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Karakas C, Herman I, Kralik SF, Webber TA, Takacs DS, Bhar S, Pehlivan D. A Comprehensive Examination of Clinical Characteristics and Determinants of Long-Term Outcomes in Pediatric Cerebral Sinus Venous Thrombosis. Pediatr Neurol 2024; 155:76-83. [PMID: 38608552 DOI: 10.1016/j.pediatrneurol.2024.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND To analyze the clinical and neuroimaging features, risk factors, treatment choices, and long-term clinical outcomes in children with cerebral sinus venous thrombosis (CSVT). METHODS This is a retrospective cohort study of children diagnosed with CSVT between 2002 and 2018 at Texas Children's Hospital. RESULTS A total of 183 children (male: 62.3%) with CSVT were included. The average presenting age was 7.7 years (S.D.: 5.6). The mean follow-up duration was 33.7 months (S.D.: 38.6). The most common presenting clinical feature was headache (36.6%). Head and neck infections other than meningitis (36.6%) were the most common risk factors. Prevalent neurological examination findings included motor deficit (21.3%) and altered mental status (AMS, 20.2%). Neuroimaging features included hemorrhagic infarction (19.6%), ischemic infarction (8.2%), and intracranial hemorrhage without infarction (5.5%). The most common site of thrombosis was the superior sagittal sinus (37.2%), with 78.2% of patients demonstrating involvement of multiple sinuses. Treatment of choice was low-molecular-weight heparin in 69.4% of patients. Factors associated with worse clinical outcomes included head and neck infections, malignancy (other than hematologic), cardiac disease, and recent surgery; seizure and dehydration on initial presentation; motor abnormalities and AMS on initial examination; ischemic infarct only; and involvement of vein of Trolard on neuroimaging. Thrombus condition on repeat imaging, receiving any anticoagulant/antithrombotic treatment, treatment duration, or follow-up duration was not associated with severity of long-term outcome. CONCLUSIONS CSVT may lead to unfavorable long-term outcomes in a remarkable portion of pediatric patients. Thus, a high index of suspicion and early and appropriate management of pediatric CSVT is imperative.
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Affiliation(s)
- Cemal Karakas
- Section of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, Texas; Department of Neurology and Neurophysiology, Baylor College of Medicine, Houston, Texas; Division of Pediatric Neurology, Department of Neurology, Norton Children's Medical Group, University of Louisville, Louisville, Kentucky
| | - Isabella Herman
- Section of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, Texas; Boys Town National Research Hospital, Boys Town, Nebraska
| | - Stephen F Kralik
- Department of Radiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Troy A Webber
- Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, Texas
| | - Danielle S Takacs
- Section of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, Texas; Department of Neurology and Neurophysiology, Baylor College of Medicine, Houston, Texas
| | - Saleh Bhar
- Division of Hematology and Oncology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Davut Pehlivan
- Section of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
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Gkrinia E, Brotis AG, Vallianou K, Ntziovara AM, Hajiioannou J. Otogenic brain complications: a systematic review and meta-analysis. J Laryngol Otol 2024:1-10. [PMID: 38440882 DOI: 10.1017/s0022215124000343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
OBJECTIVE This study aimed to form astute deductions regarding the presentation, treatment and mortality of otogenic brain complications. METHODS A systematic literature search of four medical databases (PubMed, Embase, Web of Science and Scopus) was conducted. Studies associated with otogenic brain complications were considered eligible. Fixed- and random-effects model meta-analysis was developed to assess the proportion estimate for each outcome individually. RESULTS Twenty-eight studies, with 1650 patients in total, were included. In 66 per cent of patients there was a known history of chronic otitis media. The most common symptoms were purulent otorrhoea (84 per cent), headache (65 per cent) and otalgia (45 per cent). A brain abscess was observed in 49 per cent of patients, followed by meningitis (34 per cent) and sinus thrombosis (22 per cent). A combination of surgical and conservative therapy was chosen in 84.3 per cent of cases and the mortality rate approached 11.1 per cent. CONCLUSION Otogenic brain complications are a possibly life-threatening condition. Prompt imaging examination may set the final diagnosis and lead to an effective treatment.
