scholarly journals Invasive Aspergillus niger Is the Sole Etiological Agent for CSOM : A Clinical Case from Nepal

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Ajay Kumar Chaurasiya ◽  
Rabindra Bhakta Pradhananga ◽  
Niranjan Prasad Sah ◽  
Basista Prasad Rijal ◽  
Bharat Mani Pokhrel ◽  
...  
Keyword(s):  
Aspergillus Niger ◽  
Fungal Spores ◽  
Fungal Growth ◽  
Opportunistic Pathogen ◽  
Neck Surgery ◽  
Suppurative Otitis Media ◽  
Gram Staining ◽  
History Of ◽  
Etiological Agents ◽  
The Right

Aspergillus causing chronic suppurative otitis media (CSOM) is rare in immunocompetent people; however, it can occur as a significant opportunistic pathogen in immunocompromised patients. Here, in our study, a 53-year-old diabetic patient having a history of CSOM visited the Department of Otorhinolaryngology-Head and Neck Surgery (ENT-HNS), Tribhuvan University and Teaching Hospital (TUTH), Nepal, in March 2016. Although he was on medication with an antibacterial ear drop from the last 10 days, his right ear was presented with otorrhea, pruritus, otalgia, aural fullness, hearing impairment, and tinnitus from the last 3-4 months. Preliminarily, otoscopy of the right ear revealed the presence of fungal mass. For further diagnosis, ear discharge was aseptically collected and sent to the laboratory to confirm the etiological agents. Findings of laboratory analysis indicated that Gram staining of aural discharge displayed pus cells with fungal spores but did not exhibit bacteria. Furthermore, potassium hydroxide (KOH) mount revealed the presence of fungal spores and septate hyphae with the characteristic of dichotomous branching. Culture in four different bacterial media (chocolate agar, blood agar, MacConkey agar, and Robertson’s cooked meat medium) has unveiled no bacterial growth. However, fungal growth was observed in both bacterial and fungal media. Thereafter, the fungal colony was investigated via a lactophenol cotton blue (LPCB) tease mount which displayed the structure of Aspergillus. Aspergillus niger was microbially conformed by specifically characterizing the specific phenotypic biseriate structure of phialides and the black-coloured conidia. For medication, the patient was treated with Candid Ear Drop with clotrimazole (1% w/v) plus lidocaine (2% w/v) for 4 weeks which successfully improved his condition.

scholarly journals Otitis with Aspergillus niger in a patient with SARS-CoV-2 and multiple comorbidities

2021 ◽  
Vol 24 (3) ◽  
pp. 137-140
Author(s):  
Andreea Florentina Stoenescu ◽  
◽  
Geta Vancea ◽  
Dana Ispas ◽  
Nicoleta Voicu-Pârvu ◽  
...  
Keyword(s):  
Aspergillus Niger ◽  
Antiviral Treatment ◽  
Clinical Signs ◽  
Acute Onset ◽  
Suppurative Otitis Media ◽  
Vein Thrombosis ◽  
Significant Incidence ◽  
Lower Lung ◽  
History Of ◽  
The Right

