and six (43% males. Mean age was 40 years. Cholesteatomatous chronic otitis media was diagnosed in six patients (43%, acute suppurative otitis media in six (43%, and chronic otitis media without cholesteatoma was diagnosed in two patients (14%. Besides labyrinthitis, 24 concomitant complications were identified: six cases (25% of labyrinthine fistula, five cases (21% of meningitis, five cases (21% of facial paralysis, five cases (21% of mastoiditis, two cases (8% of cerebellar abscess, and one case (4% of temporal abscess. There was one death. Eight (57% individuals became deaf, while six (43% acquired mixed hearing loss. CONCLUSION: Suppurative labyrinthitis was often associated with other complications; MRI played a role in the definitive diagnosis in the acute phase; the hearing sequel of labyrinthitis was significant.

  20. Suppurative labyrinthitis associated with otitis media: 26 years' experience.

    Science.gov (United States)

    Maranhão, André Souza de Albuquerque; Godofredo, Valeria Romero; Penido, Norma de Oliveira

    2016-01-01

    Suppurative labyrinthitis continues to result in significant hearing impairment, despite scientific efforts to improve not only its diagnosis but also its treatment. The definitive diagnosis depends on imaging of the inner ear, but it is usually clinically presumed. To analyze the clinical factors and hearing outcomes in patients with labyrinthitis secondary to middle ear infections and to discuss findings based on imaging test results. Retrospective cohort study, based on the charts of patients admitted with middle ear infection-associated labyrinthitis. We identified 14 patients, eight (57%) of whom were females and six (43%) males. Mean age was 40 years. Cholesteatomatous chronic otitis media was diagnosed in six patients (43%), acute suppurative otitis media in six (43%), and chronic otitis media without cholesteatoma was diagnosed in two patients (14%). Besides labyrinthitis, 24 concomitant complications were identified: six cases (25%) of labyrinthine fistula, five cases (21%) of meningitis, five cases (21%) of facial paralysis, five cases (21%) of mastoiditis, two cases (8%) of cerebellar abscess, and one case (4%) of temporal abscess. There was one death. Eight (57%) individuals became deaf, while six (43%) acquired mixed hearing loss. Suppurative labyrinthitis was often associated with other complications; MRI played a role in the definitive diagnosis in the acute phase; the hearing sequel of labyrinthitis was significant. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  1. Otitis Media, Learning and Community.

    Science.gov (United States)

    McSwan, David; Clinch, Emma; Store, Ron

    2001-01-01

    A 3-year research project in Queensland (Australia) implemented educational and health strategies to ameliorate effects of otitis media at three schools in remote Aboriginal communities. The interdisciplinary model brought together health and education professionals, teacher aides, and the community, with the school being the lead agency. However,…

  2. Treatment of acute proximal humeral fractures in children with modular external fixator

    Institute of Scientific and Technical Information of China (English)

    Michele Bisaccia; Paolo Ceccarini; Olga Bisaccia; Auro Caraffa; Luigi Meccariello; Mattia Manni; Gabriele Falzarano; Antonio Medici; Giuseppe Rinonapoli; Salvatore Di Giacinto; Giovanni Colleluori; Cristina Ibaez Vicente

    2016-01-01

    Objective: To evaluate the follow-up of the fractures treated by external fixator. Methods: A total of 31 children aged 6–15 years with proximal humeral fractures Grade IV according to Neer–Horowitz classification were treated. The medium follow-up was 24 months. Results: In all cases, a good stability of the fracture and a quick healing process were obtained. The mean time of follow-up was 24 months. The external fixation was removed after 6 weeks (5–8 weeks) on average. Constant shoulder score was proposed to all patients and the average result was 97.5 (84–100). Conclusions: Advantages of the external fixation are rapid mobilization of the joint, low invasiveness, a single surgery and the possibility to correct any secondary displacement. It is important to underline that the positioning of external fixator should be implanted by expert surgeons and that the patients must cooperate during the entire process up to the time of the removal of the fixator.

  3. Information on co-morbidities collected by history is useful for assigning Otitis Media risk to children.

    Science.gov (United States)

    Casselbrant, Margaretha L; Mandel, Ellen M; Doyle, William J

    2016-06-01

    Determine if a 2-Step multivariate analysis of historical symptom/sign data for comorbid diseases can abstract high-level constructs useful in assigning a child's "risk" for different Otitis Media expressions. Seventeen items related to the symptom/sign expression of hypothesized Otitis Media comorbidities were collected by history on 141 3-year-old children. Using established criteria, the children were assigned to 1 of 3 groups: Control (no significant past Otitis Media, n=45), Chronic Otitis Media with Effusion (n=45) and Recurrent Acute Otitis Media (n=51). Principal Component Analysis was used to identify factors representing the non-redundant shared information among related items and Discriminant Analysis operating on those factors was used to estimate the best predictor equation for pairwise group assignments. Six multivariate factors representing the assignable comorbidities of frequent colds, nasal allergy, gastroesophageal disease (specific and general), nasal congestion and asthma were identified and explained 81% of the variance in the 17 items. Discriminant Analysis showed that, for the Control-Chronic Otitis Media with Effusion comparison, a combination of 3 factors and, for the Control-Recurrent Acute Otitis Media comparison, a combination of 2 factors had assignment accuracies of 74% and 68%, respectively. For the contrast between the two disease expressions, a 2-factor combination had an assignment accuracy of 61%. These results show that this analytic methodology can abstract high-level constructs, comorbidities, from low-level data, symptom/sign scores, support a linkage between certain comorbidities and Otitis Media risk and suggest that specific comorbidity combinations contain information relevant to assigning the risk for different Otitis Media expressions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Factors influencing the development of otitis media among Sicilian children affected by upper respiratory tract infections

    Directory of Open Access Journals (Sweden)

    Francesco Martines

    2016-04-01

    Full Text Available ABSTRACT INTRODUCTION: Upper respiratory tract infection is a nonspecific term used to describe an acute infection involving the nose, paranasal sinuses, pharynx and larynx. Upper respiratory tract infections in children are often associated with Eustachian tube dysfunction and complicated by otitis media, an inflammatory process within the middle ear. Environmental, epidemiologic and familial risk factors for otitis media (such as sex, socioeconomic and educational factors, smoke exposure, allergy or duration of breastfeeding have been previously reported, but actually no data about their diffusion among Sicilian children with upper respiratory tract infections are available. OBJECTIVE: To investigate the main risk factors for otitis media and their prevalence in Sicilian children with and without upper respiratory tract infections. METHODS: A case-control study of 204 children with upper respiratory tract infections who developed otitis media during a 3 weeks monitoring period and 204 age and sex-matched healthy controls. Seventeen epidemiologically relevant features were inventoried by means of standardized questionnaires and skin tests were performed. Univariate analysis and multivariate logistic regression analysis were used to examine the association between risk factors and occurrence of otitis media. RESULTS: Otitis media resulted strongly associated to large families, low parental educational attainment, schooling within the third years of life (p < 0.05; children were more susceptible to develop otitis media in the presence of asthma, cough, laryngopharyngeal reflux disease, snoring and apnea (p < 0.05. Allergy and urban localization increased the risk of otitis media in children exposed to smoke respectively of 166% and 277% (p < 0.05; the joint effect of asthma and presence of pets in allergic population increased the risk of recurrence of 11%, while allergy, cough and runny nose together increased this risk of 74%. CONCLUSIONS

  5. Malassezia pachydermatis: enzymes production in isolates from external ear canal of dogs with and without otitis Malassezia pachydermatis: produção de enzimas por amostras isoladas do conduto auditivo externo de cães com e sem otite

    Directory of Open Access Journals (Sweden)

    S.D.A. Coutinho

    2005-09-01

    Full Text Available The relationship between production of enzymes and pathogenicity of Malassezia pachydermatis strains was studied. Thirty strains of M. pachydermatis isolated from dogs were used: 15 originating from animals with external otitis and 15 obtained from ears of asymptomatic dogs. The samples, obtained by introduction of a sterile swab into the auditory canal after cleaning the auricle with alcohol-ether solution, were seeded onto Sabouraud dextrose agar with chloramphenicol (100mg/l and were incubated at 37°C for up to two weeks. The colonies were identified according to their macro-and-micromorphology. All strains were investigated for the production of chondroitin-sulphatase, hyaluronidase, phospholipase and proteinase. Most of the strains showed a high production of the four enzymes. Statistical analysis did not show any differences in the enzymatic activity among the strains. M. pachydermatis originating in normal microbiota as well as in otic secretion from dogs with otitis could produce the four researched enzymes. Probably M. pachydermatis has other virulence factors that are involved in the parasitism.Pesquisou-se a possível relação entre a produção de enzimas e a patogenicidade de Malassezia pachydermatis. Foram estudadas 30 cepas de M. pachydermatis provenientes de cães: 15 isoladas de animais com otite externa e 15 isoladas de condutos auditivos de animais assintomáticos. As amostras, obtidas pela introdução de uma zaragatoa no conduto auditivo, após limpeza do pavilhão auricular com solução de álcool-éter, foram semeadas em ágar Sabouraud dextrose acrescido de cloranfenicol (100mg/l e incubadas a 37°C por até duas semanas. As colônias foram identificadas por meio de estudo macro e micromorfológico. As amostras isoladas foram investigadas quanto à produção das enzimas condroitina-sulfatase, hialuronidase, fosfolipase e proteinase. A maioria delas mostrou alta produção das quatro enzimas pesquisadas. A an

  6. 急性中耳炎儿童使用抗生素与否的疗效分析%Effects of Antibiotics on Children with Acute Otitis Media

    Institute of Scientific and Technical Information of China (English)

    陈敏; 胡艳玲; 张丰珍; 王智楠; 杨扬; 刘世琳; 张杰

    2015-01-01

    Objective To study whether the usage of antibiotics and white -blood -cell counts affect the effects of 2~12-year-old children with acute otitis media (AOM ) .Methods A total of 126 children (2~12 years old)with AOM ,from Jan 2013 to Dec 2013 ,were retrospectively analyzed .Usage of antibiotics and white -blood-cell count were recorded at first ,and the relationships between two factors and outcomes of children with AOM were studyed in one week ,one month and three months after treatment ,respectively .Results White blood cell counts were higher than normal in 59 .52% (75/126) 2~12 -year -old children with AOM ,and antibiotics were used in 73 .81% (93 /126) .Ninty three cases were followed -up until 3 month or more .Antibiotics were used in 74 cases ,and watchful waiting were used in the other 19 patients .The effective rates of two groups were 59 .45% and 52 .63% ,75 .68% and 84 .21% ,85 .14% and 78 .95% in one week ,one month and 3 months after treatment ,re‐spectively .There were no statistically significant differences(χ2 values were 0 .295 ,0 .903 ,0 .799 ,P>0 .05) .But the effective rates were signifantly higher in 1 and 3 months than that of in one week (P0 .05) between one and three months .Whether white-blood-cell count higher than normal or not ,the difference in efficacy was not statistically significant in 1 week ,1 month and 3 months after treatment (P >0 .05) .Conclusion In 2~12-year-old children with acute otitis media (AOM ) ,the final outcomes were inde‐pendent of the usage of antibiotics and white -blood-cell count .%目的:分析2~12岁急性中耳炎患儿是否使用抗生素及白细胞计数增高与否与疗效的关系。方法回顾性分析2013年1~12月126例2~12岁急性中耳炎患儿的临床资料,记录其抗生素的使用和白细胞计数,并分别于治疗后1周、1月、3月复查,比较白细胞增高与否及抗生素使用与否的疗效。结果126例患儿中,59.52%(75/126)白细胞计数

  7. Bacterial Interference in Nasopharyngeal Bacterial Flora of Otitis-prone and Non-otitis-prone Children

    NARCIS (Netherlands)

    J.M. Bernstein; S. Sagahtaheri-ALtaie; D.M. Dryja; J. Wactawski-Wende

    1994-01-01

    textabstractThe quantitative bacteriology of the adenoid was studied in 34 otitis-prone and 25 non-otitis prone children. Viridans streptococci appeared to be the predominant normal flora in children who are non-otitis prone. There was a significant decrease in viridans streptococci in the

  8. 听泡穿刺注射法构建C57BL/6小鼠急性中耳炎模型%A mouse model for acute otitis media via transbullar injection

    Institute of Scientific and Technical Information of China (English)

    黄益飞; 金春芳; 项云; 王磊; 王子萌; 王维; 何於娟

    2015-01-01

    Objective To develop a mouse model for acute otitis media (AOM) via transbullar injection method and evaluate its feasibility and practicability.Methods The middle ears (ME) of C57BL/6 mice were inoculated via transbullar injection method with 5 μl streptococcus pneumoniae (S.pn)19F suspension (1 × 107 CFU/ml),and the control group was inoculated equivalent phosphate buffered solution(PBS).Behavior changes were observed daily following inoculation.The ME tissues for histological examination and the middle ear lavage fluid (MELF) for total cells quantification,S.pn load determination and cytokines measurement were collected at 12 h,day 1,2,3,5,7 after inoculation,respectively.Results Within 24 hours after instillation,the density of S.pn and the level of acute inflammatory cytokines in ME cavity increased rapidly,some mucosal hyperplasia was evident and leukocytic infiltration (primarily neutrophils) began.The level of ME inflammatory response reached maximal at 2-3 days after inoculation,with extensive effusion,leukocytic infiltration and mucosal thickening.Meanwhile,the density of S.pn decreased gradually.Bacterial clearance was completed by day 5 with extensive resolution of ME inflammation,although mucosal hyperplasia did not resolute until day 7.Conclusion A mouse model for AOM is successfully established via transbullar injection method,laying foundation for future study of AOM.%目的 探讨听泡穿刺注射法建立小鼠急性中耳炎模型的可行性和实用性.方法 采用听泡穿刺注射的方法建立C57BL/6小鼠急性中耳炎模型,造模组注射5μl肺炎链球菌19F悬液(1×107 CFU/ml),对照组注射等量无菌磷酸盐缓冲液.观察注射后小鼠行为变化,分别于建模后12h、1d、2d、3d、5d、7d处死小鼠,分离中耳组织HE染色观察病理改变,同时收集中耳灌洗液检测炎性细胞数量、细菌载量及相关炎性因子含量.结果 接种1d后,中耳腔内细菌迅速增殖,产生大量肿瘤坏死因

  9. Results of external quality control study in flow cytometric acute lymphoblastic leukemia diagnostics

    Directory of Open Access Journals (Sweden)

    A. M. Popov

    2016-01-01

    Full Text Available Comparison of interpretation of acute lymphoblastic leukemia (ALL flow cytometric diagnostics data was the aim of the study. Immunophenotyping data obtained from 10 patients with ALL were analysed separately in 26 laboratories from Russian Federation and Kazahstan. Results comparison showed four main type of discordance: B-lineage ALL diagnostics during heavy bone marrow regeneration, great variability of T-ALL interpretation, complexity of ambiguous lineage acute leukemia and, finally, very different report types, unique for each laboratory. All these problems are the serious obstacles for standardization of flow cytometric ALL diagnostics in multicenter setting. Continuation of similar QC rounds following by consecutive discussions with further development of consensus diagnostic algorithm could be the first step for standardization of ALL immunophenotyping in Russian Federation and CIS countries.

  10. Necrotizing otitis externa: a painless reminder.

    Science.gov (United States)

    Thio, Daniel; Reece, Phillip; Herdman, Rory

    2008-08-01

    Necrotizing otitis externa is a necrotizing osteomyelitis of the skull base that predominantly affects diabetic and immunocompromised patients. Pseudomonas aeruginosa is the most frequently implicated organism. Patients present with severe otalgia, otorrhoea with or without facial palsy, or rarely, facial pain as a symptomatic feature. We report a case of necrotizing otitis externa presenting with totally painless otorrhoea and highlight the need for a high index of suspicion when treating patients with otitis externa.

