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Introduction Necrotizing otitis externa has a high impact on the quality of life of patients and has shown a significant increase in its incidence in recent years. There has been a change in the profile of affected patients and a lack of consensus on the management of these patients. Objective To develop a practical and effective care protocol to standardize the diagnostic and therapeutic management of necrotizing otitis externa. Methods A retrospective cohort study of necrotizing otitis externa patients between January 2015 and December 2020. Results There were 34 patients with two bilateral cases, totaling 36 ears. The mean age was 68.5, with a higher prevalence of males (76%). Diabetes was present in 97% of the samples. The involvement of cranial pairs was identified in 35% of the sample. Pseudomonas aeruginosa was the most frequent pathogen isolated, found in 50% of the cases. Among the cultures with bacterial agents isolated, 35% showed resistance to ciprofloxacin. The most frequent exam was computed tomography (94%). Hospital admission was indicated for 31 patients (91%), and ceftazidime was the most prescribed drug (35.5%). There were 11 recurrences (32%), and 12 patients (35%) had complications during treatment. Among the unfavorable outcomes, 12% persisted with some degree of peripheral facial paralysis, 6% maintained dysphagia, and 9% died of the disease. Conclusions The present study developed a diagnostic and therapeutic protocol for the effective management of necrotizing otitis externa. This protocol is a dynamic tool and should be revised and updated as new demands emerge during its implementation.

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BACKGROUND: Necrotizing external otitis (NEO) is a severe infectious disease in the external acoustic meatus (EAM) and mastoid that may extend to the cranial base. Due to the lack of a gold standard examination technique, the diagnosis is often difficult and delayed. This study aimed to evaluate the sensitivity and specificity of 99mTc-mononuclear leukocyte scintigraphy associated with 99mTc-phytate in suspected NEO compared to 99mTc-MDP and 67Ga-citrate. METHODS: A prospective study (32 patients) was conducted between 2011 and 2016. RESULTS: At the end, twenty-four patients remained for the study conduction; nineteen had confirmed NEO diagnosis, one had sarcoma, one had EAM cholesteatoma, one had diffuse simple external otitis, and two had an inconclusive diagnosis. 99mTc-mononuclear leukocyte scintigraphy plus 99mTc-phytate was as sensitive as 99mTc-MDP bone scintigraphy (19/19X9/19), and more sensitive than 67Ga scintigraphy (19/19 x 17/19). Regarding specificity, it was superior to bone scintigraphy, 100% × 40% (5/5 × 2/5), and 67Ga scintigraphy, 100% × 20% (5/5 × 1/5). After the infection resolution, all NEO patients had their leukocyte scintigraphy negativized. To the best of our knowledge, this is the first study that evaluates this technique in patients with suspected NEO. CONCLUSIONS: 99mTc-mononuclear leukocyte was revealed to be the best option for NEO because of its specificity.

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Abstract Introduction Necrotizing otitis externa has a high impact on the quality of life of patients and has shown a significant increase in its incidence in recent years. There has been a change in the profile of affected patients and a lack of consensus on the management of these patients. Objective To develop a practical and effective care protocol to standardize the diagnostic and therapeutic management of necrotizing otitis externa. Methods A retrospective cohort study of necrotizing otitis externa patients between January 2015 and December 2020. Results There were 34 patients with two bilateral cases, totaling 36 ears. The mean age was 68.5, with a higher prevalence of males (76%). Diabetes was present in 97% of the samples. The involvement of cranial pairs was identified in 35% of the sample. Pseudomonas aeruginosa was the most frequent pathogen isolated, found in 50% of the cases. Among the cultures with bacterial agents isolated, 35% showed resistance to ciprofloxacin. The most frequent exam was computed tomography (94%). Hospital admission was indicated for 31 patients (91%), and ceftazidime was the most prescribed drug (35.5%). There were 11 recurrences (32%), and 12 patients (35%) had complications during treatment. Among the unfavorable outcomes, 12% persisted with some degree of peripheral facial paralysis, 6% maintained dysphagia, and 9% died of the disease. Conclusions The present study developed a diagnostic and therapeutic protocol for the effective management of necrotizing otitis externa. This protocol is a dynamic tool and should be revised and updated as new demands emerge during its implementation.