Introduction. COVID-19 is associated with a significant incidence of bacterial and fungal superinfections and with the exacerbation of pre-existing infections, representing a diagnostic and therapeutic challenge. Case presentation. A 64-year-old woman, confirmed with COVID-19 by the SARS-CoV-2 antigen test, is hospitalized accusing fatigue, nausea, watery stools, cough and vertigo started 10 days ago, aggravated 4 days before the presentation. It also reports recurrent episodes of otalgia and otorrheic pluriantibiotic treatment in the last 2 months. From the personal pathological antecedents we remember: hypothyroidism, dyslipidemia, hypertension, ischemic heart disease, history of deep vein thrombosis (DVT) and secondary pulmonary thromboembolism, in chronic anticoagulant treatment. Pathological clinical signs at admission: bilateral basal crackling rales. Biologically, inflammatory syndrome is detected, and radiologically, interstitial-alveolar infiltrates in the lower lung fields. On day 3 of hospitalization, the patient shows purulent secretion in the right external auditory canal and the ENT consultation confirms chronic suppurative otitis media in acute onset. Bacteriological examination of otic secretion reveals Aspergillus niger. Antiviral treatment with Remdesivir is initiated, antibiotic therapy initiated at home with Azithromycin is continued for one day, then escalated to Ceftriaxone i.v. (in the context of clinical-paraclinical aggravation), systemic corticotherapy, anticoagulation with Dalteparin in the prophylactic regime of DVT, systemic treatment with Voriconazole p.o. (according to the antifungal program) and topical (local) with a slow favorable evolution. Conclusions. The association of COVID-19 with otitis with Aspergillus is a rare and particular clinical picture.

scholarly journals Retrosigmoid Approach for Vestibular Schwannoma

2018 ◽  
Vol 80 (S 03) ◽  
pp. S271-S271
Author(s):  
Mohammed Aref ◽  
Katherine Kunigelis ◽  
Stephen P. Cass ◽  
A. Samy Youssef
Keyword(s):  
Vestibular Schwannoma ◽  
Tumor Resection ◽  
Internal Auditory Canal ◽  
Hearing Preservation ◽  
Neck Surgery ◽  
Cochlear Nerve ◽  
Management Options ◽  
Suppurative Otitis Media ◽  
History Of ◽  
The Right

Vestibular schwannoma is a benign tumor that affects 3% of the population, but accounts for 85% of tumors occurring at the cerebellopontine angle (CPA). In this case, we present a 48-year-old female with history of cholesteatoma on the right and chronic suppurative otitis media on the left who presented with an 18 month history of bilateral hearing loss, worse on the right. Investigations revealed a right sided vestibular schwannoma measuring 1.6 cm in diameter. Audiogram revealed an AAO–HNS (American Academy of Otolaryngology–Head and Neck Surgery) class C hearing on the right and class B on the left. There are several management options for this size of vestibular schwannoma including observation and radiosurgery. However, preserving cochlear nerve function remains a challenging enterprise. Furthermore, the ideal management that confers the highest chance of hearing preservation remains heavily debated. Given the patient's young age, the goal of hearing preservation and the tumor size/extension into the CPA, surgery was decided through a right retrosigmoid transmeatal approach for tumor resection with intraoperative brain auditory evoked responses monitoring. For hearing preservation, we emphasize few important dissection techniques: tumor debulking from the top first to avoid early manipulation of the cochlear nerve at the bottom of the tumor, sharp dissection from medial to lateral off the vestibular nerve which is kept intact as a tension band to minimize cochlear nerve manipulations, and limit the drilling of the posterolateral wall of the internal auditory canal (IAC) medial to the labyrinth and endolymphatic apparatus. Postoperatively, the patient was discharged home within 2 days, with imaging showing a gross total resection. Follow-up audiogram shows unchanged pure tone thresholds.The link to the Video can be found at: https://youtu.be/Z5ftkpJN5k8.

Sociodemographic Factors of Atticoantral Chronic Suppurative Otitis Media

2020 ◽  
Vol 26 (2) ◽  
pp. 136-141
Author(s):  
Mohammed Sirazul Islam ◽  
Md Bashir Ahmed ◽  
Nazneen Khan ◽  
AKM Asaduzzaman
Keyword(s):  
Hearing Impairment ◽  
Otitis Media ◽  
Neck Surgery ◽  
Sociodemographic Factors ◽  
Chronic Suppurative Otitis Media ◽  
Military Hospital ◽  
Common Disease ◽  
Suppurative Otitis Media ◽  
The Right ◽  
Almost All