  11. 对急性中耳炎患儿开展家长系统健康教育的效果观察%Effect of systematic health education to the parents on the outcomes of children with acute otitis media

    Institute of Scientific and Technical Information of China (English)

    张中华; 何素兰; 胡细娥; 邓莹莹; 张松志

    2013-01-01

    Objective To explore the effect of systematic health education to the parents on the outcomes of children with acute otitis media.Methods Totally,200 children with acute otitis media were divided into exprimental group and control group (100 for each group).The parents of the children in the experimental group were received systematic health education and routine health education was taken in the control group.Results The recovery time of symptoms and signs and average period of treatment in the experimental group were shorter than those in the control group (P < 0.01).The curative effect rate and patient satisfaction in the experimental group were higher than those in the control group (P < 0.01).Conclusion System health education to parents of children with acute otitis media can strengthen treatment compliance,increase the clinical cure rate and shorten the treatment time.%目的 探讨开展家长系统健康教育对急性中耳炎患儿的影响.方法 按就诊顺序的单、双号将200例急性中耳炎患儿分为观察组和对照组各100例,观察组患儿家长给予系统健康教育指导,对照组患儿家长给予常规健康教育指导.结果 观察组患儿的症状及体征改善时间、平均治疗时间均低于对照组(P<0.01),临床疗效总有效率及对护理工作满意度均高于对照组(P<0.01).结论 对中耳炎患儿家长实施系统健康教育可以强化家长遵医行为,提高患儿临床治愈率,缩短治疗时间.

  12. Genetic mouse models for otitis media

    Institute of Scientific and Technical Information of China (English)

    Qingyin Zheng; Ken R Johnson

    2003-01-01

    @@ Genetics of Otitis Media (OM): OM is affected by multiple factors including eustachian tube (ET) structure and function, immune status, innate mucosal defense, genetic susceptibility, and pathogens.

  13. [Retrospective Cytogenetic Dose Evaluation. I. Chromosome Aberration Levels in Remote Periods after Acute External Exposure in Different Situations].

    Science.gov (United States)

    Nugs, V Yu; Khvostunov, I K; Goloub, E V; Kozlova, M G; Nadejina, N M; Galstian, I A

    2015-01-01

    Cytogenetic analysis of peripheral blood lymphocyte cultures of 22 persons was performed in remote terms after acute external γ-, γ-β- or γ-neutron irradiation as a result of various accidents using the classical me- thod. The initial dose estimates were obtained using physical calculations, the method of measuring the EPR signal in tooth enamel, according to haematological and/or cytogenetic parameters. The purpose of this study was to obtain evidence about the state of the lymphocyte chromosome apparatus of people approxi- mately 17-50 years after an accidental radiation exposure. In general, elevated levels of chromosome aberra- tions were detected. An average correlation was observed between the atypical chromosome frequency and absorbed dose. It is proposed to use the obtained results in the future to explore the possibility of retrospective dose evaluation on the basis of a special computer program.

  14. Otitis media in Australian Aboriginal children: an overview.

    Science.gov (United States)

    Leach, A J

    1999-10-05

    Remote and rural Australian Aboriginal children achieve lower standards of numeracy and literacy than their non-Aboriginal peers. The reasons are complex, but extraordinarily high rates of conductive hearing loss (> 50%) are, in part, responsible for poor classroom success. In addition to the burden of acute bacterial respiratory illness (highest rates of invasive pneumococcal disease in the literature), chronic disease affects virtually every young child. In the Aboriginal community studied, otitis media commenced within 3 months of birth for all infants, progressed to chronic suppurative otitis media in 60% and did not resolve throughout early childhood. Our findings, supported by mathematical modelling, show that the vicious cycle of endemic chronic otitis media is perpetuated by high carriage rates of multiple species and multiple types of respiratory bacterial pathogens, by high cross-infection rates and thus, by early age of pathogen acquisition and prolonged carriage. Long-term damage to respiratory mucosa, possibly linked to later chronic bronchitis and bronchiectasis, follows a constant series of infections by each of the concurrently held pathogens, without periods of recovery. Overcrowding and poor hygiene promote this vicious cycle. Medical and social options for intervention are limited by poor resources, low expectations for health and a complex biology that includes antibiotic resistant pneumococci.

  15. Management of chronic otitis media by subtotal petrosectomy.

    Science.gov (United States)

    Altuna, Xabier; Navarro, Juan José; Goiburu, Miren; Palicio, Idoia

    2016-01-01

    Subtotal petrosectomy is the complete exenteration of all air cell tracts of the temporal bone. The isthmus of the Eustachian tube is obliterated and the external auditory canal is closed. The aim of this study was to describe the use of this technique in the management of certain cases of chronic otitis media. We conducted a retrospective revision of the patients treated in our Institution with this technique for chronic otitis media in a 5-year period (2008-2012). All charts were reviewed and data from the otomicroscopy, audiometry, radiology, surgical findings, postoperative complications and follow-up (including diffusion magnetic resonance imaging, MRI) of a minimum of 24 months were collected. In this period petrosectomy was performed on 28 patients for chronic otitis media. We treated 13 cases as primary cases, while 15 cases were secondary (patients that had already undergone another procedure in that ear). Fifteen cases had no serviceable hearing. Only 1 case had an immediate postoperative complication (infection); during the posterior follow-up, 2 cases had to be reoperated for diffusion restriction in the mastoid area revealed in the MRI 2 years after surgery. A subtotal petrosectomy is rarely performed for the treatment of chronic otitis media. However, it is a technique that we have to keep in mind for the treatment of certain cases where there is recurrence and deep hearing loss, as well as in cases with good cochlear reserve if the disease coexists with other complications. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  16. Otitis and autism spectrum disorders

    OpenAIRE

    Tajima-Pozo, Kazuhiro; Zambrano-Enriquez, Diana; De Anta, Laura; Zelmanova, Julie; De Dios Vega, Jose Luis; Lopez-Ibor, Juan Jose

    2010-01-01

    The case of a 5-year-old child diagnosed as having pervasive developmental disorder (PDD), autistic type, from age 1 is reported. After surgery of vegetation in middle ear for repetitive otitis, the child presented an improvement in autistic behaviours, previously expressed as impaired social interactions, qualitative abnormalities in communication, a marked delay in language development, echolalia, stereotypies and self-aggressive behaviours. The aim of this paper is to bring attention to oc...

  17. Otitis and autism spectrum disorders

    OpenAIRE

    Tajima-Pozo, Kazuhiro; Zambrano-Enriquez, Diana; De Anta, Laura; Zelmanova, Julie; De Dios Vega, Jose Luis; Lopez-Ibor, Juan Jose

    2010-01-01

    The case of a 5-year-old child diagnosed as having pervasive developmental disorder (PDD), autistic type, from age 1 is reported. After surgery of vegetation in middle ear for repetitive otitis, the child presented an improvement in autistic behaviours, previously expressed as impaired social interactions, qualitative abnormalities in communication, a marked delay in language development, echolalia, stereotypies and self-aggressive behaviours. The aim of this paper is to bring attention to oc...

  18. Acute mastoiditis in Greenland between 1994-2007

    DEFF Research Database (Denmark)

    Homøe, Preben; Jensen, Ramon; Brofeldt, Susanne

    2011-01-01

    The indigenous populations of the Arctic are prone to middle ear infections starting with an early age first episode, followed by frequent episodes of acute otitis media (AOM) during childhood. A high proportion develop chronic otitis media. Acute mastoiditis is a serious complication of AOM...

  19. Acute mastoiditis in Greenland between 1994-2007

    DEFF Research Database (Denmark)

    Homøe, Preben; Jensen, Ramon; Brofeldt, Susanne

    2010-01-01

    The indigenous populations of the Arctic are prone to middle ear infections starting with an early age first episode, followed by frequent episodes of acute otitis media (AOM) during childhood. A high proportion develop chronic otitis media. Acute mastoiditis is a serious complication of AOM...

  20. Acute mastoiditis in Greenland between 1994-2007

    DEFF Research Database (Denmark)

    Homøe, Preben; Jensen, Ramon; Brofeldt, Susanne

    2011-01-01

    The indigenous populations of the Arctic are prone to middle ear infections starting with an early age first episode, followed by frequent episodes of acute otitis media (AOM) during childhood. A high proportion develop chronic otitis media. Acute mastoiditis is a serious complication of AOM in c...

  1. Detection of six cytokines by cytometric bead array in patients with acute secretory otitis media%流式细胞术微球阵列法检测多种细胞因子在分泌性中耳炎患者中的表达

    Institute of Scientific and Technical Information of China (English)

    刘振; 王跃健; 肖平; 谢雪颜

    2011-01-01

    目的 检测急性分泌性中耳炎(acute secretory otitis media,SOM)患者外周血及中耳积液中IL-2、IL-4、IL-6、IL-1O、TNF、IFN-γ的表达水平,以期综合分析免疫因素在其发病中的作用.方法 采用BD CBAFlex Set IL-2、IL-4、IL-6、IL-10、TNF、γ-干扰素试剂盒,利用流式细胞术微球阵列法检测37例急性上呼吸道感染诱发急性分泌性中耳炎外周血、耳积液,8例鼻咽癌患者放疗后分泌性中耳炎耳积液和10例正常人血清样本中6种细胞因子水平.结果 急性上呼吸道感染诱发的中耳积液中的IL-2、IL-4、IL-6、IL-1O、TNF、IFN-γ表达水平显著高于外周血(P<0.05);其中IL-6、IL-10、TNF、IFN-γ水平明显高于放疗后耳积液水平(P<0.05).急性分泌性中耳炎外周血上述六种因子较正常对照组外周血差异无统计学意义(P>0.05).结论 中耳粘膜参与了急性分泌性中耳炎患者局部的免疫反应,在其发病中可能起到一定作用.%Objective To detect the level of IL-2、 IL-4、 IL-6、IL-10、 TNF、IFN--γ in the peripheral blood and middle ear effusion in patients with secretory otitis media and determine the role of immune status in the pathogenesis of the disease. Methods The levels of the six cytokines in the serum and ear effusion from 37 cases of acute upper respiratory tract infection, 8 cases of nasopharyngeal carcinoma after radiotherapy with secretory otitis media and 10 cases of normal persons were detected by using flow cytometry and BD CBA Flex Set kit. Results The level of IL-2, IL-4, IL-6, IL-10, TNF, IFN-γ in acute upper respiratory infection-induced middle ear effusion was significantly higher than in peripheral blood (P 0.05). Conclusion Middle ear mucosa is involved in local immune response and plays an important role in the pathogenesis of acute otitis media with effusion.

  2. The Clinical Effect of Super-laser Combin ed with Ultra-short Waves Treatment of Acute Otitis Media in Children%超激光联合超短波治疗儿童急性中耳炎临床观察

    Institute of Scientific and Technical Information of China (English)

    黄宝珠; 胡红; 潘莉

    2014-01-01

    目的:观察超激光联合超短波治疗儿童急性中耳炎临床疗效。方法:将218例年龄在2~11岁的患有急性中耳炎的儿童随机分为2组。治疗组109例采用超激光局部照射联合超短波疗法;对照组109例单纯采用超短波疗法,5天为1疗程。结果:治疗组治愈率为92.66%,对照组治愈率为70.64%,2组治愈率差异有统计学意义( P <0.01)。结论:超激光联合超短波治疗儿童急性中耳炎具有协同功效,显著提高了疗效,无痛苦,无副作用,患者易接受,值得临床推广应用。%Obj ective:To observe the clinical effect of super -laser combined with ultra -short wave treatment of acute otitis media in children.Methods:218 patients suffering from otitis media aged from two to eleven were randomly divided into two groups .The treatment group of 109 cases using therapy of super -laser irradiation combined with ultra -short waves treatment;the compared group of 109 cases using the therapy of ultra -short waves treatment alone , 5 days for a course of treatment .Results:The cure rate was 92 .66%in the treat-ment group,while the compared group cure rate was 70.64%, the cure rate difference of the two groups with statistical significance (P<0.01).Conclusion:there is a synergy effect in the treatment of children with acute otitis media by using the super -laser treatment and the ultra-short waves treatment , it significantly improve the curative effect , but without pain and side effects ,it is easily to be accepted by patients and worthy of clinical application .

  3. Otitis-Prone Children Produce Functional Antibodies to Pneumolysin and Pneumococcal Polysaccharides.

    Science.gov (United States)

    Kirkham, Lea-Ann S; Wiertsema, Selma P; Corscadden, Karli J; Mateus, Tulia; Mullaney, Gemma L; Zhang, Guicheng; Richmond, Peter C; Thornton, Ruth B

    2017-03-01

    The pneumococcus is a major otitis media (OM) pathogen, but data are conflicting regarding whether otitis-prone children have impaired humoral immunity to pneumococcal antigens. We and others have shown that otitis-prone and healthy children have similar antibody titers to pneumococcal proteins and polysaccharides (vaccine and nonvaccine types); however, the quality of antibodies from otitis-prone children has not been investigated. Antibody function, rather than titer, is considered to be a better correlate of protection from pneumococcal disease. Therefore, we compared the capacities of antibodies from otitis-prone (cases) and healthy (controls) children to neutralize pneumolysin, the pneumococcal toxin currently in development as a vaccine antigen, and to opsonize pneumococcal vaccine and nonvaccine serotypes. A pneumolysin neutralization assay was conducted on cholesterol-depleted complement-inactivated sera from 165 cases and 61 controls. A multiplex opsonophagocytosis assay (MOPA) was conducted on sera from 20 cases and 20 controls. Neutralizing and opsonizing titers were calculated with antigen-specific IgG titers to determine antibody potency for pneumolysin, pneumococcal conjugate vaccine (PCV) polysaccharides, and non-PCV polysaccharides. There was no significant difference in antibody potencies between cases and controls for the antigens tested. Antipneumolysin neutralizing titers increased with the number of episodes of acute OM, but antibody potency did not. Pneumolysin antibody potency was lower in children colonized with pneumococci than in noncarriers, and this was significant for the otitis-prone group (P otitis-prone children demonstrates that they respond to the current PCV and are likely to respond to pneumolysin-based vaccines as effectively as healthy children. Copyright © 2017 Kirkham et al.

  4. Necrotizing (malignant otitis externa: An unusual localization of mucormycosis

    Directory of Open Access Journals (Sweden)

    Tuzcu A

    2006-01-01

    Full Text Available Malignant otitis externa (MOE is a severe infection of external auditory canal and skull base. A 17-year-old diabetic girl was admitted with diabetic ketoacidosis. Cellulitis of her right ear occurred on the second day of hospitalization and a black necrotic scar in the same region appeared on the next day. The lesion rapidly invaded to right side of neck and surrounding tissue of the patient. Therefore, antimycotic therapy was started. Unfortunately the patient died on seventh day of hospitalization because of probably extensive fungal invasion. Physicians should suspect MOE connected to mucormycosis especially in patients with cutaneous lesions of ear unresponsive to antibiotic therapy.

  5. [Clinical and pathophysiological patterns of otitis externa and overview of problematic cases].

    Science.gov (United States)

    Dzepina, Davor; Ajduk, Jakov; Zurak, Kreso

    2011-01-01

    Otitis externa can sometimes present itself as a difficult clinical problem, in cases such as unsuccessful outcome of usual therapy, prolonged duration of symptoms or frequent recurrencies with local or systemic complications. In these cases more attention should be focused on possible errors made in establishing the right diagnosis, incorrect sequence of applying therapeutical measures, or presence of unrecognized problems, including individual patient factors, characteristics of the pathogen, or other. In this article we present a case report of a 84-year-old patient with complicated otitis externa, together with a short review of physiology, patophysiology, diagnostic and therapeutical measures in external otitis, and suggest a possible clinical approach in the management of problematic cases.

  6. Acute effect of static stretching on power output during concentric dynamic constant external resistance leg extension.

    Science.gov (United States)

    Yamaguchi, Taichi; Ishii, Kojiro; Yamanaka, Masanori; Yasuda, Kazunori

    2006-11-01

    The purpose of the present study was to clarify the effect of static stretching on muscular performance during concentric isotonic (dynamic constant external resistance [DCER]) muscle actions under various loads. Concentric DCER leg extension power outputs were assessed in 12 healthy male subjects after 2 types of pretreatment. The pretreatments included (a) static stretching treatment performing 6 types of static stretching on leg extensors (4 sets of 30 seconds each with 20-second rest periods; total duration 20 minutes) and (b) nonstretching treatment by resting for 20 minutes in a sitting position. Loads during assessment of the power output were set to 5, 30, and 60% of the maximum voluntary contractile (MVC) torque with isometric leg extension in each subject. The peak power output following the static stretching treatment was significantly (p extensive static stretching significantly reduces power output with concentric DCER muscle actions under various loads. Common power activities are carried out by DCER muscle actions under various loads. Therefore, the result of the present study suggests that relatively extensive static stretching decreases power performance.