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Affiliation(s)
- Eleni Gkrinia
- ENT Department, University Hospital of Larissa, Larissa, Greece
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Li H, Wei S, Xu Q. Full sample analysis of cerebral venous sinus thrombosis in ophthalmology inpatients. J Fr Ophtalmol 2024; 47:104074. [PMID: 38377844 DOI: 10.1016/j.jfo.2024.104074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/19/2023] [Accepted: 03/21/2023] [Indexed: 02/22/2024]
Abstract
PURPOSE We hope that by analyzing the clinical features of cerebral venous sinus thrombosis (CVST), we can help ophthalmologists reduce misdiagnosis or delayed diagnosis. DESIGN We evaluated 47 patients with CVST in terms of clinical manifestations. METHODS All cases were analyzed in terms of risk factors, clinical symptoms, ophthalmic examination, imaging examination and lumbar puncture. RESULTS The body mass indices (BMIs) of 41 patients (87.2%; 95% CI, 77.7-96.8%) were≥24, which is overweight by Chinese standards. There were 22 patients (46.8%; 95% CI, 32.5-61.1%) with BMIs≥28, who were considered obese. Thirteen were hypertensive (27.7%; 95% CI, 14.9-40.5%). The initial symptoms included blurred vision (23, 48.9%; 95% CI, 34.6-63.2%), amaurosis fugax (13, 27.7%; 95% CI, 14.9-40.5%), headache (11 patients, 23.4%; 95% CI, 11.3-35.5%), dizziness (3, 6.4%; 95% CI, -0.6-13.4%), and bilateral diplopia (3, 6.4%; 95% CI, -0.6-13.4%). There were 9 patients (9, 19.2%; 95% CI, 7.9-30.4%) with blindness, 23 patients (48.9%; 95% CI, 34.6-63.2%) with pupillary abnormalities, and 40 patients (85.1%; 95% CI, 74.9-95.2%) with papilledema. Forty-three of the 45 patients who successfully underwent a routine lumbar puncture showed high intracranial pressure (91.7%; 95.6% CI, 89.6-101.6%). Finally, two cases are reported in greater detail for illustrative purposes. CONCLUSION The main reasons interfering with the diagnosis of CVST might be its nonspecific ocular symptoms and the physicians' clinical thought process being limited to the scope of common ophthalmological diseases.
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Affiliation(s)
- H Li
- Department of Ophthalmology, The Second Hospital of Dalian Medical University, Dalian China.
| | - S Wei
- Department of Ophthalmology, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing, PR China.
| | - Q Xu
- Department of Ophthalmology, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing, PR China.