Background: Chronic suppurative otitis media (CSOM) is an inflammatory process in the middle ear cleft. When there is attic or marginal perforation it is called the atticoantral variety of COSM which is manifested as foul smelling aural discharge and hearing impairment. In Bangladesh, chronic suppurative otitis media (CSOM) is a common disease in clinical practice. Objective: The aim of this study was to find out the clinical presentation of atticoantral chronic suppurative otitis media (CSOM) in defence personnel and their families. Methods: A retrospective study was carried out in the Department of ENT and Head-Neck Surgery, Combined Military Hospital (CMH), Dhaka from 01 April 2017 to 31 December 2019.Forty seven patients of Atticoantral variety of CSOM were included by matching inclusion and exclusion criteria. Results: Majority of the patients presented in the second and third decade of life(11-20 years: 29.79%, 21-30 years: 44.68%). All the patients belonged to the soldiers and their families. The maximum numbers of patients were from rural area(51.06%), completed only primary education (48.94%). Most of them lived in a kutcha building. Almost all the patients presented with multiple symptoms. Discharge from ear(s) (100%), and hearing impairment (82.97%) were the leading features. Only (2.14%) had extracranial complication and there was no intracranial complication. Most of the patients were having unilateral atticoantral CSOM, in the right side (61.70%), left side (36.17%) and only one (2.12%) had bilateral involvement. Audiometric tests were done in 100% of the patients and found; mild deafness (19.14%), moderate deafness (78.72%) and moderately severe deafness (2.14%). Conclusion: The frequency of chronic suppurative otitis media is higher in the younger age group and lacking of education. By increasing health awareness of the general people and early diagnosis of atticoantral CSOM and timely surgical intervention may be helpful to eradicate the disease and prevent complications. Bangladesh J Otorhinolaryngol; October 2020; 26(2): 136-141

Does the Application of a Semiocclusive Dressing Alter the Microflora of Healthy Intact Skin on the Foot?

2021 ◽  
Vol 111 (1) ◽  
Author(s):  
Rachel Forss ◽  
Zoe Hugman ◽  
Kelly Ridlington ◽  
Marissa Radley ◽  
Emma Henry-Toledo ◽  
...  
Keyword(s):  
Healing Process ◽  
Fungal Growth ◽  
Coagulase Negative Staphylococcus ◽  
Medial Longitudinal Arch ◽  
Intact Skin ◽  
Gram Staining ◽  
Longitudinal Arch ◽  
Human Participants ◽  
The Right ◽  
Semiocclusive Dressing

Background The skin on human feet presents unique environments for the proliferation of potentially pathogenic commensals. This study examined microflora changes on healthy intact skin under a semiocclusive dressing on the medial longitudinal arch of the foot to determine changes in growth, distribution, and frequency of microflora under the dressing. Methods Nine human participants wore a low-adherent, absorbent, semiocclusive dressing on the medial longitudinal arch of the left foot for 2 weeks. An identical location on the right foot was swabbed and used as a control. Each foot was swabbed at baseline, week 1, and week 2. The swabs were cultured for 48 hours. Visual identification, Gram staining, DNase test agar, and a latex slide agglutination test were used to identify genera and species. Results Microflora growth was categorized as scant (0–10 colony-forming units [CFU]), light (11–50 CFU), moderate (51–100 CFU), or heavy (>100 CFU). Scant and light growth decreased and moderate and heavy growth increased under the dressing compared with the control. Seven different genera of bacteria were identified. Coagulase-negative Staphylococcus spp appeared most frequently, followed by Corynebacterium spp. Conclusions Changes in microflora distribution, frequency, and growth were found under the dressing, supporting historical studies. Microflora changes were identified as an increase in bioburden and reduction in diversity. The application of similar methods, using more sophisticated identification and analysis techniques and a variety of dressings, could lead to a better understanding of bacterial and fungal growth under dressings, informing better dressing selection to assist the healing process of wounds and prevent infection.

scholarly journals Prevalence and Etiological Agents for Chronic Suppurative Otitis Media in a Tertiary Hospital in Tanzania.