  7. [Phospholipase and proteinase production by Malassezia pachydermatis isolated in dogs with and without otitis].

    Science.gov (United States)

    Ortiz, Gustavo; Martín, M Carmen; Carrillo-Muñoz, Alfonso J; Payá, M Jesús

    2013-01-01

    Malassezia pachydermatis is part of the skin microbiota of dogs and cats. M. pachydermatis has been associated with external otitis and seborrhoeic dermatitis, reported more often in dogs than in cats. When the physical, chemical or immunological mechanisms of the skin are altered, M. pachydermatis could act as a pathogen. Thus, several virulence factors, such as the ability to produce esterase, lipase, lipoxygenase, protease, chondroitin sulphatase, and hyaluronidase, have been studied. In the present study, we aim to identify the phospholipase activity measured at pH 6.3, and the proteinase activity measured at pH 6.3 and pH 6.8 (pH from ears of dogs with external otitis) of M. pachydermatis strains isolated from dogs with and without external otitis. The phospholipase activity was measured using a semi-quantitative method with egg yolk, and the proteinase activity with a semi-quantitative method using bovine serum albumin agar. The study was performed on 96 isolates of M. pachydermatis, 43 isolated from dogs without clinical symptoms of otitis, and 52 isolated from dogs with otitis. In our study, 75.8% of the isolates showed phospholipase activity at pH 6.3, and 81 and 97.9% of them showed proteinase activity measured at pH 6.3 and 6.8, respectively. A higher phospholipase activity was detected in strains isolated from dogs with otitis. The proteinase activity was increased at a pH of 6.8 (97.9%) in comparison to a pH of 6.3 (81%). Our results suggest that the phospholipase activity may play an important role in the invasion of host tissues in chronic canine otitis cases. The proteinase activity results obtained in this study suggest that a reduction in the pH of the treatment may improve its efficacy in the resolution of M. pachydermatis otitis. Copyright © 2012 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

  8. External validation of the APPS, a new and simple outcome prediction score in patients with the acute respiratory distress syndrome.

    Science.gov (United States)

    Bos, Lieuwe D; Schouten, Laura R; Cremer, Olaf L; Ong, David S Y; Schultz, Marcus J

    2016-12-01

    A recently developed prediction score based on age, arterial oxygen partial pressure to fractional inspired oxygen ratio (PaO2/FiO2) and plateau pressure (abbreviated as 'APPS') was shown to accurately predict mortality in patients diagnosed with the acute respiratory distress syndrome (ARDS). After thorough temporal external validation of the APPS, we tested the spatial external validity in a cohort of ARDS patients recruited during 3 years in two hospitals in the Netherlands. Consecutive patients with moderate or severe ARDS according to the Berlin definition were included in this observational multicenter cohort study from the mixed medical-surgical ICUs of two university hospitals. The APPS was calculated per patient with the maximal airway pressure instead of the plateau pressure as all patients were ventilated in pressure-controlled mode. The predictive accuracy for hospital mortality was evaluated by calculating the area under the receiver operating characteristics curve (AUC-ROC). Additionally, the score was recalibrated and reassessed. In total, 439 patients with moderate or severe ARDS were analyzed. All-cause hospital mortality was 43 %. The APPS predicted all-cause hospital mortality with moderate accuracy, with an AUC-ROC of 0.62 [95 % confidence interval (CI) 0.56-0.67]. Calibration was moderate using the original cutoff values (Hosmer-Lemeshow goodness of fit P APPS was moderate, also after recalibration of the score, and thus the APPS does not seem to be fitted for that purpose. The APPS might serve as simple tool for stratification of mortality in patients with moderate or severe ARDS. Without recalibrations, the performance of the APPS was moderate and we should therefore hesitate to blindly apply the score to other cohorts of ARDS patients.

  9. La otitis en la infancia

    OpenAIRE

    1998-01-01

    Clasificación de la otitis/Factores de riesgo/Sintomatología/Tratamiento/ ¿Por qué fallan algunos tratamientos médicos?/ ¿Cuándo debemos sospechar que existe una alergia a los antibióticos?/ ¿Qué debemos hacer ante la sospechad e una alergia a los medicamentos?/ ¿Cómo se deben aplicar las gotas en el oído?/ ¿Qué sucede con la fiebre o con el dolor?/ ¿Cuándo se ponen tubos ventilatorios?

  10. [The practice guideline 'Otitis externa' (first revision) from the Dutch College of General Practitioners; a response from the perspective of otorhinolaryngology].

    Science.gov (United States)

    Mylanus, E A M

    2008-05-24

    The first revision of the practice guideline 'Otitis externa' from the Dutch College of General Practitioners describes diagnostic, therapeutic and preventive aspects of care and focuses mainly on the acute form of the disease. In comparison with the previous guideline, some modest but valuable improvements have been made with regard to diagnosis and medical treatment. For acute otitis externa, treatment with acid and corticosteroid eardrops is considered the treatment of choice, rather than treatment with acid eardrops only. The guideline clearly discusses indications for referral of patients with otitis externa to an otorhinolaryngologist. Hypersensitivity and more severe pathology should be excluded in persistent cases. For chronic otitis externa, an otorhinolaryngologist can provide surgical treatment with a good chance of success and a low recurrence rate.

  11. Effectiveness of Tympanostomy Tubes for Otitis Media: A Meta-analysis.

    Science.gov (United States)

    Steele, Dale W; Adam, Gaelen P; Di, Mengyang; Halladay, Christopher H; Balk, Ethan M; Trikalinos, Thomas A

    2017-06-01

    Tympanostomy tube placement is the most common ambulatory surgery performed on children in the United States. The goal of this study was to synthesize evidence for the effectiveness of tympanostomy tubes in children with chronic otitis media with effusion and recurrent acute otitis media. Searches were conducted in Medline, the Cochrane Central Trials Registry and Cochrane Database of Systematic Reviews, Embase, and the Cumulative Index to Nursing and Allied Health Literature. Abstracts and full-text articles were independently screened by 2 investigators. A total of 147 articles were included. When feasible, random effects network meta-analyses were performed. Children with chronic otitis media with effusion treated with tympanostomy tubes compared with watchful waiting had a net decrease in mean hearing threshold of 9.1 dB (95% credible interval: -14.0 to -3.4) at 1 to 3 months and 0.0 (95% credible interval: -4.0 to 3.4) by 12 to 24 months. Children with recurrent acute otitis media may have fewer episodes after placement of tympanostomy tubes. Associated adverse events are poorly defined and reported. Sparse evidence is available, applicable only to otherwise healthy children. Tympanostomy tubes improve hearing at 1 to 3 months compared with watchful waiting, with no evidence of benefit by 12 to 24 months. Children with recurrent acute otitis media may have fewer episodes after tympanostomy tube placement, but the evidence base is severely limited. The benefits of tympanostomy tubes must be weighed against a variety of associated adverse events. Copyright © 2017 by the American Academy of Pediatrics.

  12. Ribotyping of strains of Moraxella (Branhamella) catarrhalis cultured from the nasopharynx and middle ear of children with otitis media

    DEFF Research Database (Denmark)

    Brygge, K; Sørensen, C H; Colding, H

    1998-01-01

    . The distribution of these types was found to be almost identical to the distribution among 16 M. catarrhalis strains cultured from middle ear exudates of 16 children with acute otitis media. Ribotype HAPA was found in two-thirds of all the cultures investigated, and 44% of the children harboured more than one......Moraxella (Branhaomella) catarrhalis is frequently present in the nasopharyngeal microflora of small children, especially during episodes of acute otitis media . By means of ribotyping (restriction endonuclease analysis of chromosomal DNA combined with rRNA probing), we studied the genetic...... heterogeneity of 78 cultures of M. catarrhalis obtained from different localities in the nasopharynx of nine young children with secretory otitis media. Using HindIII and PstI as endonucleases, five different ribotypes were recognized, representing at least five different genotypes of M. catarrhalis...

  13. Pathogenic Bacteria Distribution and Antimicrobial Susceptibility of Children with Acute Otitis Media%儿童急性化脓性中耳炎病原菌及药敏分析

    Institute of Scientific and Technical Information of China (English)

    郝丽丽; 王智楠; 张振; 李隽; 夏忠芳

    2015-01-01

    Objective To analyze pathogenic bacteria distribution and antimicrobial susceptibility in children with acute otitis media(AOM ) .Methods Otorrhea samples from 146 episodes of AOM were cultured .The antimi‐crobial susceptibility of the main pathogenic bacteria was determined .The results were analyzed by SPSS19 .0 .Re‐sults 1) The strains of bacteria were isolated from 109 children with the positive rate of 74 .66% .Streptococcus pneumoniae (SP ) was the major bacteria(64 episodes ,58 .72% ) ,followed by staphlococcus aureus(SA) (19 epi‐sodes ,17 .43% ) .2) Sp was all sensitive to vancomycin ,levofloxacin ,moderate to penicillin ,amoxicillin ,cefo‐taxime ,and highly resistent to erythromycin and clindamycin .Staphlococcus aureus were all sensitive to vancomy‐cin ,tetracycline ,and Amy card ,and moderate to amoxicillin clavulanic acid potassium ,cefoxitin ,and oxacillin ,all resistent to penicillin and ampicillin .3) The strains of SP in age≤1year ,>1 -3years ,and >3 years respectively were 31(50 .82% ) ,25(56 .82% ) ,8 (19 .51% ) .There were significant differences between them(χ2 =14 .073 ,P=0 .001) .4)The strains of SP in 2012 ,2013 ,2014 respectively were 16(30 .19% ) ,22(48 .89% ) ,26(54 .17% ) ,There were significant differences between them(χ2 =6 .557 ,P=0 .038) .The antimicrobial susceptibility of SP had no sig‐nificant differences among 2012 ,2013 ,2014 ,but a yearly resistance decreasing trend was seen .Conclusion SP was the main bacterial contributor for AOM in Wuhan children .SP detection rate increases every year ,mainly in chil‐dren less than 3 years old .T he antimicrobial susceptibility is stable .%目的:探讨儿童急性化脓性中耳炎的病原菌分布及主要病原菌的药敏。方法回顾性分析武汉市儿童医院2012年1月1日~2014年12月31日诊治的146例急性化脓性中耳炎患儿的临床资料,分析患儿中耳脓性分泌物的病原菌培养及药敏结果。结果①146例患儿中,109例(74

  14. Pathogenic bacteria distribution and drug susceptibility in children with acute otitis media in Pearl River Delta%珠三角地区儿童急性化脓性中耳炎病原菌及药敏分析

    Institute of Scientific and Technical Information of China (English)

    温瑞金; 邓秋莲; 孙昌志; 高胜利; 陶佳; 罗仁忠

    2011-01-01

    Objective: To investigate the pathogenic bacteria distribution and drug susceptibility in children with acute otitis media (AOM) in different age and different season in the Pearl River Delta region. Method: Four hundred and forty-two children diagnosed as AOM were divided into three groups by age factor and four groups by season factor. Midge ear pus collecting and culturing were used for bacteria and antimicrobial susceptibility test. Resulted:① Strains of bacteria were isolated from 356 children with the positive rate of 80. 5%. Streptococcus pneu-moniae(39. 2%), staphylococcus aureus(25. 9%) and haemophilus influenzae(7. 4%) were the most frequently I-solated pathogens. ②Streptococcus pneumoniae was the main pathogenic bacteria in 0 - 1 year group and >1 - 3 years group(P3 years group(P0. 05). Staphylococcus aureus was the main pathogen in January-March group(P<0. 05) ;④Drug sensitivity shown that linezolid and ofloxacin were most sensitive to streptococcus pneumoniae and staphylococcus aureus, and macrolides had a good therapy effect to haemophilus influenzae. Conclusion: The pathogens distribution and drug susceptibility in children with AOM were varies in different age and different season. As a result, a treatment should be done based on the climate,environment,and pathogens distribution of a region.%目的:掌握不同年龄段及不同季节珠三角地区儿童急性中耳炎(AOM)的病原菌分布及药敏情况.方法:442例经临床确诊为AOM且临床资料完整的患儿按年龄分为0~1岁组、>1~3岁组及>3岁组,同时按就诊季节分为1~3月份、4~6月份、7~9月份、10~12月份4个组.无菌操作取中耳脓液行细菌、真菌、支原体培养并进行药敏实验.结果:①442例患儿中,356例培养阳性,阳性率80.5%,病原菌以肺炎链球菌(39.2%),金黄色葡萄球菌(25.9%)和流感嗜血杆菌(7.4%)为主;②肺炎链球菌是0~1岁组(56.9%)和>1~3岁组(32.5%)的主要病原

  15. Using external lumbar CSF drainage to treat communicating external hydrocephalus in adult patients after acute traumatic or non-traumatic brain injury.

    Science.gov (United States)

    Manet, Romain; Payen, Jean-François; Guerin, Romain; Martinez, Orianne; Hautefeuille, Serge; Francony, Gilles; Gergelé, Laurent

    2017-08-08

    Despite various treatments to control intracranial pressure (ICP) after brain injury, patients may present a late onset of high ICP or a poor response to medications. External lumbar drainage (ELD) can be considered a therapeutic option if high ICP is due to communicating external hydrocephalus. We aimed at describing the efficacy and safety of ELD used in a cohort of traumatic or non-traumatic brain-injured patients. In this multicentre retrospective analysis, patients had a delayed onset of high ICP after the initial injury and/or a poor response to ICP treatments. ELD was considered in the presence of radiological signs of communicating external hydrocephalus. Changes in ICP values and side effects following the ELD procedure were reported. Thirty-three patients with a median age of 51 years (25-75th percentile: 34-61 years) were admitted after traumatic (n = 22) or non-traumatic (n = 11) brain injuries. Their initial Glasgow Coma Scale score was 8 (4-11). Eight patients underwent external ventricular drainage prior to ELD. Median time to ELD insertion was 5 days (4-8) after brain insult. In all patients, ELD was dramatically effective in lowering ICP: 25 mmHg (20-31) before versus 7 mmHg (3-10) after (p < 0.001). None of the patients showed adverse effects such as pupil changes or intracranial bleeding after the procedure. One patient developed an ELD-related infection. These findings indicate that ELD may be considered potentially effective in controlling ICP, remaining safe if a firm diagnosis of communicating external hydrocephalus has been made.

  16. Validation of the Otitis Media-6 Questionnaire for European Portuguese

    OpenAIRE

    Ana Rita Lameiras; Deodato Silva; Assunção O'Neill; Pedro Escada

    2017-01-01

    Introduction: Otitis media is one of the most prevalent childhood diseases. The impact of otitis media on quality of life of Portuguese children is unknown, because of the unavailability of a tool validated in European Portuguese to assess this consequence of otitis media. The Otitis Media-6 questionnaire (Otitis Media-6) is the most frequently used tool to assess health-related quality of life in children with otitis media. This study aims to create a version in the Portuguese language and c...

  17. Coryneform bacteria associated with canine otitis externa

    DEFF Research Database (Denmark)

    Aalbæk, Bent; Bemis, David A.; Schjærff, Mette

    2010-01-01

    of coryneform bacteria was 16% among 55 cases of canine otitis externa examined at the Danish hospital during 2007. In contrast, detectable levels of coryneform bacteria were not demonstrated in samples from the acustic meatus of 35 dogs with apparently healthy ears, attending the hospital during the same year......This study aims to investigate the occurrence of coryneform bacteria in canine otitis externa. A combined case series and case-control study was carried out to improve the current knowledge on frequency and clinical significance of coryneform bacteria in samples from canine otitis externa. A total...... of 16 cases of otitis externa with involvement of coryneform bacteria were recorded at two referral veterinary hospitals in Denmark and the US, respectively. Coryneform bacteria were identified by partial 16S rRNA gene sequencing. Corynebacterium auriscanis was the most common coryneform species (10...

  18. How often do general practitioners prescribe antibiotics for otitis media and the most common respiratory tract infections?