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Raineau M, Crowe AM, Beccaria K, Luscan R, Simon F, Roux CJ, Ferroni A, Kossorotoff M, Harroche A, Castelle M, Gatbois E, Bourgeois M, Roy M, Blanot S. Pediatric intracranial empyema complicating otogenic and sinogenic infection. Int J Pediatr Otorhinolaryngol 2024; 177:111860. [PMID: 38224655 DOI: 10.1016/j.ijporl.2024.111860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 12/20/2023] [Accepted: 01/09/2024] [Indexed: 01/17/2024]
Abstract
OBJECTIVE To describe and compare clinical and microbiological features, surgical and medical management, and outcomes of children with otogenic and sinogenic intracranial empyema (IE) in an institution with an established multidisciplinary protocol. To use the study findings to inform and update the institutional algorithm. METHODS Retrospective analysis was carried out on the electronic healthcare records of all children with oto-sinogenic IE admitted in a 5-year period. RESULTS A total of 76 patients were identified and treated according to an institutional protocol. Two distinct groups were identified: intracranial empyema related to otogenic infection (OI-IE, n = 36) or sinogenic infection (SI-IE, n = 40). SI-IE was seen in older children and had a significantly higher morbidity. Sub-dural IE was seen in a minority (n = 16) and only in SI-IE and required urgent collaborative ENT-neurosurgery. Extra-dural IE occurred more frequently and was seen in both SI-IE and OI-IE. No death and overall low morbidity were observed. Particularities found in SI-IE and OI-IE groups (as thrombosis, microbiology, antibiotic treatment, duration and outcome) permitted the delineation of these groups in our updated algorithm. CONCLUSION The presence of a collaborative multidisciplinary protocol permits the step-wise co-ordination of care for these complex patients in our institution. All patients received prompt imaging, urgent surgical intervention, and antibiotic treatment. Microbiological identification was possible for each patient and antibiotic rationalization was permitted through use of Polymerase chain reaction (PCR) testing in cases of sterile cultures. Of note, intracranial empyema related to sinogenic infection is shown to have significantly more severe clinical presentation, a higher morbidity, and a longer duration of antibiotic therapy than that related to otogenic infection. Study findings allowed for the update and clarification of the institutional protocol, which now clearly demarcates the clinical presentation, biological evidence, radiology, surgical and medical treatments in children with oto-sinogenic IE.
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Affiliation(s)
- Mégane Raineau
- Pediatric Intensive Care Unit, Assistance Publique des Hôpitaux de Paris, Hôpital Necker Enfants Malades - Université Paris Cité, Paris, France.
| | - Ann-Marie Crowe
- Pediatric Intensive Care Unit, Assistance Publique des Hôpitaux de Paris, Hôpital Necker Enfants Malades - Université Paris Cité, Paris, France.
| | - Kevin Beccaria
- Pediatric Neurosurgery Department, Assistance Publique des Hôpitaux de Paris, Hôpital Necker Enfants Malades - Université Paris Cité, Paris, France.
| | - Romain Luscan
- Pediatric ENT Department, Assistance Publique des Hôpitaux de Paris, Hôpital Necker Enfants Malades - Université Paris Cité, Paris, France.
| | - Francois Simon
- Pediatric ENT Department, Assistance Publique des Hôpitaux de Paris, Hôpital Necker Enfants Malades - Université Paris Cité, Paris, France.
| | - Charles-Joris Roux
- Pediatric Radiology Department, Assistance Publique des Hôpitaux de Paris, Hôpital Necker Enfants Malades - Université Paris Cité, Paris, France.
| | - Agnès Ferroni
- Clinical Microbiology Department, Assistance Publique des Hôpitaux de Paris, Hôpital Necker Enfants Malades - Université Paris Cité, Paris, France.
| | - Manoelle Kossorotoff
- Pediatric Neurology Department, French Center for Pediatric Stroke, Assistance Publique des Hôpitaux de Paris, Hôpital Necker Enfants Malades - Université Paris Cité, Paris, France.
| | - Annie Harroche
- Clinical Hematology Department, Assistance Publique des Hôpitaux de Paris, Hôpital Necker Enfants Malades - Université Paris Cité, Paris, France.
| | - Martin Castelle
- Pediatric Immunology Department, Assistance Publique des Hôpitaux de Paris, Hôpital Necker Enfants Malades - Université Paris Cité, Paris, France.
| | - Edith Gatbois
- Hospitalization at Home Department, Assistance Publique des Hôpitaux de Paris, Hôpital Armand Trousseau - Sorbonne Université, Paris, France.
| | - Marie Bourgeois
- Pediatric Neurology Department, French Center for Pediatric Stroke, Assistance Publique des Hôpitaux de Paris, Hôpital Necker Enfants Malades - Université Paris Cité, Paris, France.
| | - Mickaela Roy
- Pediatric Intensive Care Unit, Assistance Publique des Hôpitaux de Paris, Hôpital Necker Enfants Malades - Université Paris Cité, Paris, France.
| | - Stéphane Blanot
- Pediatric Intensive Care Unit, Assistance Publique des Hôpitaux de Paris, Hôpital Necker Enfants Malades - Université Paris Cité, Paris, France.