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Malassezia pachydermatis causes external otitis, often affecting dogs, and control methods for this microorganism have been resistant to synthetic antifungals. Therefore, this study evaluated the antifungal activity of aqueous extracts of Punica granatum Linn (AEP) fruit peel dehydrated (AEPd) and in natura (AEPn) against Malassezia pachydermatis. The M. pachydermatis samples were from the Microbiology Laboratory of the State University of Northern Paraná (UENP), PR, Brazil. The strains were identified and replicated after inoculation in the Sabouraud dextrose medium. Subsequently, the P. granatum extract was obtained through different extraction methods: cold, water bath, decoction, and infusion. Each test was run fivefold at 10, 20, 30, 40, and 50% after 10, 20, and 30 minutes. The sensitivity of isolates was determined with the Kirby-Bauer disc diffusion method and indicated by an inhibition zone larger than 15 mm. The results were evaluated with a 2x3x6 factorial study design, ANOVA, and Tukey's test at 5% significance. AEPn showed antifungal activity on M. pachydermatis strains, and AEPd did not present an inhibitory influence at any concentration and time. Extraction by decoction was the most efficient, followed by water bath, cold, and infusion. The extracts at a 50% concentration showed the best results, but all other doses determined an inhibition zone larger than 15 mm. Thus, AEP showed a significant therapeutic potential for controlling M. pachydermatis.

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The etiology of otitis in dogs and cats is multifactorial and complex, involving bacterial and fungal pathogens. As empiric antimicrobial prescription is a common practice when treating such cases, antimicrobial resistance may represent a complicating factor. The aim of this study was to describe microbiological features and susceptibility profiles of pathogens associated with 142 cases of external otitis, comprising 138 dogs and 4 cats.. The specimens were processed to identify bacterial and fungal etiologies following standard microbiological methods. Antimicrobial susceptibility was determined in vitro against 15 antibiotics and 3 antifungals. Further, Staphylococcus spp. isolates were screened for the detection of ß-lactamase enzymes using cefinase paper discs. Pseudomonas spp. and isolates from Enterobacteriaceae family were screened for colistin (Polymyxin E) resistance and for the mcr-1-mediated colistin resistance gene by PCR. The presence of mixed cultures of Enterobacteriaceae, Pseudomonas spp. and Staphylococcus spp., and co-infections with Malassezia spp., emphasizes the polymicrobial etiology of external otitis in small animals. Emerging rates of multidrug resistance observed in almost 50% of the isolates may alert for a near future of challenging veterinary cases unresponsive to first-line antimicrobials. In addition, these results highlight a potential public health concern of multidrug resistant bacteria, given the proximity of pets and their owners. This study addressed central aspects of external otitis, providing microbiologists and clinicians updated information on the etiology and treatment of challenging cases of multidrug resistant bacteria. It also provides priceless surveillance value in monitoring resistant bacteria in small animals.

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Resumen La otitis externa es una patología frecuente en la consulta médica, se estima que 10% de las personas la padecerán al menos una vez en su vida, la presentación aguda cursa con afección del conducto auditivo externo de origen infeccioso en el 90% de los casos, llamada otitis externa difusa (OED). El presente artículo tiene como objetivo exponer la mejor evidencia actual que permita una descripción general de la patología, para ello se realizó una búsqueda de literatura científica en bases de datos reconocidas. Se encontró que la OED es caracterizada microbiológicamente por la presencia de Pseudomonas aeruginosa y Staphylococcus aureus, clínicamente los pacientes refieren otalgia lo que abre la puerta a una variedad de diagnósticos diferenciales y en el tratamiento se debe hacer una clasificación a partir de diversas variables (edad, compromiso auricular y estado inmunológico) a fin de determinar la vía terapéutica adecuada.

Abstract External otitis is a frequent pathology in the medical consultation, it is estimated that 10% of people will suffer it at least once in their life, the acute presentation compromises the external auditory canal of infectious origin in 90% of cases, called diffuse external otitis (DEO). The objective of this article is to present the best current evidence that allows a general description of the pathology, for which a search of scientific literature was carried out in recognized databases, finding that it was characterized microbiologically by the presence of Pseudomonas aeruginosa and Staphylococcus aureus, clinically, patients refer to otalgia generating a variety of differential diagnoses, and for treatment, a classification must be made based on various variables (age, atrial compromise, and immune status) in order to determine the appropriate therapeutic route.