    Directory of Open Access Journals (Sweden)

    Jørund Straand

    2009-11-01

    Full Text Available  ABSTRACTObjective:  Design:  Setting:  Material:  Results:  Conclusion:  Key words:  Antibiotics, general practice, diagnoses, respiratory tract infections, otitis media, pharmacoepidemiologyExcept for upper respiratory tract infection, antibiotic treatment is the rule not an exception, forall the diagnoses studied. In general practice, improved communication- and prescribing-skills are probablyessentials for implementing a more evidence based treatment of otitis media, and the common respiratorytract infections. The significance of patient related factors for seeing a GP (or not and for (not expectingantibiotics for otitis media and the common respiratory tract infections should be explored in future research.Antibiotics were issued during 57% of all contacts for the included diagnoses, ranging from 22%(upper respiratory tract infection to 91% (tonsillitis. All patients who had first time office consultations fortonsillitis, acute bronchitis and pneumonia, were prescribed antibiotics. One out of three patients who consultedthe doctor on the telephone for these diagnoses, were also prescribed an antibiotic.8610 physician-patient contacts, and 4909 antibiotic prescriptions for otitis media, upper respiratorytract infection, tonsillitis, sinusitis, acute bronchitis, and pneumonia.Cross sectional, multipractice study.GPs in the Norwegian county of Møre & Romsdal. Data were recorded during two months.To examine how frequently general practitioners actually prescribe antibiotics for patientscontacting them for otitis media, and the most common respiratory tract infection diagnoses, – by the type ofdoctor-patient contact during prescribing, and patients' age and sex.

  19. Management of malignant (necrotising) otitis externa.

    Science.gov (United States)

    Hollis, S; Evans, K

    2011-12-01

    Although malignant (necrotising) otitis externa is not a common diagnosis, there have been a number of recently reported cases with pathogens other than Pseudomonas aeruginosa as the causative organism. In addition, there are many published reports of resistance to antibiotics in cases of malignant otitis externa caused by Pseudomonas aeruginosa. This review aims to assess the cases reported and to clarify the current opinion on the diagnostic criteria and management of such cases.

  20. Acute effects of dynamic stretching exercise on power output during concentric dynamic constant external resistance leg extension.

    Science.gov (United States)

    Yamaguchi, Taichi; Ishii, Kojiro; Yamanaka, Masanori; Yasuda, Kazunori

    2007-11-01

    The purpose of the present study was to clarify the acute effect of dynamic stretching exercise on muscular performance during concentric dynamic constant external resistance (DCER, formally called isotonic) muscle actions under various loads. Concentric DCER leg extension power outputs were measured in 12 healthy male students after 2 types of pretreatment. The pretreatments were: (a) dynamic stretching treatment including 2 types of dynamic stretching exercises of leg extensors and the other 2 types of dynamic stretching exercises simulating the leg extension motion (2 sets of 15 times each with 30-second rest periods between sets; total duration: about 8 minutes), and (b) nonstretching treatment by resting for 8 minutes in a sitting position. Loads during measurement of the power output were set to 5, 30, and 60% of the maximum voluntary contractile (MVC) torque with isometric leg extension in each subject. The power output after the dynamic stretching treatment was significantly (p after the nonstretching treatment under each load (5% MVC: 468.4 +/- 102.6 W vs. 430.1 +/- 73.0 W; 30% MVC: 520.4 +/- 108.5 W vs. 491.0 +/- 93.0 W; 60% MVC: 487.1 +/- 100.6 W vs. 450.8 +/- 83.7 W). The present study demonstrated that dynamic stretching routines, such as dynamic stretching exercise of target muscle groups and dynamic stretching exercise simulating the actual motion pattern, significantly improve power output with concentric DCER muscle actions under various loads. These results suggested that dynamic stretching routines in warm-up protocols enhance power performance because common power activities are carried out by DCER muscle actions under various loads.

  1. Otitis Media and Its Sequelae in Kenyan Schoolchildren.

    Science.gov (United States)

    Simões, Eric A F; Kiio, Francis; Carosone-Link, Phyllis J; Ndegwa, Serah N; Ayugi, John; Macharia, Isaac M

    2016-12-01

    The goal of this study was to obtain representative Kenyan data on the point prevalence of acute otitis media (AOM) and its sequelae (otitis media with effusion [OME] and chronic suppurative otitis media [CSOM]), a major cause of preventable hearing loss in children in developing countries. In Africa, there are limited studies on the prevalence of AOM and its sequelae in children. Study subjects were children aged 2 to 15 years and were enrolled from randomly selected preprimary and primary schools. After parental or guardian consent, subjects had a questionnaire administered, otoscopy and tympanometry were done, and audiometry was performed on those with ear problems detected on these examinations. A total of 9825 (75%) children was from rural schools. The prevalence of CSOM was 15 of 1000, OME was 15 of 1000, and AOM was 7 of 1000 children. Rural Rift Valley schoolchildren had the highest prevalence of CSOM (24 of 1000) compared with other regions (12 of 1000; P < .0001). Ear discharge occurred before 3.5 years in 50% of 901 children with ear discharge. A history of ear discharge was associated with abnormal tympanograms (odds ratio [OR], 11.9-19.2) and mild-to-severe hearing loss (OR, 21.6-38.6), even in children without ear disease (OR, 10.7-24.4). The burden of AOM sequelae in Kenyan preschool and schoolchildren is significant, and it occurs mostly in the first 4 years of life. By preventing early recurrent AOM, pneumococcal vaccination might partly avert nonreversible sequelae. © The Author 2015. Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  2. Risk factors for otitis media in children with special emphasis on the role of colonization with bacterial airway pathogens: the Generation R study

    Science.gov (United States)

    Labout, Joost A. M.; Duijts, Liesbeth; Lebon, Ankie; de Groot, Ronald; Hofman, Albert; Jaddoe, Vincent V. W.; Verbrugh, Henri A.; Hermans, Peter W. M.

    2010-01-01

    Acute otitis media is the most frequent diagnosis in children visiting physicians’ offices. Risk factors for otitis media have been widely studied. Yet, the correlation between bacterial carriage and the development of otitis media is not entirely clear. Our aim was to study in a population-based prospective cohort the risk factors for otitis media in the second year of life with special emphasis on the role of colonization with Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. The study was embedded in the Generation R Study. Data on risk factors and doctor-diagnosed otitis media were obtained by midwives, hospital registries and postal questionnaires in the whole cohort (n = 7,295). Nasopharyngeal swabs were obtained at the age of 1.5, 6 and 14 months in the focus cohort (n = 1,079). Of these children, 2,515 (47.2%) suffered at least one period of otitis media in their second year of life. The occurrence of otitis media during the follow-up period in the first 6 months of life and between 6 and 12 months of age was associated with the risk of otitis media in the second year of life (aOR, 1.83 95% CI 1.24–2.71 and aOR 2.72, 95% CI 2.18–3.38, respectively). Having siblings was associated with an increased risk for otitis media in the second year of life (aOR 1.42, 95% CI 1.13–1.79). No associations were found between bacterial carriage in the first year of life and otitis media in the second year of life. In our study, otitis media in the first year of life is an independent risk factor for otitis media in the second year of life. Surprisingly, bacterial carriage in the first year of life did not add to this risk. Moreover, no association was observed between bacterial carriage in the first year of life and otitis in the second year of life. PMID:20821039

  3. Risk factors for otitis media in children with special emphasis on the role of colonization with bacterial airway pathogens: the Generation R study.

    Science.gov (United States)

    Labout, Joost A M; Duijts, Liesbeth; Lebon, Ankie; de Groot, Ronald; Hofman, Albert; Jaddoe, Vincent V W; Verbrugh, Henri A; Hermans, Peter W M; Moll, Henriëtte A

    2011-01-01

    Acute otitis media is the most frequent diagnosis in children visiting physicians' offices. Risk factors for otitis media have been widely studied. Yet, the correlation between bacterial carriage and the development of otitis media is not entirely clear. Our aim was to study in a population-based prospective cohort the risk factors for otitis media in the second year of life with special emphasis on the role of colonization with Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. The study was embedded in the Generation R Study. Data on risk factors and doctor-diagnosed otitis media were obtained by midwives, hospital registries and postal questionnaires in the whole cohort (n = 7,295). Nasopharyngeal swabs were obtained at the age of 1.5, 6 and 14 months in the focus cohort (n = 1,079). Of these children, 2,515 (47.2%) suffered at least one period of otitis media in their second year of life. The occurrence of otitis media during the follow-up period in the first 6 months of life and between 6 and 12 months of age was associated with the risk of otitis media in the second year of life (aOR, 1.83 95% CI 1.24-2.71 and aOR 2.72, 95% CI 2.18-3.38, respectively). Having siblings was associated with an increased risk for otitis media in the second year of life (aOR 1.42, 95% CI 1.13-1.79). No associations were found between bacterial carriage in the first year of life and otitis media in the second year of life. In our study, otitis media in the first year of life is an independent risk factor for otitis media in the second year of life. Surprisingly, bacterial carriage in the first year of life did not add to this risk. Moreover, no association was observed between bacterial carriage in the first year of life and otitis in the second year of life.

  4. Factors influencing the development of otitis media among Sicilian children affected by upper respiratory tract infections.

    Science.gov (United States)

    Martines, Francesco; Salvago, Pietro; Ferrara, Sergio; Messina, Giuseppe; Mucia, Marianna; Plescia, Fulvio; Sireci, Federico

    2016-01-01

    Upper respiratory tract infection is a nonspecific term used to describe an acute infection involving the nose, paranasal sinuses, pharynx and larynx. Upper respiratory tract infections in children are often associated with Eustachian tube dysfunction and complicated by otitis media, an inflammatory process within the middle ear. Environmental, epidemiologic and familial risk factors for otitis media (such as sex, socioeconomic and educational factors, smoke exposure, allergy or duration of breastfeeding) have been previously reported, but actually no data about their diffusion among Sicilian children with upper respiratory tract infections are available. To investigate the main risk factors for otitis media and their prevalence in Sicilian children with and without upper respiratory tract infections. A case-control study of 204 children with upper respiratory tract infections who developed otitis media during a 3 weeks monitoring period and 204 age and sex-matched healthy controls. Seventeen epidemiologically relevant features were inventoried by means of standardized questionnaires and skin tests were performed. Univariate analysis and multivariate logistic regression analysis were used to examine the association between risk factors and occurrence of otitis media. Otitis media resulted strongly associated to large families, low parental educational attainment, schooling within the third years of life (potitis media in the presence of asthma, cough, laryngopharyngeal reflux disease, snoring and apnea (potitis media in children exposed to smoke respectively of 166% and 277% (potitis media are common childhood diseases strongly associated with low parental educational attainment (p=0.0001), exposure to smoke (p=0.0001), indoor exposure to mold (p=0.0001), laryngopharyngeal reflux disease (p=0.0002) and the lack of breast-feeding (p=0.0014); an increased risk of otitis media recurrences was observed in the presence of allergy, persistent cough and runny nose (p=0

  5. Middle Ear Infection (Chronic Otitis Media) and Hearing Loss

    Science.gov (United States)

    ... You Middle Ear Infection (Chronic Otitis Media) and Hearing Loss Middle Ear Infection (Chronic Otitis Media) and Hearing ... learning important speech and language skills. Types of hearing loss Conductive hearing loss is a form of hearing ...

  6. Allergic rhinitis is associated with otitis media with effusion

    DEFF Research Database (Denmark)

    Kreiner-Møller, E; Chawes, B L K; Thomasen, Per Caye

    2012-01-01

    Childhood otitis media with effusion is a common disease and a link to allergic diseases has been suggested.......Childhood otitis media with effusion is a common disease and a link to allergic diseases has been suggested....

  7. Validation of the Otitis Media-6 Questionnaire for European Portuguese

    Directory of Open Access Journals (Sweden)

    Ana Rita Lameiras

    2017-05-01

    Conclusion: The Portuguese version of the Otitis Media-6 questionnaire is a valid, reliable and sensitive instrument to evaluate the health-related quality of life in Portuguese children with otitis media.

  8. Classification and management challenges of otitis media in a ...

    African Journals Online (AJOL)

    2010-04-14

    Apr 14, 2010 ... Classification and management challenges of otitis media in a resource-poor ... Otitis media (OM) is a global middle ear disease with health-economic ...... media: Prevalence and practices among rural south Indian children.

  9. Bacteriology and Antimicrobial Susceptibility of Otitis Media at ...

    African Journals Online (AJOL)

    Bernt Lindtjorn

    Background: Otitis media is a major health problem of children in low income countries. Objectives: This ..... However, in India, Saini reported that S. aureus was the commonest .... Gerhard G. Challenges in reducing the burden of otitis media ...

  10. Positron Emission Tomography/Computed Tomography Findings in Malignant Otitis Externa

    Directory of Open Access Journals (Sweden)

    Gözde Dağlıöz Görür

    2015-06-01

    Full Text Available Malignant otitis externa (MOE is an infrequent but severe invasive infection of the external auditory canal generally caused by Pseudomonas aeruginosa, which mostly affects elderly diabetic patients. Progression of the disease may lead to osteomyelitis of the skull base resulting in potentially fatal intracranial complications. Herein, we describe PET/CT findings of a patient who was referred to PET/CT department for evaluation of skull base osteomyelitis.

  11. Efficacy of Argentine propolis formulation for topical treatment of canine otitis externa

    Directory of Open Access Journals (Sweden)

    L.A Lozina

    2010-12-01

    Full Text Available The therapeutic effects of Argentine propolis ear drop formulation on canine otitis externa were evaluated. Forty-eight dogs with symptoms of otitis externa were randomly assigned to double-blinded, controlled clinical trial to evaluate the efficacy of topical formulation with propolis versus a topical placebo in the treatment of otitis externa. The propolis preparation and placebo were administrated into both external ear canals, twice daily for 14 days. Throughout the study, clinical examination and microbiological analysis of dogs ear exudates were made. The most frequent microorganisms isolated in culture media were: Malassezia pachydermatis (54.2%, Staphylococcus aureus (43.8%, coagulase-negative Staphylococcus (25.0%, Pseudomonas aeruginosa (20.8%, Candida albicans (18.8%, Proteus mirabilis (16.7%, Streptococcus spp. (16.7%, Enteroccocus faecalis (12.5%, Escherichia coli (12.5%, Staphylococcus intermedius (6.3%, Klebsiella spp. (4.2%, andCandida glabrata (2.1%. Whereas the control group did not recover from the infectious ear disease, the propolis preparation exhibited antimicrobial activity against most of the microorganisms isolated from samples of the treated group. In addition, no propolis-adverse effects were observed. This allowed propolis-treated patients to show a significant improvement of the clinical parameters. Thus, this new Argentine propolis ear drop formulation may be used for topical treatment of otitis externa in dogs.

  12. Identification and antimicrobial susceptibility patterns of bacteria causing otitis externa in dogs.

    Science.gov (United States)

    Zamankhan Malayeri, Hamed; Jamshidi, Shahram; Zahraei Salehi, Taghi

    2010-06-01

    Bacterial agents are considered important pathogens causing external otitis in dogs. It is essential to carry out bacterial culture and antimicrobial susceptibility test in the case of otitis externa, particularly for chronic or recurring cases. Sterile swab samples were obtained from terminal part of vertical ear canals of 74 dogs with otitis externa for cytology, bacterial culture and antimicrobial susceptibility test. Cytologic smears were stained using Gram and Giemsa staining methods. Aerobic bacterial culture performed on blood agar and MacConkey agar. Among total number of 92 isolated bacteria, 68 were Staphylococcus intermedius. Other isolated bacteria included: Pseudomonas aeruginosa, Proteus mirabilis, Escherichia coli, Pasteurella canis, and six other species of coagulase-negative Staphylococcus. Antimicrobial susceptibility test were performed for all isolated bacteria using 14 antibiotics. Based on the results of this study, all isolated Staphylococcus spp. were sensitive to amikacin, enrofloxacin, and rifampin, and had low resistance to gentamicin, cephalothin and ceftriaxone. More than half of gram-positive isolates were resistant to penicillin and ampicillin. Generally, all isolated gram-negative bacteria, were sensitive to amikacin and enrofloxacin, and had low resistance to ceftriaxone and gentamicin. They were highly resistant to penicillin, eythromycin, and cephalothin. Regarding the results of this study, in cases of uncomplicated otitis externa, it is possible to select antimicrobial drugs merely based on cytology, but it is recommended to perform bacterial culture and antimicrobial susceptibility test. However, in complicated or refractory cases, antimicrobials should be selected based on bacterial culture and antimicrobial susceptibility test.

