Posts filed under ‘Infecciones cabeza y cuello’
Med Oral Patol Oral Cir Bucal. 2013 Jul 1;18(4):e627-32.
Moghimi M1, Salentijn E, Debets-Ossenkop Y, Karagozoglu KH, Forouzanfar T.
1Department of Oral and Maxillofacial Surgery, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherland. firstname.lastname@example.org
Actinomycosis is a chronic suppurative granulomatous infection caused by the Actinomyces genus. Orocervicofacial actinomycosis is the most common form of the disease, seen in up to 55% of cases. All forms of actinomycosis are treated with high doses of intravenous penicillin G over two to six weeks, followed by oral penicillin V. Large studies on cervicofacial actinomycosis are lacking. Therefore proper guidelines for treatment and treatment duration are difficult to establish. The aim of this study is to establish effective treatment and treatment duration for orocervicofacial actinomycosis.
A Pubmed and Embase search was performed with the focus on treatment and treatment duration for cervicofacial actinomycosis. The hospital records of all patients presenting to our department with head and neck infection from January 2000 to December 2010 were reviewed, retrospectively. The following data were collected: age, gender, clinical presentation, aetiology, duration of symptoms, microbiological findings, treatment, and duration of treatment. The treatment and treatment duration is subsequently compared to the literature.
The literature search provided 12 studies meeting the inclusion criteria. All studies were retrospective in nature. Penicillin or amoxicillin/clavulanic acid are the preferred antibiotic regimens found in the literature. Most of our patients were treated with a combination of penicillin G 12 million units/day and metronidazol 500 mg 3/day, most commonly for a duration of 1 – 4 weeks, being shorter than the 3 – 52 weeks reported in the literature.
When actinomycosis is suspected, our review has shown that a surgical approach in combination with intravenous penicillin and metronidazol until clinical improvement is seen, followed by oral antibiotics for 2 – 4 weeks is generally efficient.
Europ J of Clinical Microb & ID V.34 N.3 March 2015
Mazur, E. Czerwińska, I. Korona-Głowniak…
Increase in prevalence of Streptococcus pneumoniae serotype 6C at Eight Children’s Hospitals in the United States from 1993 to 2009.
J Clin Microbiol. 2011 Jun;49(6):2097-101.
Green MC, Mason EO, Kaplan SL, Lamberth LB, Stovall SH, Givner LB, Bradley JS, Tan TQ, Barson WJ, Hoffman JA, Lin PL, Hulten KG.
Streptococcus pneumoniae serotype 6C, which was described in 2007, causes invasive disease in adults and children.
We investigated the prevalence of 6C among pediatric isolates obtained from eight children’s hospitals in the United States.
S. pneumoniae isolates were identified from a prospective multicenter study (1993 to 2009). Fifty-seven serotype 6C isolates were identified by multiplex PCR and/or Quellung reaction. Five were isolated before 2000, and the prevalence increased over time (P < 0.000001).
The median patient age was 2.1 years (range, 0.2 to 22.5 years).
Clinical presentations included bacteremia (n = 24), meningitis (n = 7), pneumonia (n = 4), abscess/wound (n = 3), mastoiditis (n = 2), cellulitis (n = 2), peritonitis (n = 1), septic arthritis (n = 1), otitis media (n = 10), and sinusitis (n = 3).
By broth microdilution, 43/44 invasive serotype 6C isolates were susceptible to penicillin (median MIC, 0.015 μg/ml; range, 0.008 to 2 μg/ml); all were susceptible to ceftriaxone (median MIC, 0.015 μg/ml; range, 0.008 to 1 μg/ml). By disk diffusion, 16/44 invasive isolates (36%) were nonsusceptible to erythromycin, 19 isolates (43%) were nonsusceptible to trimethoprim-sulfamethoxazole (TMP-SMX), and all isolates were clindamycin susceptible.
Multilocus sequence typing (MLST) revealed 24 sequence types (STs); 9 were new to the MLST database. The two main clonal clusters (CCs) were ST473 and single-locus variants (SLVs) (n = 13) and ST1292 and SLVs (n = 23). ST1292 and SLVs had decreased antibiotic susceptibility. Serotype 6C causes disease in children in the United States.