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Malignant external otitis (MEO) is a rare inflammatory and infectious condition, typically caused by Pseudomonas aeruginosa, that mainly affects diabetic or immunocompromised elderly patients and is associated with severe morbidity and mortality. It begins in the external auditory canal and rapidly progresses through the skull base, leading to osteomyelitis and may result in cranial neuropathy, especially of the facial nerve. Here we describe a rare neurological presentation of MEO in a 65-year old diabetic man, who presented with an 8-month progressing left otitis externa and evolved with ipsilateral proptosis, ophthalmoplegia, blindness, facial palsy, hearing loss and contralateral evolvement of the temporal bone with hearing impairment. He was initially treated with oral ciprofloxacin and after one week was transferred to our tertiary hospital, where antibiotic therapy was switched to meropenem and vancomycin due to the severity of the case and to the hospital's microbiological profile. The patient underwent left canal wall-up mastoidectomy with insertion of ear ventilation tube bilaterally, with good recovery of right ear hearing capacity, but with no improvements of neurological deficits nor left hearing function. All microbiological tests performed were negative, and this was interpreted as a possible consequence of the early use of antibiotics. Unfortunately, the patient was infected by Sars-CoV-2 during hospitalization and passed away after ten days of COVID-19 intensive care unit internment.

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RESUMEN Introducción: La otomicosis en pacientes inmunosuprimidos esta caracterizada por ser bilateral y ser causada por candida. Pocos estudios comparan las características micológicas encontradas en la microscopía directa y el cultivo. Objetivo: Identificar las características clínicas y micológicas de la otomicosis en pacientes diabéticos. Material y método: Estudio transversal en centro hospitalario de segundo nivel. Criterios de inclusión: pacientes diabéticos con diagnóstico clínico de otomicosis. Intervención: la muestra se examinó directamente bajo el microscopio y se cultivó. Resultados: Se incluyeron 17 pacientes, 10 mujeres y 7 hombres con una edad media de 47,5 años. Los síntomas predominantes fueron hipoacusia en 91,4% (n =16), prurito en 82,4% (n =14), otorrea en 76,5% (n=13)y otalgia en 70,6% (n =12). Afección bilateral se encontró en 47,1% (n =8). Estudio directo al microscopio mostró levaduras en 94,1% (n =16) y 5,9% mostró aspergillus (n =1). Cándida fue el género más comúnmente encontrado en los cultivos y en el examen directo microscópico con 94,1% (n =16) y Candida albicans la especie más común con 88,2% (n =15). Conclusión: Candida albicans es el agente etiológico más común en pacientes diabéticos con otomicosis. Su presentación clínica más frecuente es hipoacusia, prurito y otorrea. El examen directo identificó adecuadamente a los géneros fúngicos.

ABSTRACT Introduction: Otomycosis in immunocompromised patients is characterize by its bilateral course and the predominant etiologic agent is Candida. Few studies compare the mycological features between microscopic direct exam and culture. Aim: To identify the clinical and mycological characteristics of otomycosis in diabetic patients. Material and method: Transversal study. Secondary care center. Inclusion criteria: diabetic patients with clinical diagnosis of otomycosis. Intervention: Direct examination under a microscope of the ear sample and culture. Results: We included 17 patients, 10 women, 7 men with a mean age of 47.5 years. Symptoms were hearing loss 94.1% (n = 16), pruritus 82.4% (n =14) otorrhoea 76.5% (n =13) and otalgia 70.6% (n =12). Bilateral involvement was found in 47.1% (n =8). Direct microscopic study found 94.1% of yeast (n =16) and 5.9% of Aspergillus (n =1). Candida was the most common fungal genus in culture and microscopic exam with 94.1% (n =16) of cases and Candida albicans was the most common species in 88.2% (n =15) cases. Conclusion: Candida albicans is the most common etiologic agent in diabetic patients with otomycosis. Main symptoms were hearing loss, itching and otorrhea. Direct exam correctly identified the fungal genus.