  13. Scedosporium apiospermum: a rare cause of malignant otitis externa.

    Science.gov (United States)

    McLaren, Oliver; Potter, Christian

    2016-09-09

    A 79-year-old man, with a history of well-controlled diabetes mellitus, presented with left-sided otalgia. With an initial diagnosis of simple otitis externa, he was discharged on topical drops. He represented 2 months later with worsening otalgia and discharge. A diagnosis of malignant otitis externa was made based on clinical and radiological findings. Intravenous Tazocin and Gentamicin were given based on previous bacterial culture from ear swabs. The patient failed to improve and developed left-sided facial nerve palsy. His condition stabilised following a change in antimicrobial therapy and his management continued in the community on intravenous Meropenem with twice weekly aural toilet. Repeated nuclear medicine imaging failed to demonstrate resolution. A bony sequestration was removed from the external auditory canal in the outpatient clinic, which following extended culture grew Scedosporium apiospermum; his management was subsequently changed to oral Voriconazole. This led to rapid clinical improvement and disease resolution over a 6 -week period.

  14. Investigation of the sensitivities of two different serotypes of Streptococcus pneumoniae in C57BL/6mice with acute otitis media%两种不同血清型肺炎链球菌致C57BL/6小鼠急性中耳炎的敏感性差异

    Institute of Scientific and Technical Information of China (English)

    王维; 周爱娥; 黄益飞; 项云; 何於娟

    2013-01-01

    目的 比较两种不同血清型肺炎链球菌致C57BL/6小鼠急性中耳炎的敏感性.方法 实验组C57BL/6小鼠经鼓膜穿刺分别接种血清型为TIGR4和6B的肺炎链球菌,对照组采用相同方法接种等体积磷酸盐缓冲液(PBS).观察小鼠发病情况,分别于感染后第1、3、5、7天制备中耳组织切片,HE染色观察中耳组织损伤及炎性细胞浸润变化,同时收集中耳灌洗液,检测灌洗液中细菌载量、炎性细胞数量和细胞因子含量.结果 6B组小鼠生存率明显低于TIGR4组和PBS对照组,差异具有统计学意义(P<0.01).接种肺炎链球菌后,小鼠中耳灌洗液中以中性粒细胞为主,TIGR4组募集的炎性细胞数量明显多于6B组;中耳灌洗液中白细胞介素6和肿瘤坏死因子α含量明显升高,其中TIGR4组细胞因子水平均明显高于6B组;6B组小鼠中耳内的细菌清除更慢.结论 在C57 BL/6小鼠急性中耳炎模型中,6B型肺炎链球菌比TIGR4型致病性更强.%Objective To compare the sensitivities of two different serotypes of Streptococcus pneumoniae in acute otitis media of C57BL/6 mice.Methods The middle ear cavity of C57BL/6 mice were inoculated via intratympanic injection of Streptococcus pneumoniae TIGR4 or 6B 1 × 108 CFU,and the control group were inoculated equivalent phosphate buffered solution (PBS).The incidence of mice,development of otitis media and the middle ear lavage fluid pathological changes by HE staining,as well as cell counts and cytokine levels were investigated.Results After inoculated with Streptococcus pneumoniae TIGR4,6B and PBS,the survival rate of 6B group was significantly less than TIGR4 group and PBS control group (P <0.01).Inflammatory cells in the middle ear cavity were mainly neutrophils,and the inflammatory cells recruitment in TIGR4 group were more than 6B group; The levels of IL-6 and TNF-α in the middle ear lavage fluid in T1GR4 group and 6B group were significantly increased compared with PBS

  15. The role of vascular endothelial growth factors and fibroblast growth factors in angiogenesis during otitis media.

    Science.gov (United States)

    Husseman, Jacob; Palacios, Sean D; Rivkin, Alexander Z; Oehl, Heinz; Ryan, Allen F

    2012-01-01

    The middle ear response to otitis media includes transformation and hyperplasia of the mucosal epithelium and subepithelial connective tissue. Significant neovascularization is also noted, which occurs both to support the hypertrophied mucosa and to mediate the increased trafficking of leukocytes. We investigated the role of two known potent angiogenic growth factor families, the fibroblast growth factors (FGFs) and vascular endothelial growth factors (VEGFs), in middle ear mucosal angiogenesis. DNA microarrays were used to evaluate the expression of FGFs and VEGFs, as well as their receptors and unique signaling proteins, in the middle ears of mice undergoing a complete course of acute bacterial otitis media. In addition, a member of each family was introduced to the middle ear submucosal compartment of the normal middle ears of guinea pigs, by a continuous-release osmotic minipump system over 1 week. During the course of bacterial otitis media, a significant regulation of a number of genes important for angiogenesis was identified. Histologic evaluation of middle ear mucosa following micropump infusion of both FGF1 and VEGF-A showed significant angiogenesis at the site of infusion in comparison to control saline infusion. These results support a role for FGFs and VEGFs in the neovascularization of the middle ear mucosa during otitis media, and offer a potential avenue for therapeutic intervention.

  16. Otitis media aguda: nuevo enfoque terapéutico

    Directory of Open Access Journals (Sweden)

    Ileana Alvarez Lam

    2004-03-01

    Full Text Available La otitis media aguda continúa siendo una de las enfermedades infecciosas más frecuentes en la infancia. Se hace una revisión del tema haciendo énfasis en la conducta terapéutica actual luego del surgimiento de complejos mecanismos de resistencia bacteriana creados por los microorganismos causantes de la enfermedad. Como toda enfermedad infecciosa las esperanzas están cifradas en el surgimiento de una vacuna que impacte de forma positiva en nuestra población infantil. En tal sentido se hace una reflexión sobre el uso de la vacuna antineumocócica de 7 valencias (Prevnar y su repercusión sobre esta enfermedad.Acute otitis media is still one of the most common infectious diseases among children. A review of the topic is made giving emphasis to the present therapeutic conduct after the appearance of complex mechanisms of bacterial resistance created by the microorganisms causing the disease. As in every infectious disease, we place our hopes on the emergence of a vaccine with a positive impact on our infantile population. In this sense, a reflection is made on the use of the heptavalent antipneumococcic vaccine (Prevnar and its repercussion on this disease.

  17. 维吾尔族、汉族新生儿中耳炎84例临床探讨%Clinical analysis of 84 cases of infant otitis media in Uighur and Han neonates

    Institute of Scientific and Technical Information of China (English)

    刘国英; 曲亚明; 李芳芳; 曲宁

    2016-01-01

    Objective To discuss the clinical features of otitis media in Uighur and Han neonate. Methods Eighty-four cases of neonatal otitis media patients admitted January 2012 to January 2015 in neonatal department of Xinjiang autonomous regions maternal and child health-care hospital were selected, they were divided into two groups (36 Uighur, 48Han) according to the ethnic, and the features of acute otitis media in neonates were analyzed. Results In 36 cases of Uighur infantile otitis media, external purulent secretion was seen in 9 cases (25%), only 12 cases (33.3%) caused fever, 9 cases (25%) were observed because of irritable and crying, other non-specific manifestations of 6 cases (jaundice,16.6%). In 48 cases of Han infantile otitis media, external purulent secretion accompanied with jaundice was seen in 15 cases (31.2%), only 9 cases (18.7%) caused fever, 6 cases (12.5) caused ear scratching and head shaking because of earache, other non-specific manifestations of 18 cases(jaundice,37.5%). Conclusion Clinical features of otitis media in both Uighur and Han neonates are variable and atypical. But the constituent ratios of complication of otitis media between Uighur and Han infantile patients have difference. Pneumonia and septicemia of newborn are frequently observed in Uighur neonatal otitis media, and the acute upper respiratory tract infection is often diagnosed in Han neonatal otitis media. Pediatricians should improve the understanding on otitis media, for the atypical clinical symptoms, early diagnosis and early treatment necessary to both Uighur and Han neonatal otitis media.%目的:探讨新疆维吾尔自治区妇幼保健院新生儿科维吾尔族(简称维族)、汉族新生儿中耳炎的病因及临床特点,为临床医师早期认识和诊治提供依据。方法抽取我院新生儿科2012年1月-2015年1月份收治的84例患中耳炎的维、汉族新生儿作为研究对象,其中维族36例(男15例,女21例),汉族48

  18. Oral Antibiotic Use for Otitis Media with Effusion: Ongoing Opportunities for Quality Improvement.

    Science.gov (United States)

    Roditi, Rachel E; Liu, C Carrie; Bellmunt, Angela M; Rosenfeld, Richard M; Shin, Jennifer J

    2016-05-01

    (1) To evaluate the probability of antibiotic administration associated with ICD-9 diagnosis of otitis media with effusion (OME) in the absence of acute otitis media, (2) to determine whether usage varies according to visit setting, and (3) to ascertain if practice gaps are such that future practice changes might be measured. Cross-sectional analysis of an administrative database. Ambulatory visits in the United States. National Ambulatory and Hospital Ambulatory Medical Care Surveys, 2005-2010; univariate, multivariate, and stratified analyses of antibiotic usage were performed. The study population was restricted to children without acute or unspecified otitis media. The primary outcome was the probability of oral antibiotic administration when OME was diagnosed. The impact of the location of service and subspecialty care was also analyzed. Data from 1,390,404,196 pediatric visits demonstrated that oral antibiotics were administered for 32% of visits with an OME diagnosis, even in the absence of acute otitis media (odds ratio, 4.31; 95% confidence interval: 2.88-6.44; P < .001). The highest antibiotic administration was seen in the emergency department (risk difference, 37.1%; number needed to harm, 3). No significant increased risk of antibiotic usage was seen during otolaryngology visits. Diagnoses of infections at nonotologic sites were associated with a 1.98 to 26.60 increase in odds of oral antibiotic administration. Oral antibiotics continue to be administered in children with OME in the absence of acute infection, with risk varying by location of service. There is a potential opportunity for quality improvement through reducing antibiotic administration for pediatric OME. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  19. Epidemiology, natural history, and risk factors: panel report from the Ninth International Research Conference on Otitis Media.

    Science.gov (United States)

    Daly, Kathleen A; Hoffman, Howard J; Kvaerner, Kari Jorunn; Kvestad, Ellen; Casselbrant, Margaretha L; Homoe, Preben; Rovers, Maroeska M

    2010-03-01

    The 2007 Recent Advances in Otitis Media Research Conference Panel Report provides an update on otitis media (OM) research published from 2003 to 2007. This report summarizes important trends in disease incidence and prevalence, describes established and newly identified risk factors for acute and chronic OM and OM with effusion, and conveys information on newly discovered genetic factors. In this report, researchers have described declining rates of OM diagnosis, antibiotic prescriptions, offices visits for OM, and middle ear surgery since the licensure and routine use of pneumococcal conjugate vaccine in infants. The panel report also recommends short and long term goals for current and future OM research.

  20. [Comparative characteristic of the local application of anti-inflammatory agents for the treatment of otitis externa and otitis media].

    Science.gov (United States)

    Magomedov, M M; Starostina, A E; Magomedov, M G

    2012-01-01

    The objective of the present work was the clinical study of candibiotic exhibitic antibacterial, antimycotic, anti-inflammatory, and anesthetic properties when applied for the treatment of otitis externa and otitis media. This agent was included together with traditionally used systemic medications in the combined treatment of 26 patients. It was applied in the form of endoaural drops, transtubal administration through a catheter, and transtympanic pumping by the Politzer balloon technique (in case of perforation). In the patients with otomycosys, the preparation was used for the treatment of the external acoustic canal after the removal of fungal masses thrice daily for 1 month. Good clinical effect achieved in all the patients was manifest as the normal otoscopic picture and less frequent complaints on days 8-10 after the onset of therapy. Its maximum duration was 21 days. Positive dynamics (pain relief) was apparent within the first 2 days of the treatment. Fungal mycelium was absent after 14-16 days of the treatment in 100% of the patients initially presenting with yeast-like fungi.

  1. Coryneform bacteria associated with canine otitis externa.

    Science.gov (United States)

    Aalbæk, Bent; Bemis, David A; Schjærff, Mette; Kania, Stephen A; Frank, Linda A; Guardabassi, Luca

    2010-10-26

    This study aims to investigate the occurrence of coryneform bacteria in canine otitis externa. A combined case series and case-control study was carried out to improve the current knowledge on frequency and clinical significance of coryneform bacteria in samples from canine otitis externa. A total of 16 cases of otitis externa with involvement of coryneform bacteria were recorded at two referral veterinary hospitals in Denmark and the US, respectively. Coryneform bacteria were identified by partial 16S rRNA gene sequencing. Corynebacterium auriscanis was the most common coryneform species (10 cases). Small colony variants of this species were also observed. Other coryneform isolates were identified as Corynebacterium amycolatum (3 cases), Corynebacterium freneyi (2 cases) and an Arcanobacterium-like species (1 case). The coryneform bacteria were in all cases isolated together with other bacteria, mainly Staphylococcus pseudintermedius alone (n=5) or in combination with Malassezia pachydermatis (n=5). Some coryneform isolates displayed resistance to fusidic acid or enrofloxacin, two antimicrobial agents commonly used for the treatment of otitis externa in dogs. The frequency of isolation of coryneform bacteria was 16% among 55 cases of canine otitis externa examined at the Danish hospital during 2007. In contrast, detectable levels of coryneform bacteria were not demonstrated in samples from the acustic meatus of 35 dogs with apparently healthy ears, attending the hospital during the same year. On basis of the current knowledge, these coryneform bacteria should be regarded as potential secondary pathogens able to proliferate in the environment of an inflamed ear canal.

  2. Genetic characteristics of Haemophilus influenzae and Streptococcus pneumoniae isolated from children with conjunctivitis-otitis media syndrome.

    Science.gov (United States)

    Sugita, Gen; Hotomi, Muneki; Sugita, Rinya; Kono, Masamitsu; Togawa, Akihisa; Yamauchi, Kazuma; Funaki, Toshinari; Yamanaka, Noboru

    2014-08-01

    Acute conjunctivitis is the most common ocular disorders among children and frequently concomitant with acute otitis media (AOM) as conjunctivitis-otitis syndrome. In this study, we evaluated prevalence of causative pathogens and PCR-based genotypes of Haemophilus influenzae and Streptococcus pneumoniae among children with conjunctivitis-otitis media syndrome. Nontypeable H. influenzae (NTHi) is identified most often at 61.8% in conjunctiva exudates followed by S. pneumoniae at 28.2% and Moraxella catarrhalis at 19.1%. Genetic β-lactamase nonproducing ampicillin resistant (gBLNAR) strains of NTHi and genetic penicillin resistant S. pneumoniae (gPRSP) were identified at 72.1% and at 74.2% among conjunctiva isolates by polymerase chain reaction (PCR), respectively. Pneumococcal strains having either ermB or mefE genes were identified at 93.5% among conjunctiva isolates. The restriction fragment of patterns of 89.7% pairs of H. influenzae isolates and 100% pairs of pneumococcal isolates from conjunctiva exudates, middle ear fluids (MEFs) and nasopharyngeal swabs were identical. In contrast to the previous reports, most prevalent strains from conjunctivitis-otitis media syndrome was BLNAR H. influenzae in this study. The causative pathogen responsible for acute conjunctivitis will be originated from the nasopharynx. In the absence of MEFs one can possibly rely on the nasopharyngeal culture to guide an appropriate treatment.