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Engelhardt MI, Phan N, Zavala H, Chinnadurai S, Roby BB. Head and neck venous thrombosis secondary to pediatric otolaryngologic infection. Int J Pediatr Otorhinolaryngol 2023; 168:111513. [PMID: 37003017 DOI: 10.1016/j.ijporl.2023.111513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 02/16/2023] [Accepted: 03/11/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVES Head and neck venous thrombosis is a rare but potentially devastating complication of childhood otolaryngologic infections. This study examines the presentation and management of this condition. METHODS A retrospective chart review was performed on all pediatric patients with otolaryngologic infections complicated by cranial and cervical venous thrombosis at a tertiary children's hospital from 2007 to 2018. Patient demographics, presentation, site of infection, thrombosis location, implicated pathogen, length of hospital stay, need for surgery, and anticoagulant regimen were assessed. RESULTS This study included 33 patients (mean age, 7.5 years; age range, 0.8-17 years; 19 [58%] male). The most common infection source was otologic (n = 20), followed by ophthalmic and sinonasal pathology (n = 9), and neck infections (n = 4). The most common site of thrombosis secondary to ear pathology was the sigmoid sinus. The ophthalmic veins were the most common site of thrombosis for ophthalmic/sinonasal infections. Nine CN VI palsies, one CN VII palsy, and one CN III palsy were observed. Twenty-six subjects (79%) required surgical intervention. All those who experienced a nerve palsy required surgery. Length of hospitalization significantly differed with the stay for a neck infection complicated by thrombosis longer compared to otologic and sinonasal infections (F[2,30] = 7.08, p = 0.003). Length of hospital stay was significantly correlated with admission temperature (r = 0.506, p = 0.003) and CRP (r = 0.400, p = 0.03) but not WBC (r = 0.181, p = 0.31). Culture growth predominantly isolated a single causative organism rather than polymicrobial involvement. Forty-eight species were identified, most (n = 41/48, 85%) being Gram-positive bacteria. Alpha-hemolytic Streptococcus was the most common isolate from children with vessel thrombosis secondary to ear infections, with Streptococcus pyogenes predominant in sinonasal infections and Staphylococcus aureus the most common in neck abscesses. There was significant variability in anticoagulation management within the patient population, but no bleeding complications were documented. Most patients had no evidence of underlying thrombophilia (n = 15); for those with positive hypercoagulability screens, the most common positive marker was the presence of lupus inhibitor (n = 6). CONCLUSION Venous thrombosis resulting from adjacent otolaryngologic infection is a serious complication requiring proper recognition and management. The involved vasculature and cranial nerve findings are dependent on the anatomic location of the underlying infection. Cranial neuropathies in the presence of these infections should prompt evaluation for possible thrombosis.
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Affiliation(s)
- Margaret I Engelhardt
- University of Minnesota, Department of Otolaryngology - Head and Neck Surgery, Minneapolis, MN, USA; Children's of Minnesota, Pediatric ENT & Facial Plastic Surgery, Minneapolis, MN, USA.
