We describe a new exanthematous type of hypersensitivity reaction to the smallpox vaccine. Hypersensitivity reactions occur at a rate higher than previously reported. In a carefully screened military population, these three hypersensitivity reactions are much more common than life-threatening or serious reactions. Although the reactions have distinct clinical and pathologic features, they are all characterized by mild or absent systemic symptoms and a benign outcome.
OBJECTIVES: Nowadays, facial paralysis is an uncommon complication of acute otitis media, representing an estimated incidence of 0.005%. However, without appropriate therapy the prognosis is poor. This fact justifies a precise therapeutic protocol to accelerate recovery. METHODS: A retrospective study of all acute otitis media that came in to an emergency unit during the last six years. Six children who presented acute otitis media and facial paralysis were reviewed. Pathophysiological mechanisms and different treatment methods are discussed. RESULTS: The patient ages range from 22 months to 15 years. Facial palsies were identified a few hours to four days from the onset of acute otitis media. Two cases debuted with pain and otorrhea. In the other four cases the tympanic membrane was reddish and swollen. All patients received oral or endovenous treatment (antibiotics and corticosteroides). Myringotomy and local culture was performed in all nonotorrheic patients, except in one whose endovenous treatment immediately improved his paralysis. All patients showed rapid improvement after treatment and recovered completely. CONCLUSIONS: Immediate medical and surgical treatment was crucial to avoid permanent facial paralysis.
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