Emerging CC1292 expressed TMP-SMX resistance and decreased susceptibility to penicillin and ceftriaxone. Continued surveillance is needed to monitor changes in serotype prevalence and possible emergence of antibiotic resistance in pediatric pneumococcal disease.
Ulster Med J. 2013 Jan;82(1):23-5.
Shoakazemi A, Amit A, Nooralam N, Abouharb A, Gormley M, McKinstry S.
Psoas and epidural spinal abscesses have been described as relatively rare conditions. The incidence of epidural spinal abscess, however, has doubled in the recent two decades, reaching 1 in 10000 hospital admissions.
Early diagnosis and management of these two pathologies, especially when presenting with insidious and vague symptoms, require a high degree of suspicion. In this case, unusual evolving cervical disc space infection was also noted …
World Allergy Organ J. 2012 Jan;5(Suppl 1):S14-7.
Potter PC, Pawankar R.
Allergy Diagnostic and Clinical Research Unit, University of Cape Town, South Africa.
Rhinosinusitis is a significant health problem, causing significant morbidity and resulting in considerable financial cost. Some patients suffer persistent or recurrent symptoms despite receiving optimal medical and surgical treatment. Rhinosinusitis can be acute or chronic, acute often due to viral or bacterial infections and chronic which is classified into chronic with nasal polyposids or chronic rhinosinusitis without nasal polyposis. The disease affects the quality of life significantly and presents a significant burden on health costs globally. The anatomical linkage of the nose with the paranasal sinuses facilitates a common pathology in both organs.
Chronic rhinosinusitis (CRS) has heterogeneous origins, including viruses, bacteria, fungal infections, anatomical abnormalities, polyposis, and aspirin sensitivity. Other conditions such as human immunodeficiency virus acquired immunodeficiency and cystic fibrosis may also be predisposing factors. Nasal polyposis is often associated with increased numbers of Th2 lymphocytes, fibroblasts, goblet cells, mast cells, and eosinophils, with upregulation of IL-13 and the release of specific IgE to staphylococcal enterotoxins.
There is recent evidence that antibiotic treatment may not be as effective as higher doses of intranasal steroids in acute uncomplicated rhinosinusitis, especially in those with allergic disease. The broad inflammatory basis of the pathology of CRS also reveals a cellular infiltrate theoretically suppressed by intranasal corticosteroids. This has been confirmed in recent clinical studies of CRS with or without polyps. A treatment approach based on such studies reported in the European Position Paper on Rhinosinusitis guidelines and a guideline summary are presented.
The current review represents the proceedings of a session (3 talks) by the authors at the first Middle East-Asia Allergy, Asthma, Immunology Congress in 2009.
Rapidly progressing subperiosteal orbital abscess: an unexpected complication of a group-A streptococcal pharyngitis in a healthy young patient.
Head Face Med. 2012 Oct 16;8:28.
Costantinides F, Luzzati R, Tognetto D, Bazzocchi G, Biasotto M, Tirelli GC.
Division of Oral Medicine, Department of Dental Sciences, Piazza dell’Ospitale 1, University of Trieste, Trieste 34100, Italy. email@example.com.
Complications associated to group-A streptococcal pharyingitis include non-suppurative complications such as acute rheumatic fever and glomerulonephritis and suppurative complications such as peritonsillar or retropharyngeal abscess, sinusitis, mastoiditis, otitis media, meningitis, brain abscess, or thrombosis of the intracranial venous sinuses.
We described a case of a 15-year-old patient with a history of acute pharyngodinia early followed by improvise fever and a progressive formation of a diffuse orbital edema, corneal hyperaemia, diplopia and severe decrease of visual acuity.The patient was surgically treated with functional endoscopic sinus surgery (FESS) after the response of a maxillofacial computed tomography scans that showed a pansinusitis complicated by a left orbital cellulites. Numerous colonies of Streptococcus pyogenes were found in the samples of pus and an antibiotic therapy with meropenem was initiated on the basis of the sensitivity test to antibiotics. The patient was finally discharged with diagnosis of left orbital cellulites with periorbital abscess, endophtalmitis and acute pansinusitis as a consequence of streptococcal pharyngitis.
The case highlights the possible unusual complication of a group-A streptococcal pharyingitis in a immunocompetent child and the needing of a prompt surgical and medical approach toward the maxillofacial complications associated to the infection.