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Se realizó un estudio descriptivo de serie de casos, de 42 pacientes con otitis externa maligna, atendidos en el Servicio de Otorrinolaringología del Hospital Provincial Docente Clinicoquirúrgico Saturnino Lora de la provincia de Santiago de Cuba desde enero de 2002 hasta diciembre de 2014 y tratados básicamente con ciprofloxacina, a fin de caracterizarles clínica, epidemiológica y terapéuticamente, así como determinar su evolución clínica con el tratamiento indicado. También se incluyó un segundo grupo de 29 integrantes con la misma afección, quienes durante esos 12 años recibieron otros antibióticos y no la citada quinolona, tratados igualmente en dicho Servicio durante el período señalado. Entre los principales resultados sobresalió el predominio del grupo etario de 55-64 años (30,6 por ciento) en los que se utilizó ciprofloxacino y de 75 y más (74,8 por ciento) en los que se indicaron otros antimicrobianos; del tiempo de evolución de la diabetes mellitus de 0-10 años en 24 (57,1 por ciento) de quienes recibieron ciprofloxacino y en 14 (48,2 por ciento) de aquellos que no la consumieron y de la Pseudomonas aeruginosa como el germen más frecuentemente aislado. La evolución de los pacientes fue favorable, independientemente del tratamiento antimicrobiano prescrito, pero todos los tratados con ciprofloxacina egresaron en menos de 30 días mejorados o curados. Se concluyó que la edad avanzada favorece la aparición de la otitis externa maligna, sin importar el tiempo de evolución de la diabetes mellitus

A descriptive, serial cases study, of 42 patients with malignant external otitis was carried out. They were assisted in the Otolaryngology Service of Saturnino Lora Torres Teaching Clinical Surgical Provincial Hospital in Santiago de Cuba from January, 2002 to December, 2014 and treated basically with ciprofloxacin, in order to characterize them clinical, epidemiological and therapeutically, as well as to determine their clinical course with the suitable treatment. A second group of 29 members with the same disorder was also included who received other antibiotics during those 12 years, treated in this Service during that period. Among the main results there was a prevalence of the 55-64 years age group (30.6 percent) in which ciprofloxacin was used and over 75 years (74.8 percent) in which other antimicrobians were indicated; of the time in the diabetes mellitus course 0-10 years in 24 (57.1 percent) of those who received ciprofloxacin and in 14 (48.2 percent) of those that didn't consume it and of the Pseudomonas aeruginosa as the most frequently isolated germ. The patients had a favorable clinical course, no matter the antimicrobian prescribed treatment, but all the patients treated with ciprofloxacin got better or were cured and were discharged in less than 30 days. It was concluded that the advanced age favors the emergence of the malignant external otitis, no matter the time of the diabetes mellitus course

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ABSTRACT Objective . To characterize and identify yeasts of the genus Malassezia by phenotypic features. Materials and methods. First, the macroscopic and microscopic morphological characteristics were described. In addition we performed biochemical and physiological assays as Tweens and Cremophor, including more. Results. Our results evidenced of 105 isolates obtained from dogs diagnosed with external otitis, it was possible to identify two distinct species from 46 isolates within the Malassezia genus: 36.19% (n=38) were identified as M. pachydermatis and 7.62% (n=8) as M. furfur. According to phenotypic patterns the remaining 56.19% (n=59) were reported as Malassezia spp., possibly corresponding to M. furfur and/or M. pachydermatis. Conclusions. Results emphasize the necessity to characterize according to species. It is not feasible to define Malassezia by species based on morphological, biochemical, and physiological findings. Therefore, molecular genotyping should be performed to identify markers allowing a more precise isolate identification. This would broaden our epidemiological knowledge regarding different species involved in canine otitis pathologies.

RESUMEN Objetivo . Caracterizar e identificar levaduras del género Malassezia, mediante características fenotípicas. Materiales y métodos . Inicialmente se describieron las características morfológicas macroscópicas y microscópicas, adicionalmente se realizaron pruebas bioquímicas y fisiológicas como Tween y Cremophor, entre otras. Resultados . De 105 aislamientos de caninos diagnosticados previamente con otitis, 46 fueron caracterizados hasta especie, así: El 36.19% (n=38) correspondió a M. pachydermatis, el 7.2% (n=8) a M. furfur; y 56.19% (n=59) restante fueron reportados como Malassezia spp., debido a los patrones fenotípicos atípicos que presentaron, y que podrían corresponder a variantes de M. furfur y/o M. pachydermatis. Conclusión. Estos resultados enfatizan la necesidad de hacer una caracterización a nivel de especie y/o genotipos mediante marcadores moleculares que permitan una identificación más precisa de los aislamientos. Con el presente estudio, se contribuye al conocimiento de las diferentes especies involucradas en patologías óticas en caninos.