2019 ◽  
Author(s):  
Zephania Saitabau Abraham ◽  
Daudi Ntunaguzi ◽  
Aveline Aloyce Kahinga ◽  
Kassim Babu Mapondella ◽  
Enica Richard Massawe ◽  
...  
Keyword(s):  
Otitis Media ◽  
Microbial Growth ◽  
Tertiary Hospital ◽  
Chronic Suppurative Otitis Media ◽  
Suppurative Otitis Media ◽  
Male Preponderance ◽  
Amoxicillin Clavulanic Acid ◽  
Etiological Agents ◽  
Attic Perforation ◽  
The Right

Abstract Objective: Chronic suppurative otitis media is among the most common otological condition reported in otorhinolaryngology practice commonly attributing to preventable hearing loss. The aim of this study was to determine the prevalence and etiological agents for chronic suppurative otitis media in our department. Results: A total of 5591 patients were recruited in this study and only 79 (1.4%) had chronic suppurative otitis media. A male preponderance 43 (54.4%) was noted in this study and the left ear (58.2%) was more commonly affected compared to the right ear. Central perforation was the commonest pattern of presentation and was reported in 53% of cases though none had attic perforation. Of the 81 processed ear swabs, microbial growth was seen in majority 80 (98.8%) whilst one sample showed no microbial growth whereas 52.5% had polymicrobial growth. Among the isolates, most were gram negative species accounting for 59.7% while gram positive bacteria accounted for 25.6% and fungi accounted for 14.7%. Most of these isolates were facultative anaerobes. Klebsiella pneumoniae (20.2%) was the commonest isolates while Escherchia coli and Pseudomonas aeruginosa were equally least isolated (10.9%). Tested isolates were most sensitive to Ciprofloxacin, Gentamycin, Ceftriaxone and Amikacin and least sensitive to Amoxicillin/clavulanic acid and Ampicillin.

scholarly journals Capillary Hemangioma of the Temporal Bone

2017 ◽  
Vol 32 (1) ◽  
pp. 37-40
Author(s):  
Jose Z. Fernando ◽  
Rosario R. Ricalde
Keyword(s):  
Temporal Bone ◽  
Bone Erosion ◽  
Recurrent Infection ◽  
Punch Biopsy ◽  
Capillary Hemangioma ◽  
Suppurative Otitis Media ◽  
Aural Polyp ◽  
Keywords Hemangioma ◽  
History Of ◽  
The Right

Objective: To discuss a rare case of temporal bone capillary hemangioma, and its diagnosis and management. Methods:             Design:           Case Report             Setting:           Tertiary Government Hospital             Patient:           One Results: A 44-year old woman with a history of on-and-off right ear discharge, tinnitus and decreased hearing, and a pinkish, smooth-surfaced, non-friable, non-pulsating mass occluding the right external auditory canal, was initially treated for chronic suppurative otitis media with aural polyp. A punch biopsy due to persistence of disease despite medical treatment revealed capillary hemangioma.  She underwent canal wall down mastoidectomy with obliteration to completely resect the tumor. Conclusion: Capillary hemangiomas of the temporal bone are benign lesions that may lead to complications such as bone erosion, hearing loss, recurrent infection and bleeding if left untreated. Surgery remains the ideal treatment, and recurrence is rare and the prognosis is good if resection is complete. Keywords: Hemangioma, capillary hemangioma, temporal bone, middle ear  

scholarly journals Myringoplasty: underlay versus overlay techniques- a comparative study

2018 ◽  
Vol 4 (2) ◽  
pp. 381 ◽  
Author(s):  
Mahesh S. G. ◽  
Vishwas K. Pai ◽  
Pallavi Pavithran ◽  
Nithin P. S.
Keyword(s):  
Hearing Loss ◽  
Neck Surgery ◽  
Hearing Improvement ◽  
Ear Surgery ◽  
Suppurative Otitis Media ◽  
Type Selection ◽  
History Of ◽  
Atticoantral Disease ◽  
Middle Ear Cleft