| | - Noel Phan
- Icahn School of Medicine at Mount Sinai, Department of Otolaryngology - Head and Neck Surgery, New York City, NY, USA
| | - Hanan Zavala
- Children's of Minnesota, Pediatric ENT & Facial Plastic Surgery, Minneapolis, MN, USA
| | - Sivakumar Chinnadurai
- University of Minnesota, Department of Otolaryngology - Head and Neck Surgery, Minneapolis, MN, USA; Children's of Minnesota, Pediatric ENT & Facial Plastic Surgery, Minneapolis, MN, USA
| | - Brianne B Roby
- University of Minnesota, Department of Otolaryngology - Head and Neck Surgery, Minneapolis, MN, USA; Children's of Minnesota, Pediatric ENT & Facial Plastic Surgery, Minneapolis, MN, USA
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Malinovic M, Peterson J, Lee F. Pneumococcal meningitis complicated by otomastoiditis and pneumocephalus confounding an acute ischemic stroke diagnosis. JOURNAL OF NEUROCRITICAL CARE 2021. [DOI: 10.18700/jnc.210003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Duygu E, Şevik Eliçora S. Our experience on the management of acute mastoiditis in pediatric acute otitis media patients. Int J Pediatr Otorhinolaryngol 2020; 138:110372. [PMID: 32927353 DOI: 10.1016/j.ijporl.2020.110372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/03/2020] [Accepted: 09/03/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The incidence of complications due to acute otitis media (AOM) in childhood has decreased significantly with the use of new antibiotics in recent years. However, acute mastoiditis (AM) is still the most common complication that can lead to further intracranial conditions with high morbidity. Our study aimed to evaluate the clinical characteristics of children with AM and identify possible indicators for further intracranial complications associated with this condition. METHODS Children hospitalized in our clinic with a diagnosis of AM were reviewed. Demographic data, disease-related symptoms, types of complications accompanied by AM, medical/surgical treatments modalities, and culture results were screened. The patients were divided into two groups as those with and without intracranial complications (ICCs). Routine complete blood count tests, biochemical analysis, and C-reactive protein (CRP) level measurement were evaluated and compared between the groups. RESULTS Of the 28 AM patients, five (17.9%) had isolated AM. Complications associated with AM included sub-periosteal abscess (28.6%), facial paralysis (25%), meningitis (17.9%), meningitis with sigmoid sinus thrombosis (7.1%), and meningitis with cerebellar abscess (3.6%). Eight patients developed ICCs (28.6%), of whom three had more than one complication. Ceftriaxone was found to be the first-line medical treatment (57.1%). Streptococcus pneumoniae was the most common pathogen isolated from the cultures (42.9%). Three patients (10.7%) were treated non-surgically, eight (28.6%) with myringotomy and ventilation tube (VT) insertion, eight patients (28.6%) with abscess drainage and VT insertion, and nine (32.1%) with cortical mastoidectomy and VT insertion. There was no significant difference between the patients with and without ICCs in terms of complete blood count parameters. The CRP level and the CRP-albumin ratio were significantly higher in patients with ICCs than those without these complications (p < 0.001). CONCLUSION AM remains to be the most common complication of AOM in childhood and can lead to further life-threatening conditions. Additional interventions according to the type of the complication with VT insertion is safe and effective in the management of AM. In patients with AM, it is of great importance to determine whether there is an accompanying ICC. The CRP-albumin ratio is a simple and reliable calculation to detect ICCs in patients with AM.
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Affiliation(s)
- Erdem Duygu
- Department of Otorhinolaryngology, Faculty of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey.
| | - Sultan Şevik Eliçora
- Department of Otorhinolaryngology, Faculty of Medicine, Zonguldak Bülent Ecevit University, Zonguldak, Turkey.
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Abstract
OBJECTIVE Otogenic brain abscess is a well-recognized clinical condition that describes brain abscess secondary to an ear infection or mastoiditis. Current evidence remains limited on risk factors associated with mortality as most data are from case series. We aimed to 1) report the mortality rate among patients who did and did not receive mastoidectomy 2) identify factors associated with inpatient mortality. STUDY DESIGN Retrospective cohort study. SETTING Multi-institutional. PATIENTS We identified a cohort of patients for years 2008 to 2014 who in their inpatient hospitalization carried the diagnoses of both brain abscess and infectious ear disease. INTERVENTIONS Inpatient neurotology and neurosurgical procedures. MAIN OUTCOME MEASURES A multivariable logistics regression model was built to identify the factors associated with inpatient mortality. RESULTS The final analysis included 252 patients, of which 84 (33.3%) underwent mastoidectomy. The rate of inpatient morbidity and mortality were 17.5% and 4.0%, respectively. The rate of mortality in patients without mastoidectomy versus those with mastoidectomy was 4.2% versus 3.6%, respectively (p > 0.99). The odds of inpatient mortality were significantly increased for every 10-year increase in age (odds ratio [OR] 2.73, 95% confidence interval [CI]: 1.39-7.01, p = 0.011) and for Black compared to White patients (OR: 45.81, 95% CI: 4.56-890.92, p = 0.003). CONCLUSION Older age and Black race were associated with increased odds of inpatient mortality and there were no significant differences in mortality between mastoidectomy cohorts. This research serves to generate further hypotheses for larger observational studies to investigate the association between sociodemographic factors and surgical variables with outcomes among this surgical population.