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Introducción: La otitis externa infecciosa es una consulta otorrinolaringológica frecuente en usuarios de audífonos. Las propiedades antibacterianas descritas del cobre, han motivado el desarrollo de aplicaciones clínicas de este metal. Objetivo: Evaluar la capacidad antibacteriana de moldes de audífonos manufacturados con polímeros sensible a luz UV, silicona y acrílico que incorporan cobre metálico, en un sistema experimental in vitro. Material y método: Se diseñaron moldes de audífonos con y sin cobre, que fueron inoculados con distintas concentraciones de microorganismos (S aureus y P aeruginosa), para luego determinar el porcentaje de adherencia bacteriana a distintos tiempos de contacto (4, 8 y12 horas). Resultados: Existió reducción significativa en la adhesión bacteriana a los moldes con cobre respecto a aquellos sin cobre, independiente del material, del tipo de microorganismo y del inóculo bacteriano. Discusión: La disminución en la adherencia bacteriana en los prototipos con cobre, puede atribuirse a su actividad inhibitoria sobre los microorganismos en función de su concentración y el tiempo de contacto, ejerciendo su efecto por difusión a través de los distintos materiales. Conclusión: Con estos resultados, se hace necesario el desarrollo de estudios clínicos enfocados en comprobar si el uso de audífonos con cobre disminuyen las otitis externas de origen infeccioso.

Introduction: External otitis of infectious etiology among hearing aid users is a common motive of otolaryngology consultation. Antibacterial properties described copper, they have motivated the development of clinical applications of this metal. Aim: Evaluate the antibacterial capacity of copper-based ear molds manufactured with different materials such UV sensitive polymers, silicone and acrylic incorporating metallic copper, in an experimental system in vitro. Material and method: Ear molds with and without copper, were inoculated with different concentrations of microorganisms (S aureus and P aeruginosa) and determine the percentage of bacterial adherence to different contact times (4-8 and 12 hours). Results: There was significant reduction in bacterial adhesion to copper molds than those without copper, independent of the material, the type of microorganism and the bacterial inoculum. Discussion: The decrease in bacterial adherence on prototypes with copper, can be attributed to inhibitory activity on microorganisms depending on their concentration and contact time, exerting its effect by diffusion through the various materials. Conclusion: With these results, is necessary the development of clinical studies focused on checking whether the use of hearing aids with copper decreases external otitis of infectious origin.

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Os objetivos do estudo foram identificar a presença de microrganismos nos condutos auditivos dos cães através dos exames citológico e microbiológico, assim como avaliar a associação destes à otoacaríase e seus sinais clínicos. O diagnóstico da infestação por Otodectes cynotis foi realizado através de otoscopia bilateral e pela coleta de material e visualização do parasito sob microscópio esterioscópico, constituindo o exame parasitológico. Outras coletas de secreção otológica de cada orelha foram realizadas para confecção de lâminas para a citologia e para o isolamento microbiológico, sendo este último material coletado através de "swab" estéril. Dos 250 animais examinados, em 15 (6%) foi identificado o ácaro O. cynotis.Observou-se associação entre a presença do parasito e a ocorrência de otite clínica externa caracterizada especialmente por eritema auricular (P<0,001) e a produção excessiva de secreção otológica (P=0,0016), assim como a observação, pelos proprietários, de prurido ótico nos cães (P<0,001). Sugere-se a possibilidade de essas associações serem efeito da infestação. Houve também a associação (P<0,01) entre a otoacaríase e a ocorrência de microrganismos nos dois condutos auditivos de cada animal, detectados através da citologia. No entanto, não houve associação (P=0,04 e p=0,07) entre a presença do ácaro O. cynotis e a ocorrência de microrganismos no exame microbiológico das orelhas direita e esquerda, respectivamente.

