RESUMEN
An interesting case of pyogenic vertebral osteomyelitis with multiple epidural abscesses caused by non-pigmented Prevotella oralis is reported. The patient was a 68-year-old female who presented to the emergency room (ER) with severe pain and tenderness in her lower back with fever. She had recently undergone esophagogastroduodensoscopy (EGD) for complaints of esophageal reflux, which showed submucosal cyst in the esophagus. Magnetic resonance imaging (MRI) of the thoracic spine revealed multiple spinal epidural abscesses with signal enhancement at the level of T6 and T7, suggestive of vertebral osteomyelitis. Two blood cultures drawn one hour apart grew Prevotella oralis. The body fluid aspirated from the abscesses was also positive for the anaerobic commensal P. oralis. Necrosis associated with the submucosal cyst was implicated as the cause of sepsis and osteomyelitis due to this organism.
Asunto(s)
Anciano , Femenino , Humanos , Infecciones por Bacteroidaceae/complicaciones , Absceso Epidural/microbiología , Osteomielitis/microbiología , Prevotella/aislamiento & purificación , Enfermedades de la Columna Vertebral/microbiología , Vértebras Torácicas , Infecciones por Bacteroidaceae/diagnóstico , Absceso Epidural/diagnóstico , Osteomielitis/diagnóstico , Enfermedades de la Columna Vertebral/diagnósticoRESUMEN
An interesting case of pyogenic vertebral osteomyelitis with multiple epidural abscesses caused by non-pigmented Prevotella oralis is reported. The patient was a 68-year-old female who presented to the emergency room (ER) with severe pain and tenderness in her lower back with fever. She had recently undergone esophagogastroduodensoscopy (EGD) for complaints of esophageal reflux, which showed submucosal cyst in the esophagus. Magnetic resonance imaging (MRI) of the thoracic spine revealed multiple spinal epidural abscesses with signal enhancement at the level of T6 and T7, suggestive of vertebral osteomyelitis. Two blood cultures drawn one hour apart grew Prevotella oralis. The body fluid aspirated from the abscesses was also positive for the anaerobic commensal P. oralis. Necrosis associated with the submucosal cyst was implicated as the cause of sepsis and osteomyelitis due to this organism.
Asunto(s)
Infecciones por Bacteroidaceae/complicaciones , Absceso Epidural/microbiología , Osteomielitis/microbiología , Prevotella/aislamiento & purificación , Enfermedades de la Columna Vertebral/microbiología , Vértebras Torácicas , Anciano , Infecciones por Bacteroidaceae/diagnóstico , Absceso Epidural/diagnóstico , Femenino , Humanos , Osteomielitis/diagnóstico , Enfermedades de la Columna Vertebral/diagnósticoAsunto(s)
Carcinoma de Células Escamosas/diagnóstico , Neoplasias Craneales/diagnóstico , Hueso Temporal/patología , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/terapia , Resultado Fatal , Humanos , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Neoplasias Craneales/patología , Neoplasias Craneales/terapia , Tomografía Computarizada por Rayos XAsunto(s)
Humanos , Masculino , Persona de Mediana Edad , Carcinoma de Células Escamosas/diagnóstico , Neoplasias Craneales/diagnóstico , Hueso Temporal/patología , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/terapia , Resultado Fatal , Invasividad Neoplásica , Neoplasias Craneales/patología , Neoplasias Craneales/terapia , Tomografía Computarizada por Rayos XRESUMEN
UNLABELLED: Myiasis in ENT, once a deadly disease still presents as a significant outdoor problem, though advances in management including supportive therapy has led to early healing with significant reduction in bed occupancy rate. AIMS: To assess the clinico etiology, relationship of myiasis to habit and habitat of patients and to assess the changes in age, seasonal, socioeconomic incidence, nasal bacterial flora and usefulness of certain commonly done tests with reference to a gap of 25 years. MATERIALS & METHODS: The presenting study was conducted on 80 patients selected over a period of two time intervals ; first 40 cases were chosen from 1979 to 1980 and next 40 over 2003 to 2004. Cases were studied in a retrograde manner and data tabulated. RESULTS & CONCLUSIONS: Atrophic turbinates was the commonest pathological finding in nose in 30% of cases . Significant change seen was in the age group 51 and above with a rise of 30%. Mode during 2003-04 was 60 years. Incidence of palatal perforation dropped from 17.88 to 2.5% . Klebsiella emerged as a significant contributor to the nasal microbial flora. VDRL and split skin smear showed poor etiological association for the diseases.
Asunto(s)
Conducto Auditivo Externo/parasitología , Miasis/etiología , Nariz/parasitología , Faringe/parasitología , Adolescente , Adulto , Animales , Niño , Preescolar , Femenino , Humanos , Incidencia , India/epidemiología , Lactante , Recién Nacido , Larva , Masculino , Persona de Mediana Edad , Miasis/diagnóstico , Miasis/epidemiología , Estudios Retrospectivos , Estaciones del Año , Factores Socioeconómicos , Adulto JovenRESUMEN
Myiasis in ENT, once a deadly disease still presents as a significant outdoor problem, though advances in management including supportive therapy has led to early healing with significant reduction in bed occupancy rate. AIMS: To assess the clinico etiology, relationship of myiasis to habit and habitat of patients and to assess the changes in age, seasonal, socioeconomic incidence, nasal bacterial flora and usefulness of certain commonly done tests with reference to a gap of 25 years. MATERIALS & METHODS: The presenting study was conducted on 80 patients selected over a period of two time intervals ; first 40 cases were chosen from 1979 to 1980 and next 40 over 2003 to 2004. Cases were studied in a retrograde manner and data tabulated. RESULTS & CONCLUSIONS: Atrophic turbinates was the commonest pathological finding in nose in 30 percent of cases . Significant change seen was in the age group 51 and above with a rise of 30 percent. Mode during 2003-04 was 60 years. Incidence of palatal perforation dropped from 17.88 to 2.5 percent . Klebsiella emerged as a significant contributor to the nasal microbial flora. VDRL and split skin smear showed poor etiological association for the diseases.
Miíase em ORL não é mais uma doença fatal, mas ainda está presente como um significativo problema em ambientes externos. Entretanto, progressos alcançados no tratamento, incluindo terapêutica de suporte, têm levado à cura precoce com significativa redução na taxa de internação hospitalar por causa dessa enfermidade. OBJETIVOS: Avaliar a etiologia clínica e as associações entre miíase e os hábitos e habitats dos pacientes; e avaliar diferenças no tocante à idade, estação do ano, incidência socioeconômica, flora bacteriana nasal e a utilidade de certos exames comumente feitos - um estudo retrospectivo de 25 anos. MATERIAIS E MÉTODOS: O presente estudo envolveu 80 pacientes selecionados em dois períodos; os primeiros 40 casos foram selecionados de 1979 a 1980, e os 40 seguintes foram coletados entre 2003 e 2004. Os casos foram estudados de forma retrospectiva e os dados foram analisados em tabelas. RESULTADOS E CONCLUSÕES: Cornetos atróficos representaram o achado nasal patológico mais comum - em 30 por cento dos casos. Alterações significativas foram encontradas na faixa etária dos 51 anos e acima, com um aumento de 30 por cento nestes. A média etária entre 2003-04 foi de 60 anos. A incidência de perfuração palatina caiu de 17,88 por cento para 2,5 por cento. Klebsiella foi o germe mais significativamente presente na flora microbiana nasal. Os exames de VDRL e teste cutâneo mostraram pobre associação etiológica entre as doenças.