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Marom T, Shemesh S, Habashi N, Gluck O, Tamir SO. Adult Otogenic Meningitis in the Pneumococcal Conjugated Vaccines Era. Int Arch Otorhinolaryngol 2020; 24:e175-e181. [PMID: 32256838 PMCID: PMC6986945 DOI: 10.1055/s-0039-1697995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 08/11/2019] [Indexed: 10/31/2022] Open
Abstract
Introduction Streptococcus pneumoniae is a major pathogen of otogenic meningitis (OgM), the most commonly reported intra-cranial complication of otitis media (OM). Objectives To study the changes in adult OgM patients in the pneumococcal conjugated vaccines (PCVs) era. Methods Retrospective cohort of adults presenting with concurrent OM and meningitis in a secondary medical care center between 2005 and 2015. Data collected included demographics, OM-related symptoms, cerebrospinal fluid (CSF) and ear culture results, pre- and during hospitalization antibiotic treatment, imaging findings, and complications. We compared the pre-PCV years (2005-2009) with the post-PCV years (2010-2015). Outcomes were 1) incidence of all-cause adult OgM from the total meningitis cases; 2) impact of PCVs on the clinical presentation of OgM and bacteriology. Results Otogenic meningitis was diagnosed in 26 out of 45 (58%) cases of all-cause meningitis admissions. Of those, 10 (38%) were male, with a mean age of 62.4 years old. Ear-related signs and symptoms were documented in 70% of the patients, and OgM was diagnosed following imaging studies in 6 out of 26 (23%) patients. All of the patients received intravenous antibiotic therapy, and 7 (27%) patients required surgical interventions: 6 required myringotomy and 1 required mastoidectomy. There were 12 (46%) patients in the pre-PCV years and 14 (56%) in the post-PCV years. The positive pneumococcal CSF and ear culture rates remained high and unchanged (∼ 75%). There were no significant changes in the clinical presentation or mortality rates. Conclusion Micro-otoscopy should be included in the routine work-up of any suspected adult meningitis, because OgM is underdiagnosed. Unlike their impact on pediatric otitis media, PCVs did not change the epidemiology and bacteriology of OgM.
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Affiliation(s)
- Tal Marom
- Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben-Gurion University of the Negev Faculty of Health Sciences, Ashdod, Israel
| | - Shay Shemesh
- Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben-Gurion University of the Negev Faculty of Health Sciences, Ashdod, Israel
| | - Nadeem Habashi
- Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben-Gurion University of the Negev Faculty of Health Sciences, Ashdod, Israel
| | - Ofer Gluck
- Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben-Gurion University of the Negev Faculty of Health Sciences, Ashdod, Israel
| | - Sharon Ovnat Tamir
- Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Ben-Gurion University of the Negev Faculty of Health Sciences, Ashdod, Israel
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Palchun VT, Guseva AL, Derbeneva ML, Guseva OA. [Otogenic and rhinogenic intracranial complications: meningitis and brain abscess in adults]. Vestn Otorinolaringol 2020; 84:61-68. [PMID: 32027325 DOI: 10.17116/otorino20198406161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study is to review etiology, diagnosis and management strategies of rhinogenic and otogenic meningitis and brain abscess in adults. Current diagnostic procedures, effective surgery and antibiotic treatment are discussed. The clinical case of diagnosis and successful treatment of the patient with rhinogenic meningitis and brain abscesses is presented.