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Chronic suppurative otitis media is an inflammation of the mucoperiosteal lining of the middle ear cleft. 10% of Indian population suffers from hearing impairment. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">The study comprises of 60 patients admitted in the department of ENT and head and neck surgery, AJIMS, Mangalore between June 2015 and May 2017. All patients suffered from CSOM, tubotympanic type. Selection criteria was patients with CSOM, TTD type with no or minimal SNHL, AB gap more than 20dB, absence of ossicular defects, no history of previous ear surgery and was operated on worse hearing ear. Exclusion criteria were atticoantral disease, ossicular defects, previous ear surgery, otomycosis and systemic diseases.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The majority of the patients were between the age group of 20-40 years. Out of the 60 patients, 28 were male and 32 female. 8 patients with moderate size and 20 with large perforations underwent underlay myringoplasty. For onlay corresponding numbers were 17 and 13. 26 patients (86.7%) who underwent underlay and 27 patients (90%) who underwent overlay had good hearing improvement. 43.3% of the group had significant hearing improvement at 6 months follow up. 20 patients had pneumatised and 40 patients had sclerotic mastoids in the study. Graft take up was 90% for underlay and 96.6% for overlay. The hearing loss was more with larger perforations.18 patients with large perforations who underwent underlay had good hearing improvement versus 13 for overlay whereas for moderate perforations, only 8 patients had good hearing improvement for underlay versus 15 for overlay. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">The hearing improvement obtained with underlay and overlay myringoplasty are comparable. The cellularity of mastoid has no influence on the hearing improvement. The size of the perforation correlates well with the degree of hearing loss. Underlay myringoplasty seems to give better results for large perforations, overlay for moderate sized ones.</span></p><p class="abstract"> </p>

scholarly journals Pseudomonas aeruginosainhibitsRhizopus microsporusgermination through sequestration of free environmental iron

2018 ◽  
Author(s):  
Courtney Kousser ◽  
Callum Clark ◽  
Kerstin Voelz ◽  
Rebecca A. Hall
Keyword(s):  
Fungal Infections ◽  
Fungal Spores ◽  
Fungal Growth ◽  
Antibacterial Treatment ◽  
Nutrient Restriction ◽  
Rhizopus Microsporus ◽  
Risk Patients ◽  
Host Mortality ◽  
Etiological Agents

AbstractRhizopus sppare the most common etiological agents of mucormycosis, causing over 90% mortality in disseminated infection. Key to pathogenesis is the ability of fungal spores to swell, germinate, and penetrate surrounding tissues. Antibiotic treatment in at-risk patients increases the probability of the patient developing mucormycosis, suggesting that bacteria have the potential to control the growth of the fungus. However, research into polymicrobial relationships involvingRhizopus spphas not been extensively explored. Here we show that co-culturingRhizopus microsporusandPseudomonas aeruginosaresults in the inhibition of spore germination. This inhibition was mediated via the secretion of bacterial siderophores, confirming the essential role of iron for fungal growth. Addition ofP. aeruginosasiderophores toR. microsporusspores in the zebrafish larval model of infection resulted in inhibition of fungal germination and reduced host mortality. Therefore, during infection antibacterial treatment may relieve bacterial imposed nutrient restriction resulting in secondary fungal infections.

scholarly journals Blindness from Fungal Rhinosinusitis of the Paranasal Sinuses: A Case Report

2020 ◽  
Vol 35 (2) ◽  
pp. 41
Author(s):  
Daniel Rico De Jesus ◽  
Patrick Joseph Estolano
Keyword(s):  
Nasal Congestion ◽  
Fungal Growth ◽  
Pregnant Patient ◽  
Sinus Surgery ◽  
Fungal Rhinosinusitis ◽  
History Of ◽  
Left Maxillary Sinus ◽  
The Right ◽  
High Index Of Suspicion ◽  
Ethmoid Sinuses

