RESUMEN
OBJECTIVE: To evaluate the effect of pre- and post-admission antibiotic treatment in paediatric acute mastoiditis. DESIGN: Retrospective study. METHOD: Eighty-eight children with acute mastoiditis, from 2003 to 2012, were studied to investigate the effect of antibiotic therapy on short and long-term sequelae. RESULTS: The median period of antibiotic therapy immediately following hospital discharge was 10 days (range, 5-49 days; standard deviation = 7.46). There were no sequelae within the fortnight following antibiotic therapy completion, but 14 of 40 patients had significant sequelae thereafter, including recurrent otorrhoea, acute otitis media and ventilation tube insertion requirement. Complication rates were significantly higher among patients who had pre-admission antibiotic therapy (52 per cent), compared to patients previously untreated (27 per cent). CONCLUSION: Paediatric acute mastoiditis patients treated with antibiotic therapy prior to admission are at higher risk for complication development. The advised time period for oral antibiotic therapy following hospital discharge remains as 10 days in all cases of uncomplicated acute mastoiditis.
Asunto(s)
Antibacterianos/uso terapéutico , Cefalosporinas/uso terapéutico , Mastoiditis/tratamiento farmacológico , Penicilinas/uso terapéutico , Enfermedad Aguda , Niño , Preescolar , Femenino , Hospitalización , Humanos , Lactante , Tiempo de Internación , Masculino , Ventilación del Oído Medio/estadística & datos numéricos , Otitis Media , Pronóstico , Recurrencia , Estudios RetrospectivosRESUMEN
Adult epiglottitis is a disease that is well known to otolaryngologists, but is less commonly encountered in general medical practice. It is being recognized with increasing frequency, and in many respects is different from paediatric epiglottitis. Three patients with adult epiglottitis are described, with an emphasis on the variation in clinical presentation and the difficulty in diagnosis. The appropriate examinations and the management of the disease are discussed.