Prognostic effect of pre- and post-admission antibiotic treatment in paediatric acute mastoiditis

Carmel, Eldar; Curotta, John; Cheng, Alan

doi:10.1017/s0022215116009063

Cited by 9 publications

(5 citation statements)

References 13 publications

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“…Regarding antibiotic treatment, Posa et al [20] recommended the use of intravenous third-generation cephalosporin, as it had a good meningeal penetration and target the majority of causative organisms. Carmel et al [21] reported that, the commonest causative organisms are Streptococcus pneumoniae, Staphylococcus aureus, and Streptococcus pyogenes.…”

Section: Discussionmentioning

confidence: 99%

Facial Nerve Paralysis as A Complication of Acute Otitis Media

Ramadan

Elsaied

Hassan

2021

International Journal of Medical Arts

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Background: Facial nerve paralysis is not a very frequent association with acute otitis media (AOM). The pathophysiology and treatment of this condition still under debate.Aim of the Work: to review the treatment strategies and extent of recovery in patients with facial nerve paralysis after AOM. Patients and Methods:The study was a retrospective study. Authors reviewed a total of 4710 cases of AOM seen during the period form 2010 to 2020. Fourty cases developed facial nerve paralysis. All were reviewed for epidemiological data and clinical assessment. Facial palsy was graded by House-Brackmann scale. All patients were treated with antibiotics combined with oral or intravenous corticosteroids. Myringotomy with or without application of a ventilation and mastoidectomy without decompression of the facial nerve were performed in selected cases.Result: Normal facial function was resumed to normal in all patients. The paralysis was mainly of acute onset (90.0%) and otorrhea reported among 12.5%. The initial paralysis grade was mainly grade IV (41.3%) followed by grade III (26.3%). The topography was mainly infrageniculate (86.3%). A collected material for bacteriology was reported for 40.0%, and 53.1% of them had negative culture. The most common detected organism was staphylococcus aureus (18.8%). Myringotomy was done for 7.5%, aspiration for 10.0% and Mastoidectomy for 10.0%. The overall outcome was good among 90.0% and bad among 10.0%. The duration for complete cure in cases with good outcome not exceeded 3 months. Only lower initial grade on House-Brackmann scale and infrageniculate topography were associated with favorable outcome. Conclusion:The management of facial nerve paralysis due to acute otitis media could be conservative by antibiotics with corticosteroids.

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Section: Discussionmentioning

confidence: 99%

Facial Nerve Paralysis as A Complication of Acute Otitis Media

Ramadan

Elsaied

Hassan

2021

International Journal of Medical Arts

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“…The prognosis of mastoiditis is good if the disease is diagnosed and treated before a more serious complication develops. Increasing rates of morbidity and mortality are seen when the infection results in septic thrombosis of the cavernous sinus and/or spread to the temporal lobe of the brain [11].…”

Section: Treatment Of Mastoiditismentioning

confidence: 99%

“…Interestingly, patients who have recently been treated with antibiotics for AOM have some of the highest rates of complications. This suggests that causative bacteria are particularly pathogenic or have become resistant to more conservative treatments [11]. Known complications involve contiguous spread of the infection to adjacent structures and include subperiosteal abscesses, Bezold's abscesses (infection of the sternocleidomastoid and trapezius muscle attachments), facial nerve paralysis, meningitis, subdural empyema, brain abscess, venous sinus thrombosis, labyrinthitis, temporal bone osteomyelitis, cerebrospinal fluid otorrhea, or conductive hearing loss secondary to destruction of the bony ossicles.…”

Section: Complications Of Mastoiditismentioning

confidence: 99%

Otitis, Sinusitis, and Mastoiditis

Berry

2019

Introduction to Clinical Infectious Diseases

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Learning Objectives 5 Know the common clinical presentations for otitis, sinusitis, and mastoiditis. 5 Identify common and uncommon microbiologic causes of otitis, sinusitis, and mastoiditis. 5 Understand the distinguishing characteristics for acute, recurrent, and chronic clinical courses of each disease. 5 List the important risk factors for developing severe infections of the paranasal sinuses. 5 Outline the approach to diagnosis, including signs and symptoms that warrant laboratory or imaging evaluations. 5 Describe the indications for medical and surgical treatment of otitis, sinusitis, and mastoiditis. 4.1 Otitis 4.1.1 Introduction The term "otitis" encompasses pathology of both the middle and outer ear. It is generally divided into two categoriesotitis media and otitis externa. Otitis media can present either as an acute infectious process of the middle ear (acute otitis media) or as a serous noninfectious process (otitis media with effusion). Otitis externa is an infectious inflammatory condition of the external auditory canal (EAC). Approaches to the diagnosis and treatment of acute otitis media have evolved over the last several decades as new immunizations, and more antibiotic choices have become available. 4.2 Definitions Otitis media with effusion (OME)-A collection of serous fluid in the middle ear space without signs of acute inflammation. OME is not an infectious process. Chronic otitis media with effusion (COME)-A collection of serous fluid in the middle ear space that persists for more than 3 months Acute otitis media (AOM)-An acute infection of the middle ear with signs and symptoms of acute inflammation. An effusion is also present. Recurrent AOM-Three or more episodes of AOM in a 6-month period or 4 or more episodes of AOM in a 12-month period Otorrhea-The presence of a discharge from the ear Chronic suppurative otitis media (CSOM)-The presence of a purulent middle ear effusion associated with otorrhea, secondary to chronic tympanic membrane perforation, for more than 6 weeks in the setting of antibiotic treatment Otitis externa (OE)-An infection of the external auditory canal 4.3 Basic Concepts 4.3.1 Otitis Externa. Fig. 4.1 Normal tympanic membrane.

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“…The most common bacteria identified were Streptococcus pneumoniae , Staphylococcus aureus and Streptococcus pyogenes 3. If recovery is delayed, imaging such as CT helps to exclude other pathologies or malformations and to plan surgical intervention 1 2 4 5…”

Section: Answer To Questionmentioning

confidence: 99%