The goals of this study were to identify microorganisms in dogs' ear canals through cytological and microbiological examination, and evaluate their association with otoacariasis and its clinical signs. Otodectes cynotis infestation diagnosis was achieved by bilateral otoscopy, and by parasite viewing on cerumem under stereoscopic microscope, representing the parasitological exam. Ear discharge was also collected from each canal to fix cytology slides and for microbiological isolation, but this last sample was collected with sterile swab. Among the 250 studied animals, 15 (6%) had ear mites. There was an association between the parasite and external clinical otitis specially as established by auricular erythema (P<0,001) and excessive production of ear discharge (P=0,0016), as well as ear pruritus observed by the owners (P<0,001). It has been suggested that these associations can be an effect of the infestations. There was also an association (P<0,01) between otoacariasis and microorganisms detected by cytological exam in both ear canals of each dog. However, there was no association (P=0,04 e P=0,07) between the presence of ear mite and microorganisms detected by microbiological exam of right and left ears.

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Os objetivos do estudo foram identificar a presença de microrganismos nos condutos auditivos dos cães através dos exames citológico e microbiológico, assim como avaliar a associação destes à otoacaríase e seus sinais clínicos. O diagnóstico da infestação por Otodectes cynotis foi realizado através de otoscopia bilateral e pela coleta de material e visualização do parasito sob microscópio esterioscópico, constituindo o exame parasitológico. Outras coletas de secreção otológica de cada orelha foram realizadas para confecção de lâminas para a citologia e para o isolamento microbiológico, sendo este último material coletado através de "swab" estéril. Dos 250 animais examinados, em 15 (6%) foi identificado o ácaro O. cynotis.Observou-se associação entre a presença do parasito e a ocorrência de otite clínica externa caracterizada especialmente por eritema auricular (P<0,001) e a produção excessiva de secreção otológica (P=0,0016), assim como a observação, pelos proprietários, de prurido ótico nos cães (P<0,001). Sugere-se a possibilidade de essas associações serem efeito da infestação. Houve também a associação (P<0,01) entre a otoacaríase e a ocorrência de microrganismos nos dois condutos auditivos de cada animal, detectados através da citologia. No entanto, não houve associação (P=0,04 e p=0,07) entre a presença do ácaro O. cynotis e a ocorrência de microrganismos no exame microbiológico das orelhas direita e esquerda, respectivamente(AU)

The goals of this study were to identify microorganisms in dogs' ear canals through cytological and microbiological examination, and evaluate their association with otoacariasis and its clinical signs. Otodectes cynotis infestation diagnosis was achieved by bilateral otoscopy, and by parasite viewing on cerumem under stereoscopic microscope, representing the parasitological exam. Ear discharge was also collected from each canal to fix cytology slides and for microbiological isolation, but this last sample was collected with sterile swab. Among the 250 studied animals, 15 (6%) had ear mites. There was an association between the parasite and external clinical otitis specially as established by auricular erythema (P<0,001) and excessive production of ear discharge (P=0,0016), as well as ear pruritus observed by the owners (P<0,001). It has been suggested that these associations can be an effect of the infestations. There was also an association (P<0,01) between otoacariasis and microorganisms detected by cytological exam in both ear canals of each dog. However, there was no association (P=0,04 e P=0,07) between the presence of ear mite and microorganisms detected by microbiological exam of right and left ears.(AU)

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Ear infections in cats are uncommon, especially involving yeasts. This report describes the first isolation of the Stephanoascus ciferrii, teleomorph of the Candida genus, in a case of feline otitis in Brazil. The identification and characterization of Stephanoascus ciferrii were confirmed by the Vitek2 System (BioMerieux ®).

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Ear infections in cats are uncommon, especially involving yeasts. This report describes the first isolation of the Stephanoascus ciferrii, teleomorph of the Candida genus, in a case of feline otitis in Brazil. The identification and characterization of Stephanoascus ciferrii were confirmed by the Vitek2 System (BioMerieux ®).

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Ear infections in cats are uncommon, especially involving yeasts. This report describes the first isolation of the Stephanoascus ciferrii, teleomorph of the Candida genus, in a case of feline otitis in Brazil. The identification and characterization of Stephanoascus ciferrii were confirmed by the Vitek2 System (BioMerieux ®).