  3. A multi-centre open-label randomised non-inferiority trial comparing watchful waiting to antibiotic treatment for acute otitis media without perforation in low-risk urban Aboriginal and Torres Strait Islander children (the WATCH trial): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Abbott, Penelope; Gunasekera, Hasantha; Leach, Amanda Jane; Askew, Deborah; Walsh, Robyn; Kong, Kelvin; Girosi, Federico; Bond, Chelsea; Morris, Peter; Lujic, Sanja; Hu, Wendy; Usherwood, Tim; Tyson, Sissy; Spurling, Geoffrey; Douglas, Markeeta; Schubert, Kira; Chapman, Shavaun; Siddiqui, Nadeem; Murray, Reeion; Rabbitt, Keitha; Porykali, Bobby; Woodall, Cheryl; Newman, Tina; Reath, Jennifer

    2016-03-03

    Treatment guidelines recommend watchful waiting for children older than 2 years with acute otitis media (AOM) without perforation, unless they are at high risk of complications. The high prevalence of chronic suppurative otitis media (CSOM) in remote Aboriginal and Torres Strait Islander communities leads these children to be classified as high risk. Urban Aboriginal and Torres Strait Islander children are at lower risk of complications, but evidence to support the subsequent recommendation for watchful waiting in this population is lacking. This non-inferiority multi-centre randomised controlled trial will determine whether watchful waiting is non-inferior to immediate antibiotics for urban Aboriginal and Torres Strait Islander children with AOM without perforation. Children aged 2 - 16 years with AOM who are considered at low risk for complications will be recruited from six participating urban primary health care services across Australia. We will obtain informed consent from each participant or their guardian. The primary outcome is clinical resolution on day 7 (no pain, no fever of at least 38 °C, no bulging eardrum and no complications of AOM such as perforation or mastoiditis) as assessed by general practitioners or nurse practitioners. Participants and outcome assessors will not be blinded to treatment. With a sample size of 198 children in each arm, we have 80 % power to detect a non-inferiority margin of up to 10 % at a significance level of 5 %, assuming clinical improvement of at least 80 % in both groups. Allowing for a 20 % dropout rate, we aim to recruit 495 children. We will analyse both by intention-to-treat and per protocol. We will assess the cost- effectiveness of watchful waiting compared to immediate antibiotic prescription. We will also report on the implementation of the trial from the perspectives of parents/carers, health professionals and researchers. The trial will provide evidence for the safety and effectiveness of watchful waiting

  4. Management of radiation-induced otitis externa

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, A.C. (Royal Free Hospital, London (UK). Dept. of Otorhinolaryngology)

    1990-06-01

    Four cases of otitis externa secondary to radiotherapy are described. This fairly common complication of irradiation to the head and neck, may impede a satisfactory completion of the therapy. Water precautions and regular otoscopic examination of the ears should be encouraged as prevention or early recognition of the condition is essential for the well being of the patient. The treatment of established otitis externa consists of frequent aural toilet and the application of weak antiseptic solutions. However, complete resolution will not occur until the cutaneous reaction has fully settled. (author).

  5. A randomized trial comparing hypofractionated and conventionally fractionated three-dimensional external-beam radiotherapy for localized prostate adenocarcinoma. A report on acute toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Norkus, Darius; Miller, Albert; Kurtinaitis, Juozas; Valuckas, Konstantinas Povilas [Dept. of Radiotherapy, Inst. of Oncology, Vilnius Univ. (Lithuania); Haverkamp, Uwe [Dept. of Radiology, Clemenshospital, Muenster (Germany); Popov, Sergey [Dept. of Radiotherapy, Riga Eastern Hospital, Latvian Oncology Center, Riga (Latvia); Prott, Franz-Josef [Inst. of Radiology and Radiotherapy (RNS), St. Josefs Hospital, Wiesbaden (Germany)

    2009-11-15

    Purpose: to compare acute gastrointestinal (GI) and genitourinary (GU) toxicity between patient groups with localized prostate adenocarcinoma, treated with conventionally fractionated (CFRT) and hypofractionated (HFRT) three-dimensional conformal external-beam radiotherapy (3D-CRT). Patients and methods: 91 patients were enrolled into a randomized study with a minimum follow-up of 3 months. 44 men in the CFRT arm were irradiated with 74 Gy in 37 fractions at 2 Gy per fraction for 7.5 weeks. 47 men in the HFRT arm were treated with 57 Gy in 17 fractions for 3.5 weeks, given as 13 fractions of 3 Gy plus four fractions of 4.5 Gy. The clinical target volume (CTV) included the prostate and the base of seminal vesicles. The CTV-to-PTV (planning target volume) margin was 8-10 mm. Study patients had portal imaging and/or simulation performed on the first fractions and repeated at least weekly. Results: no acute grade 3 or 4 toxicities were observed. The grade 2 GU acute toxicity proportion was significantly lower in the HFRT arm: 19.1% versus 47.7% ({chi}{sup 2}-test, p = 0.003). The grade 2 GU acute toxicity-free survival was significantly better in the HFRT arm (log-rank test, p = 0.008). The median duration of overall GI acute toxicity was shorter with HFRT: 3 compared to 6 weeks with CFRT (median test, p = 0.017). Conclusion: in this first evaluation, the HFRT schedule is feasible and induces acceptable or even lower acute toxicity compared with the toxicities in the CFRT schedule. Extended follow-up is needed to justify this fractionation schedule's safety in the long term. (orig.)

  6. Prediction Models and Their External Validation Studies for Mortality of Patients with Acute Kidney Injury: A Systematic Review

    Science.gov (United States)

    Ohnuma, Tetsu; Uchino, Shigehiko

    2017-01-01

    Objectives To systematically review AKI outcome prediction models and their external validation studies, to describe the discrepancy of reported accuracy between the results of internal and external validations, and to identify variables frequently included in the prediction models. Methods We searched the MEDLINE and Web of Science electronic databases (until January 2016). Studies were eligible if they derived a model to predict mortality of AKI patients or externally validated at least one of the prediction models, and presented area under the receiver-operator characteristic curves (AUROC) to assess model discrimination. Studies were excluded if they described only results of logistic regression without reporting a scoring system, or if a prediction model was generated from a specific cohort. Results A total of 2204 potentially relevant articles were found and screened, of which 12 articles reporting original prediction models for hospital mortality in AKI patients and nine articles assessing external validation were selected. Among the 21 studies for AKI prediction models and their external validation, 12 were single-center (57%), and only three included more than 1,000 patients (14%). The definition of AKI was not uniform and none used recently published consensus criteria for AKI. Although good performance was reported in their internal validation, most of the prediction models had poor discrimination with an AUROC below 0.7 in the external validation studies. There were 10 common non-renal variables that were reported in more than three prediction models: mechanical ventilation, age, gender, hypotension, liver failure, oliguria, sepsis/septic shock, low albumin, consciousness and low platelet count. Conclusions Information in this systematic review should be useful for future prediction model derivation by providing potential candidate predictors, and for future external validation by listing up the published prediction models. PMID:28056039

  7. Polymorphisms in Toll-like receptors 2 and 4 genes and their expression in chronic suppurative otitis media.

    Science.gov (United States)

    Jotic, Ana; Jesic, Snezana; Zivkovic, Maja; Tomanovic, Nada; Kuveljic, Jovana; Stankovic, Aleksandra

    2015-12-01

    Toll-like receptors (TLRs) have a prominent role in inducing innate immune response. It has been suggested that regulation of TLRs is involved in the pathogenesis of chronic otitis media. TLR 2 and TLR 4 polymorphisms were connected with susceptibility to acute otitis and chronic otitis with effusion. The objective of this study was to establish expression of TLR 2 and 4 on middle ear mucosa in different types of chronic suppurative otitis media (CSOM), and the influence of gene polymorphisms TLR 2 Arg753Gln and TLR 4 Thr399Ile and Asp299Gly to susceptibility to CSOM. Middle ear mucosa and full blood samples were obtained from 85 patients with chronic suppurative otitis media with and without cholesteatoma. Control group for mucosal TLR expression consisted of 71 samples of middle ear mucosa taken from patients with otosclerosis, and control group for DNA polymorphism consisted of 100 full blood samples in healthy subjects. DNA polymorphism detection was done with restriction fragment length polymorphism in RT PCR. Expression of TLR 2 and 4 was determined with immunohistochemical staining. TLR 2 and TLR 4 expression on the middle ear mucosa was not influenced by age of the patients with chronic otitis media. Incidence of TLR 2 Arg753Gln polymorphism was significantly higher in patients with chronic otitis media, compared to control group. Significant association between TLR 2 Arg753Gln polymorphism and different types of mucosal changes in patients with chronic otitis media was established. TLR 2 and 4 expression on experimental group mucosa was significantly different compared to control group, where there was no expression (p=0.000). Strong dependence of TLR 2 and TLR 4 expression on middle ear mucosa with different mucosal changes and immunohistochemical activity after staining was detected. Certain polymorphisms in TLR genes could be indicative for susceptibility to chronic otitis media. Expression of TLR 2 and 4 on middle ear mucosa was more dependable on

  8. Chronic granulomatous otitis externa as an initial presentation of cutaneous Crohn disease.

    Science.gov (United States)

    Raynor, Eileen M

    2014-08-01

    In the limited number of Crohn disease cases involving the head and neck, there is a predilection for mucosal surfaces and rare reports of involvement in the postauricular region. To our knowledge, in all previously reported cases involving the head and neck, the patients had a known diagnosis of Crohn disease. This case describes a 10-year-old boy with a history of psoriasis and psoriasiform dermatitis who presented with bilateral chronic granulomatous otitis externa, obliteration of the external auditory canal, and fissuring, resulting in separation of the lobule from the preauricular skin. Pathologic examination results were consistent with granulomatous dermatitis concerning for cutaneous Crohn disease, and a subsequent gastroenterologic workup confirmed the diagnosis of Crohn disease. This is a report of chronic granulomatous otitis as the initial presentation of cutaneous Crohn disease in a child.

  9. Otitis media in young Aboriginal children from remote communities in Northern and Central Australia: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Silberberg Peter

    2005-07-01

    Full Text Available Abstract Background Middle ear disease (otitis media is common and frequently severe in Australian Aboriginal children. There have not been any recent large-scale surveys using clear definitions and a standardised middle ear assessment. The aim of the study was to determine the prevalence of middle ear disease (otitis media in a high-risk population of young Aboriginal children from remote communities in Northern and Central Australia. Methods 709 Aboriginal children aged 6–30 months living in 29 communities from 4 health regions participated in the study between May and November 2001. Otitis media (OM and perforation of the tympanic membrane (TM were diagnosed by tympanometry, pneumatic otoscopy, and video-otoscopy. We used otoscopic criteria (bulging TM or recent perforation to diagnose acute otitis media. Results 914 children were eligible to participate in the study and 709 were assessed (78%. Otitis media affected nearly all children (91%, 95%CI 88, 94. Overall prevalence estimates adjusted for clustering by community were: 10% (95%CI 8, 12 for unilateral otitis media with effusion (OME; 31% (95%CI 27, 34 for bilateral OME; 26% (95%CI 23, 30 for acute otitis media without perforation (AOM/woP; 7% (95%CI 4, 9 for AOM with perforation (AOM/wiP; 2% (95%CI 1, 3 for dry perforation; and 15% (95%CI 11, 19 for chronic suppurative otitis media (CSOM. The perforation prevalence ranged from 0–60% between communities and from 19–33% between regions. Perforations of the tympanic membrane affected 40% of children in their first 18 months of life. These were not always persistent. Conclusion Overall, 1 in every 2 children examined had otoscopic signs consistent with suppurative ear disease and 1 in 4 children had a perforated tympanic membrane. Some of the children with intact tympanic membranes had experienced a perforation that healed before the survey. In this high-risk population, high rates of tympanic perforation were associated with high

  10. LOCAL COMPLEX TREATMENT EXPERIENCE FOR PATIENTS WITH CHRONIC PURULENT OTITIS MEDIA

    Directory of Open Access Journals (Sweden)

    Nilufar Jurakulovna Khushvakova

    2015-09-01

    Full Text Available  In this article, we have analyzed the results of the application of the combined solution of decasan and ozone-oxygen mixture, as a local conservative treatment, for 135 patients with acute exacerbation of chronic purulent medial otitis (CPOM. Its use increases the effectiveness of treatment and reduces time. The study of long-term results has shown persistence of sustained remission in 91,4% of patients.A comparative analysis of traditional treatments and topical administration of antiseptic 0.002 % solution of “Dekasan” (dekametansin, in combination with ozone-oxygen mixture in patients with suppurative otitis media, was carried out. The analysis was conducted using ozone-oxygen mixture along with a local irrigation of middle ear cavity with “Dekasan.”

  11. Developing a vaccine to prevent otitis media caused by nontypeable Haemophilus influenzae.

    Science.gov (United States)

    Khan, M Nadeem; Ren, Dabin; Kaur, Ravinder; Basha, Saleem; Zagursky, Robert; Pichichero, Michael E

    2016-07-01

    Nontypeable Haemophilus influenzae (NTHi) is a predominant organism of the upper respiratory nasopharyngeal microbiota. Its disease spectrum includes otitis media, sinusitis, non-bacteremic pneumonia and invasive infections. Protein-based vaccines to prevent NTHi infections are needed to alleviate these infections in children and vulnerable populations such as the elderly and those with chronic obstructive pulmonary disease (COPD). One NTHi protein is included in a pneumococcal conjugate vaccine and has been shown to provide efficacy. Our lab has been interested in understanding the immunogenicity of NTHi vaccine candidates P6, protein D and OMP26 for preventing acute otitis media in young children. We expect that continued investigation and progress in the development of an efficacious protein based vaccine against NTHi infections is achievable in the near future.

  12. Oral use of Streptococcus salivarius K12 in children with secretory otitis media: preliminary results of a pilot, uncontrolled study

    Directory of Open Access Journals (Sweden)

    Di Pierro F

    2015-09-01

    Full Text Available Francesco Di Pierro,1 Daniele Di Pasquale,2 Maurizio Di Cicco2 1Velleja Research, Milan, Italy; 2ORL Department, Ospedale Maggiore Policlinico Ca’ Grande IRCCS, Milan, Italy Abstract: Secretory otitis media (SOM remains a common disease among children. Although its cause is not yet perfectly established, the pathology, often a sequel of acute otitis media (AOM, is mainly characterized by persistent fluid in the middle ear cavity. Twenty-two children with a diagnosis of SOM were treated daily for 90 days with an oral formulation containing the oral probiotic Streptococcus salivarius K12 (Bactoblis®. After treatment, the children were evaluated for AOM episodes and subjected to tone audiometry, tympanometry, endonasal endoscopy, otoscopy, and tonsillar examination. Subject compliance and probiotic tolerability and side effects have also been evaluated. Our results indicate a good safety profile, a substantial reduction of AOM episodes, and a positive outcome from the treatment for all of the clinical outcomes tested. We conclude that strain K12 may have a role in reducing the occurrence and/or severity of SOM in children. From our perspective, this study constitutes a starting point toward the organization of a more extensive placebo-controlled study aimed at critically appraising our preliminary observations. Keywords: BLIS K12, Bactoblis®, acute otitis media, exudative otitis media

  13. EOSINOPHILIC OTITIS MEDIA A LITERATURE REVIEW

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    Balasubramanian Thiagarajan

    2013-01-01

    Full Text Available Eosinophilic otitis media is actually a recent introduction. These patients may manifest with sudden hearing loss. There may be associated bronchial asthma and allergic rhinitis. Diagnostic criteria of this condition are rather vague. A review of literature shows that demonstration of eosinophils in the middle ear secretion of these patients could be considered to be pathognomonic of this condition

  14. Mucosal biofilm detection in chronic otitis media

    DEFF Research Database (Denmark)

    Wessman, Marcus; Bjarnsholt, Thomas; Eickhardt-Sørensen, Steffen Robert

    2015-01-01

    The objectives of this study were to examine middle ear biopsies from Greenlandic patients with chronic otitis media (COM) for the presence of mucosal biofilms and the bacteria within the biofilms. Thirty-five middle ear biopsies were obtained from 32 Greenlandic COM patients admitted to ear...