ABSTRACT Objective: To present a unique case of blindness resulting from fungal rhinosinusitis involving multiple sinuses mimicking a malignant process in a pregnant patient. Methods:Design: Case ReportSetting: Tertiary Government Training HospitalPatient: One Result: A 36-year-old pregnant woman developed unilateral blindness during her 20th week of gestation with a history of  binocular diplopia, unilateral nasal obstruction and anosmia for 13 months during the pre-pregnancy period. Sphenoid sinus malignancy was suspected on imaging. The planned biopsy was intraoperatively shifted to endoscopic sinus surgery when clay-like materials were seen involving the left maxillary sinus and bilateral sphenoid and ethmoid sinuses. Histopathologic examination confirmed fungal growth. Postoperatively, nasal symptoms resolved but blindness of the left eye and blurring of vision of the right eye persisted. Conclusion: Fungal rhinosinusitis rarely occurs in multiple sinuses and is commonly misdiagnosed. It can afflict pregnant patients and mimic a malignant process. A high index of suspicion early on, especially in the presence of nasal congestion and diplopia may prevent potentially irreversible complications.

scholarly journals 261. A Rare Case of Meningitis and Symptomatic Hydrocephalus by Listeria Monocytogenes in Dermatomyositis: A Case Report

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S237-S238
Author(s):  
Eylem Kiral ◽  
Ebru kacmaz ◽  
Gurkan Bozan ◽  
Ozgur Arslanoglu ◽  
Omer Kilic ◽  
...  
Keyword(s):  
Listeria Monocytogenes ◽  
Intestinal Flora ◽  
Pediatric Intensive Care ◽  
Gram Staining ◽  
History Of ◽  
Cellular And Humoral Immunity ◽  
Meningitis In Children ◽  
Listeria Meningitis ◽  
The Right ◽  
The Brain

Abstract Background Listeria monocytogenes is a gram-positive, facultative anaerobic bacillus common in the intestinal flora of many animals and humans. We describe an unusual case of meningitis by Listeria monocytogenes (LM) complicated by hydrocephalus in a child with dermatomyositis. Methods A 15-year-old girl presented to an outside hospital (OH) after a three-day history of headache, fever and was hospitalized with a diagnosis of meningitis and lumbar puncture performed. CSF sample could not be evaluated clearly due to its hemorrhagic nature. Her past medical history was significant for dermatomyositis for five years. She had received induction of IVIG five days prior. She was also taking cyclosporin A and hydroxychloroquine. She was empirically treated with intravenous cefotaxime, vancomycin, and acyclovir. She was urgently transferred to the theatre for an external shunt placement in the right lateral ventricle. The interval between the first symptoms and the diagnosis of hydrocephalus was around 4 days. CSF from this catheter showed growth of LM with sensitivity to meropenem and resistance to erythromycin, ampicillin, and sulfamethoxazole-trimethoprim. Gram staining of CSF resulted negative for bacteria. Cefotaxime was switched to intravenous meropenem. Immunological screening of cellular and humoral immunity, complement, and blood iron levels were normal. SARS-Cov2 PCR and HIV tests were negative. Herpes virus, mycobacterium tuberculosis real-time PCR, respiratory viral panel studied in the CSF sample were negative. MRI and Angio of the brain showed no abnormality. She is being followed in the pediatric intensive care unit as intubated. Results In patients who received immunosuppressive medication, L. monocytogenes should be evaluated in the differential diagnosis of central nervous system infections. Even if effective antibiotic therapy has been initiated, this case highlights the need of recognizing early hydrocephalus as a consequence of Listeria meningitis in children with neurological deterioration a few days after initial presentation. Conclusion The literature on the management and outcome of Listeria meningitis-related hydrocephalus in children is limited. Disclosures All Authors: No reported disclosures

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