RESUMEN
Actinomycosis is an infrequent infectious disease caused by Actinomyces species. Actinomycoses in the nasopharynx are extremely rare, especially in the Rosenmüller's fossa. This report presents a case of actinomycosis in the Rosenmüller's fossa. A 75-year-old woman presented with a 6-month history of bloody sputum. A grayish-white caseous tissue was found in the right Rosenmüller's fossa after retracting the torus tubarius. Magnetic resonance imaging showed a well-defined lesion with low-signal intensity on T1- and T2-weighted images; small low-signal areas were interspersed inside. The lesion was removed under an endoscope. Histopathological examination revealed eosinophilic, club-shaped structures surrounding a hematoxylophilic center, leading to the diagnosis of actinomycosis. The symptoms improved after 3 months of amoxicillin administration but recurred quickly. After 6 months of amoxicillin administration, the bloody sputum disappeared, and local and imaging findings were normal.
Asunto(s)
Actinomicosis , Actinomyces , Actinomicosis/diagnóstico , Actinomicosis/tratamiento farmacológico , Anciano , Amoxicilina/uso terapéutico , Femenino , Hemoptisis , Humanos , Imagen por Resonancia MagnéticaRESUMEN
OBJECTIVES: A nationwide epidemiological survey involving 23 hospitals in Japan was conducted and the predictive values of demographic data were examined statistically. METHODS: A total of 642 patients from 23 hospitals, including 20 university hospitals, in Japan were enrolled in the study. Age ranged from 8 to 87 years, and all were diagnosed with acute low-tone sensorineural hearing loss (ALHL) between 1994 and 2016. Demographic data for the patients, such as symptoms, gender, mean age, and distribution of ALHL grading, were collected and analyzed in relation to prognosis using Student's t-test, χ2 test and logistic regression. RESULTS: Female gender (p < .013), younger age (p < .001), low-grade hearing loss (p < .001), and shorter interval between onset and initial visit (p < .004) were significantly predictive of a good prognosis. The prognosis for definite ALHL was significantly better than that for probable ALHL (p < .007). CONCLUSIONS: The severity of initial hearing loss, interval between onset and initial visit and age were important prognostic indicators for ALHL, while female gender was an important prognostic indicator peculiar to ALHL.
Asunto(s)
Pérdida Auditiva Sensorineural/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Humanos , Japón/epidemiología , Masculino , Persona de Mediana Edad , Pronóstico , Adulto JovenRESUMEN
BACKGROUND: Mucosal melanoma of the head and neck is rare and is associated with a poor prognoses because of locoregional failure and distant metastasis. The aim of our study was to review the characteristics of these patients in northern Japan and to analyze their outcomes. METHODS: The medical records of 94 patients who had been provided initial treatment in 12 institutes from 1998 to 2007 were reviewed. RESULTS: When the 5-year overall survival rates of patients were evaluated, we found that the survival rates of patients treated by chemotherapy were significantly lower than those of patients treated by surgery or radiation. The survival rates of the single-treatment modality, 2-modality, and ≥3-modality groups were 23.4%, 38.0%, and 33.6%, respectively. CONCLUSION: Our results suggest that patients who underwent combined treatment had better prognoses. However, we found that chemotherapy had no additional survival benefits.