  15. The microbiome of otitis media with effusion.

    Science.gov (United States)

    Chan, Chun Ling; Wabnitz, David; Bardy, Jake Jervis; Bassiouni, Ahmed; Wormald, Peter-John; Vreugde, Sarah; Psaltis, Alkis James

    2016-12-01

    The adenoid pad has been considered a reservoir for bacteria in the pathogenesis of otitis media with effusion. This study aimed to characterize the middle ear microbiota in children with otitis media with effusion and establish whether a correlation exists between the middle ear and adenoid microbiota. Prospective, controlled study. Middle ear aspirates adenoid pad swabs were collected from 23 children undergoing ventilation tube insertion. Adenoid swabs from patients without ear disease were controls. Samples were analyzed using 16S rRNA sequencing on the Illumina MiSeq platform. Thirty-five middle ear samples were collected. The middle ear effusion microbiota was dominated by Alloiococcus otitidis (23% mean relative abundance), Haemophilus (22%), Moraxella (5%), and Streptococcus (5%). Alloiococcus shared an inverse correlation with Haemophilus (P = .049) and was found in greater relative abundance in unilateral effusion (P = .004). The microbiota of bilateral effusions from the same patient were similar (P otitis media with effusion microbiota were found to be dissimilar to that of the adenoid (P = .01), whereas the adenoid microbiota of otitis media with effusion and control patients were similar (P > .05) (permutational multivariate analysis of the variance). Dissimilarities between the local microbiota of the adenoid and the middle ear question the theory that the adenoid pad is a significant reservoir to the middle ear in children with otitis media with effusion. A otitidis had the greatest cumulative relative abundance, particularly in unilateral effusions, and shares an inverse correlation with the relative abundance of Haemophilus. NA Laryngoscope, 126:2844-2851, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  16. Comportamiento de la otitis media aguda

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    Gladys Fuentes Fernández

    Full Text Available Introducción: la otitis media aguda es una complicación de las infecciones respiratorias agudas altas, frecuente en los niños menores de 5 años. Objetivos: caracterizar su comportamiento, según edad y sexo, e identificar algunos factores de riesgo en este grupo de edad. Métodos: se realizó un estudio descriptivo retrospectivo de 554 niños ingresados en el hospital Pediátrico de Centro Habana con el diagnóstico de otitis media aguda, durante los años 2006-2010. Los datos se recogieron de las historias clínicas. Resultados: la otitis media aguda fue más frecuente en el sexo masculino (58,7 % y en los menores de 1 año (53,1 %. El antecedente de bajo peso (33,9 % y la prematuridad (27,5 %, la asistencia a círculos infantiles (43,5 % y el hábito de fumar de los padres (58,4 %, además del antecedente de ingresos hospitalarios por otitis media en el mes previo a la aparición del episodio actual (59,0 %, constituyeron los principales factores de riesgo en el presente estudio. Conclusiones: la otitis media es una causa frecuente de ingresos hospitalarios, y se identifican como principales factores de riesgo la asistencia a círculos infantiles y el tabaquismo de algunos de los padres.

  17. External validation of the APPS, a new and simple outcome prediction score in patients with the acute respiratory distress syndrome

    NARCIS (Netherlands)

    Bos, Lieuwe D; Schouten, Laura R; Cremer, Olaf L; Ong, David S Y; Schultz, Marcus J

    2016-01-01

    BACKGROUND: A recently developed prediction score based on age, arterial oxygen partial pressure to fractional inspired oxygen ratio (PaO2/FiO2) and plateau pressure (abbreviated as 'APPS') was shown to accurately predict mortality in patients diagnosed with the acute respiratory distress syndrome (

  18. 头孢地尼与阿莫西林克拉维酸钾治疗儿童急性中耳炎的临床观察%Observation of Cefdinir with Amoxicillin/Clavulanatein in Treatment of Children Acute Otitis Media

    Institute of Scientific and Technical Information of China (English)

    杨丽; 艾文彬; 罗琴

    2015-01-01

    Objective To compare the efficacy,safety,compliance difference of cefdinir and amoxicillin/clavulanate in treatment of children with acute otitis media(AOM). Methods 201 cases (232 ears) with AOM who received either cefdinir particles (daily dose of 7mg/kg/d,divided two times daily for 5 days) or amoxicillin/clavulanate(daily dose of 13. 3 mg/kg,divided two times daily for 10 days) treatment from 2011 January to 2012 December were reviewed retrospec-tively. According to the clinical symptoms and signs recovery,compare the efficacy,drug compliance and safety differences of two groups. Results At the end of treatment,104 ears were cured or improved (104/106,98. 11%) in the cefdinir group,while in the amoxicillin/clavulanate group 96 ears were cured or improved (96/106,90. 57%). Cefdinir was signifi-cantly better than amoxicillin/clavulanate in efficacy (P0. 05). Conclusion 5-day oral cefdidir treatment was significantly better than 10-day oral amoxicillin/clavulanate treatment for children acute o-titis media in efficacy、medication adherence and safety,it seems to be a better choice of short treatment.%目的:比较头孢地尼与阿莫西林克拉维酸钾治疗儿童急性中耳炎( AOM)的疗效、用药依从性、安全性差别。方法对2011年1月~2012年12月资料完整的分别使用头孢地尼(日剂量7.0mg/kg,每日2次,连续服用5天,91例)或阿莫西林克拉维酸钾(日剂量13.3mg/kg,每日2次,连续服用10天,110例)治疗的AOM患儿进行回顾性分析。根据患儿临床症状与体征是否恢复评定疗效,比较两种药物对儿童AOM的疗效、药物依从性及安全性。结果头孢地尼组完成疗程的病例90例(106耳),治疗7~9天时有效率为98.11%(104/106耳);阿莫西林克拉维酸钾组完成疗程的病例95例(106耳),治疗12~14天时有效率为90.57%(96/106耳)。头孢地尼组疗效明显高于阿莫西林克拉维酸钾组,差异具有显著统计学意义(P0.05)。结论

  19. Otimizando o diagnóstico para o tratamento adequado das principais infecções agudas em otorrinopediatria: tonsilite, sinusite e otite média Optimizing the management of the main acute infections in pediatric ORL: tonsillitis, sinusitis, otitis media

    Directory of Open Access Journals (Sweden)

    Tania Maria Sih

    2008-10-01

    Full Text Available As sinusites, otites médias agudas e tonsilites são muito freqüentes em crianças. A maioria dessas infecções é causada por vírus, mas em geral, elas são tratadas com antibióticos. O uso inapropriado de antibióticos favorece a seleção, crescimento e disseminação de bactérias resistentes que colonizam as vias respiratórias, atingindo toda a comunidade. A emergência de bactérias resistentes dificulta os tratamentos das infecções respiratórias, sendo essencial desenvolver estratégias efetivas para restringir o uso de antibióticos sem prejudicar as crianças que realmente precisam desses medicamentos. OBJETIVO: Analisar os resultados de estudos randomizados e controlados sobre critérios clínicos e laboratoriais utilizados para diagnóstico e tratamento das tonsilites, sinusites e otites. MÉTODOS: Levantamento dos estudos randomizados e controlados sobre o tema, publicados no MEDLINE e SCIELO, de 2000 a 2006. CONCLUSÕES: Como a maioria dessas infecções evolui bem sem antibióticos, deve-se evitar o uso desses medicamentos a menos que a criança pertença aos grupos de alto risco para complicações ou apresente persistência ou piora dos sintomas com tratamento sintomático. É necessário que os médicos e leigos conheçam melhor a evolução natural das infecções respiratórias agudas e que seja garantido o acesso das crianças a serviços médicos de boa qualidade para orientação e reavaliação, quando necessária.Sinusitis, acute otitis media and tonsillitis are very frequent in children. Most of these infections are caused by viruses, but are generally treated with antibiotics. Inappropriate use of antibiotics favors the selection, growth and spread of resistant bacteria; these bacteria colonize the airways and affect the entire community. With the emergence of antibiotic-resistant bacteria, respiratory infections have become more difficult to treat. Effective strategies are needed to restrict the use of

  20. Technique of stepwise intracranial decompression combined with external ventricular drainage catheters improve the prognosis of acute post-traumatic hemispheric brain swelling patients

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    Lei eShi

    2015-09-01

    Full Text Available Background: Acute post-traumatic cerebral hemispheric brain swelling (ACHS is a serious disorder that occurs after traumatic brain injury (TBI, and it often requires immediate treatment. The aim of our clinical study was to assess the effects of stepwise intracranial decompression combined with external ventricular drainage catheters on the prognosis of ACHS patients.Methods: A retrospective study was performed on 172 cases of severe craniocerebral trauma patients with acute cerebral hemispheric swelling. The patients were divided into two groups: unilateral stepwise standard large trauma craniectomy (S-SLTC combined with external ventricular drainage (EVD catheter implants (n = 86 and unilateral routine frontal temporal parietal SLTC (control group, n = 86.Result: No significant differences in age, sex, or preoperative Glasgow Coma Scale score were observed between groups (P < 0.05. There were no significant differences in the ipsilateral subdural effusion incidence rates between the S-SLTC+EVD treatment group and the routine SLTC group. However, the incidence rates of intraoperative acute encephalocele and contralateral epidural and subdural hematoma in the S-SLTC+EVD group were significantly lower than those in the SLTC group (17.4% and 3.5% vs. 37.2% and 23.3%, respectively. The mean intracranial pressure (ICP values of patients in the S-SLTC+EVD group were also lower than those in the SLTC group at days 1 through7 (P<0.05. A positive neurological outcome (GOS score 4 to 5, 50.0% and decreased mortality (15.1% was observed in the S-SLTC+EVD group compared to the neurological outcome (GOS score 4 to 5, 33.8%; 36.0% in the SLTC group (P<0.05.Conclusions: Our data suggest that S-SLTC+EVD is more effective for controlling ICP, improving neurological outcome, and decreasing mortality rate compared with routine SLTC.

  1. Key components of external facilitation in an acute stroke quality improvement collaborative in the Veterans Health Administration.

    Science.gov (United States)

    Bidassie, Balmatee; Williams, Linda S; Woodward-Hagg, Heather; Matthias, Marianne S; Damush, Teresa M

    2015-05-14

    Facilitation is a key component for successful implementation in several implementation frameworks; however, there is a paucity of research specifying this component. As part of a stroke quality improvement intervention in the Veterans Health Administration (VHA), facilitation plus data feedback was compared to data feedback alone in 11 VA medical facilities. The objective of this study was to elucidate upon the facilitation components of the stroke quality improvement. We conducted a secondary evaluation of external facilitation using semi-structured interviews. Five facilitators and two program directors were interviewed. Qualitative analysis was performed on transcribed interviews to gain an understanding of the role and activities of external facilitators during the on-site and telephone facilitation. Quantitative frequencies were calculated from the self-reported time spent in facilitation tasks by facilitators. The external facilitators saw their role as empowering the clinical teams to take ownership of the process changes at the clinical sites to improve their performance quality. To fulfill this role, they reported engaging in a number of core tasks during telephone and on-site visits including: assessing the context in which the teams were currently operating, guiding the clinical teams through their planned changes and use of process improvement tools, identifying resources and making referrals, holding teams accountable for plan implementation with on-site visits, and providing support and encouragement to the teams. Time spent in facilitation activities changed across time from guiding change (early) to supporting efforts made by the clinical teams (later). Facilitation activity transitioned to more monitoring, problem solving, and intentional work to hand over the clinical improvement process to the site teams with the coach's role being increasingly that of a more distant consultant. Overall, this study demonstrated that external facilitation is not

  2. Feature and significance of bacterial biofilm formation in middle-ear mucosa in the rat model of acute otitis media%细菌生物膜在急性中耳炎大鼠中耳腔的形成特点及意义

    Institute of Scientific and Technical Information of China (English)

    柯朝阳; 杨名保; 龚桃根; 刘明

    2011-01-01

    目的 通过观察细菌生物膜在急性中耳炎大鼠中耳腔的形成特点,分析其与急性中耳炎的关系,并探讨该中耳炎模型用于细菌生物膜研究的可行性.方法 30只健康雄性SD大鼠,采用随机数字表法分为实验组(24只)和对照组(6只).麻醉后将50μl肺炎链球菌悬液[1×108菌落形成单位(colony forming unit,CFU)/ml]经听泡穿刺注入到实验组大鼠双侧中耳腔,等量生理盐水注入到对照组大鼠双侧中耳腔.分别于注射后1、3、5、7、10、14 d各取3只实验组大鼠和1只对照组大鼠的双侧听泡行中耳黏膜扫描电镜观察;另取1只实验组大鼠,显微镜下刮取收集双侧中耳腔表面附着的膜状物,行异硫氰酸荧光素标记的刀豆球蛋白(FITC-ConA)及碘化丙啶(propidium iodide,PI)免疫荧光二重染色,激光扫描共聚焦显微镜观察和革兰染色观察.结果 实验组大鼠在炎性反应早期(1 d、3 d)可见中耳腔大量细菌黏附,定植于局部区域形成微菌落,有吞噬细胞混杂其中,形成初级细菌生物膜;炎性反应中期(5 d、7 d)可见成熟细菌生物膜散在于黏膜表面,形成特征性的"蘑菇状"、"塔状"三维立体结构;炎性反应后期(10 d、14 d)部分细菌生物膜呈现衰退迹象.中耳腔膜状物经FITC-ConA、PI二重荧光染色原位标记及革兰染色观察证实由细菌及多糖基质组成.结论 细菌生物膜在中耳急性感染的早期即已开始形成,并可能成为日后炎性反应反复发作或迁延不愈的原因;本研究建立的大鼠急性中耳炎模型是研究中耳细菌生物膜较为理想的动物模型.%Objective To investigate the relationship between bacterial biofilm and acute otitis media by observing the feature of bacterial biofilm formation in middle-ear mucosa in the rat model of acute otitis media and to study thc possibility of application this rat model in bacterial biofilm research. Methods A total of 30 healthy, male SD rats were

  3. Complications of otitis media - a potentially lethal problem still present

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    Norma de Oliveira Penido

    Full Text Available ABSTRACT INTRODUCTION: It is an erroneous but commonly held belief that intracranial complications (ICCs of chronic and acute otitis media (COM and AOM are past diseases or from developing countries. These problems remain, despite improvements in antibiotic care. OBJECTIVE: This paper analyzes the occurrence and clinical characteristics and course of the main ICCs of otitis media (OM. METHODS: Retrospective cohort study of 51 patients with ICCs from OM, drawn from all patients presenting with OM to the emergency room of a large inner-city tertiary care hospital over a 22-year period. RESULTS: 80% of cases were secondary to COM of which the incidence of ICC was 0.8%; 20% were due to AOM. The death occurrence was 7.8%, hearing loss in 90%, and permanent neurological sequelae in 29%. Patients were 61% male. In the majority, onset of ear disease had occurred during childhood. Delay of diagnosis of both the initial infection as well as the secondary ICC was significant. ICCs included brain abscess and meningitis in 78%, and lateral sinus thrombosis, empyema and otitic hydrocephalus in 13%, 8% and 1% of cases, respectively. Twenty-seven neurosurgical procedures and 43 otologic surgery procedures were performed. Two patients were too ill for surgical intervention. CONCLUSION: ICCs of OM, although uncommon, still occur. These cases require expensive, complex and long-term inpatient treatment and frequently result in hearing loss, neurological sequelae and mortality. It is important to be aware of this potentiality in children with COM, especially, and maintain a high index of suspicion in order to refer for otologic specialty care before such complications occur.