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Otite externa é uma afecção frequente na clínica de pequenos animais. Em cães esta enfermidade tem apresentação clínica variável o que exige diferentes terapias. Neste estudo objetivou-se avaliar o efeito da lavagem do canal auditivo externo com solução salina estéril em orelhas com otite externa purulenta. Foram estudadas 36 orelhas de cães com otite purulenta, através de inspeção das conchas acústicas, otoscopia, cultura bacteriana e antibiograma. As orelhas foram divididas nos grupos A (18) e B (18). Nas do grupo A foi realizada uma única lavagem audititva no dia "0" e em ambos os grupos as orelhas foram tratadas com solução tópica e antibacteriano sistêmico de 12 em 12 horas. Ao final de 15 dias de tratamento foi demonstrada diferença estatística (p=0,023) entre os grupos para quantidade de exsudato na otoscopia. No mesmo período, observaram-se diferenças estatísticas no grupo A para prurido (p=0,0009), otalgia (p=0,001) e eritema (p=0,001) enquanto que no grupo B apenas para eritema (p=0,004). Foram isoladas bactérias Gram+ e Gram- que diminuíram em ambos os grupos. As bactérias foram mais sensíveis a gentamicina. A lavagem auditiva da orelha externa de cães com instilação e aspiração de solução salina contribuiu para o tratamento da otite externa purulenta reduzindo prurido, otalgia, eritema e exsudato(AU)

External otitis is a frequent affection in small animals clinic. In dogs this illness has variable clinic presentation which demands different therapies. The objective of this study was evaluated the effect of flushing external auditory conduit with sterile saline solution in purulent ears with external otitis. 36 ears with purulent otitis of dogs were studied, through inspection of acoustic shells, otoscopy, bacterial culture and antibiogram. The ears were divided in groups A (18) and B (18). In the group A was realized only one ear flushing in the day “0” and in both groups the ears were treated with topi solution and systemic anti-bacterial 12 in 12 hours. In the final of 15 days of treatment was demonstrated statistic difference (p=0,023) between the groups for quantity of exudates in otoscopy. In the same period was observed statistic differences in group A for itch(p=0,0009), otalgia (p=0,001 and erythema (p=0,001), while in group B just for erythema (p=0,004). Gram+ and Gram- bactéria was isolated, that decreased in both groups. The bacteria were more sensitive to gentamicin. The ear flushing of external ear of dogs with instillation and aspiration of saline solution contributed to external otitis treatment, reducing itch, otalgia, eythema and exudates(AU)

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RESUMO

Otite externa é uma afecção frequente na clínica de pequenos animais. Em cães esta enfermidade tem apresentação clínica variável o que exige diferentes terapias. Neste estudo objetivou-se avaliar o efeito da lavagem do canal auditivo externo com solução salina estéril em orelhas com otite externa purulenta. Foram estudadas 36 orelhas de cães com otite purulenta, através de inspeção das conchas acústicas, otoscopia, cultura bacteriana e antibiograma. As orelhas foram divididas nos grupos A (18) e B (18). Nas do grupo A foi realizada uma única lavagem audititva no dia "0" e em ambos os grupos as orelhas foram tratadas com solução tópica e antibacteriano sistêmico de 12 em 12 horas. Ao final de 15 dias de tratamento foi demonstrada diferença estatística (p=0,023) entre os grupos para quantidade de exsudato na otoscopia. No mesmo período, observaram-se diferenças estatísticas no grupo A para prurido (p=0,0009), otalgia (p=0,001) e eritema (p=0,001) enquanto que no grupo B apenas para eritema (p=0,004). Foram isoladas bactérias Gram+ e Gram- que diminuíram em ambos os grupos. As bactérias foram mais sensíveis a gentamicina. A lavagem auditiva da orelha externa de cães com instilação e aspiração de solução salina contribuiu para o tratamento da otite externa purulenta reduzindo prurido, otalgia, eritema e exsudato