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Affiliation(s)
- V T Palchun
- N.I. Pirogov Russian National Research Medical University of the Ministry of Health of Russia, Moscow, Russia, 117997; Sverzhevsky Research Institute of Clinical Otorhinolaryngology, Moscow, Russia, 117152
| | - A L Guseva
- N.I. Pirogov Russian National Research Medical University of the Ministry of Health of Russia, Moscow, Russia, 117997
| | - M L Derbeneva
- N.I. Pirogov City Clinical Hospital #1 of the Department of Health of Moscow, Moscow, Russia, 119049
| | - O A Guseva
- N.I. Pirogov Russian National Research Medical University of the Ministry of Health of Russia, Moscow, Russia, 117997; Sverzhevsky Research Institute of Clinical Otorhinolaryngology, Moscow, Russia, 117152
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Zeng Z, Li Y, Lu S, Huang W, Di W. Efficacy of CoQ10 as supplementation for migraine: A meta-analysis. Acta Neurol Scand 2019; 139:284-293. [PMID: 30428123 DOI: 10.1111/ane.13051] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 10/10/2018] [Accepted: 10/27/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Migraine ranks among the most frequent neurological disorders globally. Co-enzyme Q10 (CoQ10) is a nutritional agent that might play a preventative role in migraine. This meta-analysis aimed to investigate the effects of CoQ10 as a supplemental agent in migraine. SUBJECTS AND METHODS Web of Science, PubMed, and Cochrane Library were searched for potential articles that assessed the effects of CoQ10 on migraine. Data were extracted by two independent reviewers and analyzed with Revman 5.2 software (The Nordic Cochrane Centre, Copenhagen, Denmark). RESULTS We included five studies with 346 patients (120 pediatric and 226 adult subjects) in the meta-analysis. CoQ10 was comparable with placebo with respect to migraine attacks/month (P = 0.08) and migraine severity/day (P = 0.08). However, CoQ10 was more effective than placebo in reducing migraine days/month (P < 0.00001) and migraine duration (P = 0.009). CONCLUSION This is the first study to demonstrate the effects of CoQ10 supplementation on migraine. The results support the use of CoQ10 as a potent therapeutic agent with respect to migraine duration and migraine days/month. Nonetheless, more studies are needed to support the conclusions.
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Affiliation(s)
- ZhiYong Zeng
- Department of Pediatrics; The Second People’s Hospital of Longgang District; Shenzhen China
| | - YunPeng Li
- Department of Neurosurgery; The People’s Hospital of Ningdu Country; Ganzhou China
| | - ShunYu Lu
- Department of Pharmacy; The Fourth Affiliated Hospital of Guangxi Medical University/Liuzhou Worker’s Hospital; Liuzhou China
| | - WanSu Huang
- Department of Criminal Science and Technology; Guangxi Police College; Nanning China
| | - Wei Di
- Department of Neurology; Shaanxi Provincial People’s Hospital, Third Affiliated Hospital of Medical College, Xi’an Jiaotong University; Xi’an China
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Idiopathic, Infectious and Reactive Lesions of the Ear and Temporal Bone. Head Neck Pathol 2018; 12:328-349. [PMID: 30069844 PMCID: PMC6081288 DOI: 10.1007/s12105-018-0952-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 07/13/2018] [Indexed: 12/13/2022]
Abstract
A number of infectious, inflammatory and idiopathic lesions develop within otologic tissues that may share similar clinical and/or microscopic features. This review first provides a working classification for otitis externa, and then otitis media and includes two recently described entities, eosinophilic otitis media and otitis media with ANCA-associated vasculitis. Next, the microscopic findings of a spectrum of otopathologic conditions are described, including post-inflammatory conditions such as tympanosclerosis and aural polyps, an overview of animate aural foreign body as well as iatrogenic aural foreign body reactions. Finally, a review of fungal disease affecting the ear with a brief synopsis of Candida auris, a recently described and virulent organism, is presented.
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