  4. Complications of otitis media - a potentially lethal problem still present.

    Science.gov (United States)

    Penido, Norma de Oliveira; Chandrasekhar, Sujana Sreedevi; Borin, Andrei; Maranhão, André Souza de Albuquerque; Gurgel Testa, José Ricardo

    2016-01-01

    It is an erroneous but commonly held belief that intracranial complications (ICCs) of chronic and acute otitis media (COM and AOM) are past diseases or from developing countries. These problems remain, despite improvements in antibiotic care. This paper analyzes the occurrence and clinical characteristics and course of the main ICCs of otitis media (OM). Retrospective cohort study of 51 patients with ICCs from OM, drawn from all patients presenting with OM to the emergency room of a large inner-city tertiary care hospital over a 22-year period. 80% of cases were secondary to COM of which the incidence of ICC was 0.8%; 20% were due to AOM. The death occurrence was 7.8%, hearing loss in 90%, and permanent neurological sequelae in 29%. Patients were 61% male. In the majority, onset of ear disease had occurred during childhood. Delay of diagnosis of both the initial infection as well as the secondary ICC was significant. ICCs included brain abscess and meningitis in 78%, and lateral sinus thrombosis, empyema and otitic hydrocephalus in 13%, 8% and 1% of cases, respectively. Twenty-seven neurosurgical procedures and 43 otologic surgery procedures were performed. Two patients were too ill for surgical intervention. ICCs of OM, although uncommon, still occur. These cases require expensive, complex and long-term inpatient treatment and frequently result in hearing loss, neurological sequelae and mortality. It is important to be aware of this potentiality in children with COM, especially, and maintain a high index of suspicion in order to refer for otologic specialty care before such complications occur. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  5. CHRONIC SUPPURATIVE OTITIS MEDIA: CLINICAL PRESENTATION OF INTRACRANIAL COMPLICATIONS IN A RURAL AREA

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    Sushant

    2015-09-01

    Full Text Available INTRODUCTION: Chronic suppurative otitis media (CSOM remains one of the most common childhood chronic infectious diseases worldwide. Microbial, immunological, and genetically determined factors, Eustachian tube characteristics, are supposed to be involved in the pathogenesis of CSOM. The objective of this study was to describe the clinical presentation of intracranial complications of chronic suppurative otitis media in a rural area of An warpur, Hapur. MATERIALS AND METHOD S: Patients suffering from CSOM attending outpatient department of Ear, Nose and Throat Department of Saraswathi institute of medical S ciences, anwrpur, Hapur from 2012 to 2015 were included in this study. All admitted cases of intracranial complications due to chronic suppurative otitis media of any age and gender were included. Cases of intracranial complications due to acute suppurative otitis media were excluded from the study. After confirmation of complications by computed tomography, a multidisciplinary approach was followed, including initial treatment by intravenous systemic antibiotics to the definitive final treatment of mastoid surgery. RESULTS: Out of the 50 reported cases of csom with intracranial complicati ons the age of patients ranged from 10 to 70 years, with majority, about 42%, being between 10 - 25 years of age . Male predominance was (62% . Majority of patients belonged to (69% poor socioeconomic status. Otorrhoea (92% was the commonest presentation. Pe rforation of the tympanic membrane was seen in in 80% cases, while only 64% cases were marginal or attic perforation. Meningitis (50% is the commonest intracranial complication of chronic suppurative otitis media followed by brain abscess (temporal lobe abscess . CONCLUSIONS: Meningitis (50% is the commonest intracranial complication of chronic suppurative otitis media followed by brain abscess which was found to be 24% (temporal lobe abscess was seen in 16% . In this era of antibiotics, a high degree

  6. External auditory canal stenosis due to the use of powdered boric acid.

    Science.gov (United States)

    Dündar, Riza; Soy, Fatih Kemal; Kulduk, Erkan; Muluk, Nuray Bayar; Cingi, Cemal

    2014-09-01

    Acquired stenosis of the external auditory canal (EAC) may occur because of chronic external otitis, recurrent chronic catarrhal otitis media associated with tympanic membrane perforation, chronic dermatitis, tumors, and trauma. Stenosis occurs generally at the one-third bone part of the external auditory canal. In this article, we present 3 cases of acquired EAC stenosis due to the previous powdered boric acid application. Besides the presentation of surgical intervetions in these cases, we want to notify the physicians not to use or carefully use powdered boric acid because of the complication of EAC stenosis.

  7. A mouse model of otitis media identifies HB-EGF as a mediator of inflammation-induced mucosal proliferation.

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    Keigo Suzukawa

    Full Text Available Otitis media is one of the most common pediatric infections. While it is usually treated without difficulty, up to 20% of children may progress to long-term complications that include hearing loss, impaired speech and language development, academic underachievement, and irreversible disease. Hyperplasia of middle ear mucosa contributes to the sequelae of acute otitis media and is of important clinical significance. Understanding the role of growth factors in the mediation of mucosal hyperplasia could lead to the development of new therapeutic interventions for this disease and its sequelae.From a whole genome gene array analysis of mRNA expression during acute otitis media, we identified growth factors with expression kinetics temporally related to hyperplasia. We then tested these factors for their ability to stimulate mucosal epithelial growth in vitro, and determined protein levels and histological distribution in vivo for active factors.From the gene array, we identified seven candidate growth factors with upregulation of mRNA expression kinetics related to mucosal hyperplasia. Of the seven, only HB-EGF (heparin-binding-epidermal growth factor induced significant mucosal epithelial hyperplasia in vitro. Subsequent quantification of HB-EGF protein expression in vivo via Western blot analysis confirmed that the protein is highly expressed from 6 hours to 24 hours after bacterial inoculation, while immunohistochemistry revealed production by middle ear epithelial cells and infiltrating lymphocytes.Our data suggest an active role for HB-EGF in the hyperplasia of the middle ear mucosal epithelium during otitis media. These results imply that therapies targeting HB-EGF could ameliorate mucosal growth during otitis media, and thereby reduce detrimental sequelae of this childhood disease.

  8. Relationship of the Middle Ear Effusion Microbiome to Secretory Mucin Production in Pediatric Patients With Chronic Otitis Media.

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    Krueger, Anna; Val, Stéphanie; Pérez-Losada, Marcos; Panchapakesan, Karuna; Devaney, Joe; Duah, Vanessa; DeMason, Christine; Poley, Marian; Rose, Mary; Preciado, Diego

    2017-07-01

    Acute otitis media, an infection of the middle ear, can become chronic after multiple episodes. Microbial influence on chronic otitis media remains unclear. It has been reported that mucin glycoproteins are required for middle ear immune defense against pathogens. We aim to characterize the middle ear effusion (MEE) microbiome using high-throughput sequencing and assess potential associations in microbiome diversity with the presence of the secretory mucins MUC5B and MUC5AC. We hypothesize that MEEs containing MUC5B will exhibit a microbiome largely devoid of typical acute otitis media bacteria. Fifty-five MEEs from children undergoing myringotomy at Children's National Health System were recovered. Mucin was semiquantitatively determined through Western blot analysis. DNA was subjected to 16S rRNA amplicon sequencing using the Illumina MiSeq platform. Raw data were processed in mothur (SILVA reference database). Alpha- and beta-diversity metrics were determined. Abundance differences between sample groups were estimated. MUC5B was present in 94.5% and MUC5AC in 65.5% of MEEs. Sequencing revealed 39 genera with a relative abundance ≥0.1%. Haemophilus (22.54%), Moraxella (11.11%) and Turicella (7.84%) were the most abundant. Turicella and Pseudomonas proportions were greater in patients older than 24 months of age. In patients with hearing loss, Haemophilus was more abundant, while Turicella and Actinobacteria were less abundant. Haemophilus was also more abundant in samples containing both secretory mucins. The microbiome of MEEs from children with chronic otitis media differs according to specific clinical features, such as mucin content, age and presence of hearing loss. These associations provide novel pathophysiologic insights across the spectrum of otitis media progression.

  9. [The practice guideline 'Otitis externa' (first revision) from the Dutch College of General Practitioners; a response from the perspective of otorhinolaryngology

    NARCIS (Netherlands)

    Mylanus, E.A.M.

    2008-01-01

    The first revision of the practice guideline 'Otitis externa' from the Dutch College of General Practitioners describes diagnostic, therapeutic and preventive aspects of care and focuses mainly on the acute form of the disease. In comparison with the previous guideline, some modest but valuable impr

  10. STUDY OF EXTRA CRANIAL COMPLICATIONS OF CHRONIC SUPPURATIVE OTITIS MEDIA

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    Sanal Mohan

    2016-10-01

    Full Text Available BACKGROUND Chronic Suppurative Otitis Media (CSOM refers to a chronic inflammatory condition of the middle ear and mastoid cavity. There is acute inflammation of middle ear leading to irritation and then inflammation of the mucosa producing oedema. Breakdown of the epithelium causes ulceration subsequent infection and formation of granuloma/granulation tissue. Granuloma formation leads to the development of polyps in middle ear. Factors influencing development of complications are, age, low socio-economic status, virulence of organism, immune compromised host, previous surgeries, fractures, fistulas, cholesteatoma. The complications developed spread through various modes like direct bone erosion, thrombophlebitis, preformed pathways, congenital bony defects, sutures of skull that remains patent, old fractures-heal by fibrosis, defects caused by surgery, oval and round windows, infection from labyrinth. The extracranial complications which can be encountered in chronic suppurative otitis media are, acute mastoiditis, petrositis, facial nerve palsy, labyrinthitis and discharging sinuses. MATERIALS AND METHODS Sample size for the present study was fifty four. This study was done in the Department of ENT, Travancore Medical College, Kollam. This study was done from January 2015 To January 2016. Detailed clinical history was taken and the clinical examination was conducted. The extracranial complications were noted and reported. RESULTS In the present study, maximum number of cases belonged male sex which was thirty eight cases. Sixteen cases belonged to female sex. Maximum number of cases which amounted to forty one in number belonged to age group zero to twenty years, followed by age group twenty to forty years which amounted to eleven cases, followed by age group forty to sixty which amounted to two cases. No cases were reported in age group more than sixty years in our study. Based on socioeconomic data, maximum number of cases belonged to low

  11. The forced-response test does not discriminate ears with different otitis media expressions.

    Science.gov (United States)

    Casselbrant, Margaretha L; Mandel, Ellen M; Seroky, James T; Swarts, J Douglas; Doyle, William J

    2014-11-01

    Test the hypothesis that the eustachian tube (ET) function measured using standard manometric test methods is different between groups of ears with tympanostomy tubes inserted for recurrent acute otitis media (RAOM) and for chronic otitis media with effusion (COME). A cross-sectional study of ET function in populations of young children with different otitis media expressions. The results for forced-response testing of ET function were compared using a general linear model between 37 ears of 26 children and 34 ears of 26 children, aged 3 and 4 years, with ventilation tubes inserted for COME and RAOM, respectively. There were no significant between-group differences in either the active measure of ET opening function, dilatory efficiency, or in the passive measures reflecting the magnitude of the forces that tend to hold the ET lumen closed, the opening and closing pressures, and passive trans-ET conductance. The results do not support the hypothesis that ET closing forces are less in ears with RAOM when compared to ears with COME, and from the results of earlier studies, ears without disease. Both groups were characterized by a low ET opening efficiency (referenced to ears of adults with no disease history). Because both disease expressions present the same pattern of ET dysfunction, other factors are required to explain why a subset of ears with that type of dysfunction develop RAOM, as opposed to the default expression of COME. 2b © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  12. Lessons learnt from the diagnosis and antimicrobial management of necrotising (malignant) otitis externa: our experience in a tertiary referral centre.

    Science.gov (United States)

    Williams, S P; Curnow, T L; Almeyda, R

    2014-01-01

    Necrotising otitis externa is an uncommon and aggressive infection of the external auditory canal with a tendency to present in the elderly and immunocompromised patient. We report a series of twenty-five patients admitted to our institution over a four-year period with this diagnosis. We review the diagnosis and antimicrobial management of these cases, and propose a treatment algorithm based on our experience.

  13. Overview ofTCM External Treatment on Acute Gouty Arthritis%中医外治法治疗急性痛风性关节炎综述

    Institute of Scientific and Technical Information of China (English)

    田雪梅; 张丽君

    2011-01-01

    系统回顾并总结了近5年来有关中医外治法治疗急性痛风性关节炎的方法,并对其作用机理进行了初步探讨,以期为进一步进行科学的临床总结和机理探讨提供思路和途径.%Through systematic review and summarizing the external treatment method of traditional Chinese medicinal on acute gouty arthritis for the past five years, and to explore its mechanism of action,in order to provide ideas and approaches for further scientific clinical summary and mechanism study.

  14. Intra cranial complications of tuberculous otitis media

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    M Prakash

    2015-01-01

    Full Text Available Tuberculosis is one of the most common infections in the world. It is seen that tuberculous otitis media (TOM is almost secondary to pulmonary tuberculosis. In this review we have tried to deal with all the aspects of the intra cranial complications of TOM such as tuberculoma, otitic hydrocephalus, brain abscess and tuberculous meningitis. The aspects covered in this review are the pathology, clinical features, and investigations of the intra cranial manifestations.

  15. Quality-of-Life Differences among Diagnostic Subgroups of Children Receiving Ventilating Tubes for Otitis Media.

    Science.gov (United States)

    Heidemann, Christian Hamilton; Lauridsen, Henrik Hein; Kjeldsen, Anette Drøhse; Faber, Christian Emil; Johansen, Eva Charlotte Jung; Godballe, Christian

    2015-10-01

    The pathological picture may differ considerably between diagnostic subgroups of children with otitis media receiving ventilating tubes. The aims of this study are to investigate differences in quality of life among diagnostic subgroups of children treated with ventilating tubes and to investigate possible predictors for clinical success. Longitudinal observational study. Secondary care units. Four hundred ninety-one families were enrolled in the study. The Otitis Media-6 questionnaire was applied in the assessment of child quality of life. Caregivers completed questionnaires at 7 time points from before treatment to 18-month follow-up. Logistic regression analysis was used to investigate possible predictors for clinical success. Response rates ranged from 96% to 81%; diagnostic distribution: 15% recurrent acute otitis media (rAOM), 47% otitis media with effusion (OME), and 38% mixed diagnosis of rAOM and OME (rAOM/OME). There were no significant differences between children diagnosed with rAOM and children diagnosed with rAOM/OME. However, these children had a significantly poorer quality of life at baseline compared with children diagnosed with only OME. Factors associated with clinical success included a diagnosis of rAOM, number of interrupted nights, physician visits, and canceled social activities due to OM. Results highlight the importance of distinguishing between diagnostic subgroups of children having ventilating tube treatment. A diagnosis of rAOM was found to predict baseline quality of life. Children with rAOM with or without OME were found to suffer significantly more than children with only OME before treatment. Factors associated with disease severity were found to predict clinical success. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2015.

  16. SUSCEPTIBILITY AND DETECTION OF EXTENDED SPECTRUM β-LACTAMASE ENZYMES FROM OTITIS MEDIA PATHOGENS

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    Ejikeugwu Chika

    2013-01-01

    Full Text Available Otitis media is the bacterial infection of the middle ear usually accompanied with inflammation, effusions and pain. It can present clinically in two major forms: Acute Otitis Media (AOM and Otitis Media with Effusion (OME and it is one of the leading cause of hospital visits and antibiotic prescriptions amongst children and even adults. Antibiotic resistance is a global public health problem and Extended Spectrum β-Lactamase (ESBL enzymes is one of the new mechanisms of resistance in especially Gram negative bacteria including Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. ESBLs are plasmid-mediated β-lactamase enzymes that hydrolyze extended-spectrum oxyimino 3rd generation cephalosporins and monobactams. Organisms producing ESBLs have remained important nosocomial and community-acquired pathogens over the years. Ear swab specimens of children (aged 0-7 with suspected Otitis media infections and who attended a tertiary hospital in Enugu, Nigeria were cultured on growth media. E. coli, K. pneumoniae and P. aeruginosa were isolated and identified by standard microbiological techniques. Antibiogram was conducted on all isolated ear pathogens by Kirby-Bauer disk diffusion method and ESBL production was evaluated by the Double Disk Synergy Test (DDST method. Imipenem and meropenem were the most active antibiotics against the E. coli, K. pneumoniae and P. aeruginosa ear pathogens. Sulphamethoxazole-trimethoprim was the least active agent against the tested ear pathogens and this was followed by ofloxacin, ciprofloxacin, gentamicin, cefotaxime and ceftazidime. None of the E. coli, K. pneumoniae and P. aeruginosa ear pathogens produced ESBLs by the method used. ESBL production by pathogenic bacteria confers on organisms the ability to be multidrug resistant. Their prompt and accurate detection from clinical specimens, together with reporting them along with hospitals routine antibiogram results is vital as this will help to

  17. Quality of life measures in otitis media.

    Science.gov (United States)

    Maile, E J; Youngs, R

    2013-05-01

    Disabling hearing impairment is the world's most common disability. Traditionally, hearing levels measured by pure tone audiometry have been used to define and quantify hearing loss. The effects of disabling hearing loss on patients' quality of life can be profound, and audiometric data alone may not correlate with quality of life measures. Generic measures of quality of life can be used to compare different diseases, and as such are useful in resource allocation and burden of disease studies. Their disadvantage is that they are not disease-specific and can therefore under-estimate the effects of a disease on patients' quality of life. Disease-specific measures are more sensitive. In chronic otitis media, additional factors such as discharge augment the effect of hearing loss alone on quality of life. Many of the quality of life measures developed for chronic otitis media have been used to assess improvement following reconstructive surgery. Quality of life measures have also been used to assess the effect of paediatric otitis media. Quality of life measures also have utility in the developing world, where hearing impairment is a huge burden.