External otitis is a frequent affection in small animal’s clinic. In dogs this illness has variable clinic presentation which demands different therapies. The objective of this study was evaluated the effect of flushing external auditory conduit with sterile saline solution in purulent ears with external otitis. 36 ears with purulent otitis of dogs were studied, through inspection of acoustic shells, otoscopy, bacterial culture and antibiogram. The ears were divided in groups A (18) and B (18). In the group A was realized only one ear flushing in the day “0” and in both groups the ears were treated with topi solution and systemic anti-bacterial 12 in 12 hours. In the final of 15 days of treatment was demonstrated statistic difference (p=0,023) between the groups for quantity of exudates in otoscopy. In the same period was observed statistic differences in group A for itch(p=0,0009), otalgia (p=0,001 and erythema (p=0,001), while in group B just for erythema (p=0,004). Gram+ and Gram- bactéria was isolated, that decreased in both groups. The bacteria were more sensitive to gentamicin. The ear flushing of external ear of dogs with instillation and aspiration of saline solution contributed to external otitis treatment, reducing itch, otalgia, eythema and exudates

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RESUMO

A otite canina é doença a mais comum do canal auditivo em cães e representa 8 a 15% dos casos atendidos na clínica médica de animais de pequeno porte. O objetivo deste trabalho fazer a avaliação retrospectiva de 274 fichas clínicas de cães com otite externa atendidos no Hospital "Dr Halim Atique", durante o período de janeiro de 2006 a agosto de 2010. Foi realizada a análise de prontuário formato papel e eletrônico quanto a influência do sexo, idade e raça dos animais nas otites externas. Posteriormente, foi realizada a descrição de agentes etiológicos e teste de sensibilidade aos antimicrobianos. Duzentas e quatorze culturas foram positivas (78,68%) ao crescimento de microrganismos, e 60 (21,32%) negativas. Quanto ao isolamento em cultura, a freqüência de Staphylococcus spp foi de 47,08%; Proteus spp. de 14,39%; Pseudomonas spp. De 13,23%; Escherichia coli de 10,51% entre outros. Maior isolamento bacteriano foi descrito na faixa etária de 0 a 3 anos (p=0,059), perfazendo 89 casos (32,04%). Quanto às raças, 59 (21,24%) eram cães Sem Raça Definida (SRD) e 40 Poodles (14,40%). Não houve diferença estatística entre o isolamento de microrganismo quanto ao sexo. A distribuição de otite externa de acordo com o sexo e infecção monomicrobiana em fêmeas foi de 113 casos (41,22%) e em 63 machos (22,97%). A infecção monomicrobiana foi significantemente maior em relação à polimicrobiana (p<0,0001). Houve uma maior sensibilidade, estatisticamente significante do Staphylococcus spp. a cefalexina (60,86%), ciprofloxacina (59,09%) e enrofloxacina (59,09%) foram estatisticamente significante em relação a sulfametoxazol/trimetoprima (16,66%).

A canine otitis is the most common disease of the ear canal in dogs and represents 8-15% of cases treated in the medical clinic of small animals. This study aimed to do a retrospective evaluation of 274 medical records of dogs with external otitis treated at the "Dr Halim Atique" Hospital during the period of January 2006 to August 2010. It was performed the analysis of paper and electronic records in way to examine the influence of sex, age and breed of animals in external otitis. After that, it was done the description of etiologic agents and sensibility test for antimicrobials. Two hundred and fourteen cultures were positive (78.68%) for the growth of microorganisms, and 60 (21.32%) were negative. Regarding to culture growth, the frequency of Staphylococcus spp. was 47.08%; Proteus spp. of 14.39%; Pseudomonas spp. 13.23%; 10.31% of Escherichia coli and others. Bigger bacterial isolation was described in the age group of 0-3 years (p = 0.059), accounting for 89 cases (32.04%). Regarding the breed, 59 (21.24%) were mongrel dogs and 40 Poodles (14.40%). There was no statistical difference between the microorganism isolation and the sex. The distribution of external otitis according to sex and monomicrobial infection in females was of 113 cases (41.22%) and 63 males (22.97%). Monomicrobial infection was significantly higher compared to polymicrobial (p < 0.0001). There was a higher sensitivity, a statistically significant of Staphylococcus spp., cephalexin (60.86%), ciprofloxacin (59,09%) and enrofloxacin (59,09%) were statistically significant compared to trimethoprim-sulfamethoxazole (16.66%).

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