Posts filed under ‘Infecciones cabeza y cuello’

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.

Abstract

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.

PDF

http://jcm.asm.org/content/49/6/2097.full.pdf+html

January 21, 2014 at 1:51 pm

Panspinal epidural and psoas abscess with secondary cervical disc space infection.

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 …

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3632845/pdf/umj0082-0023.pdf

January 15, 2014 at 8:27 am

Indications, efficacy, and safety of intranasal corticosteriods in rhinosinusitis.

World Allergy Organ J. 2012 Jan;5(Suppl 1):S14-7.

Potter PC, Pawankar R.

Source

Allergy Diagnostic and Clinical Research Unit, University of Cape Town, South Africa.

Abstract

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.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3488931/pdf/waoj-5-S14.pdf

November 21, 2013 at 9:29 am

Lesions in the Oral Cavity

N Engl J of Medic Feb.21, 2013 V.368

IMAGES IN CLINICAL MEDICINE

Jose Narciso Rosa Assunção, D.D.S., Ms.C., and Gustavo Davi Rabelo, D.D.S., Ph.D.

University of São Paulo, São Paulo, Brazil

A 59-year-old man presented with multiple painful ulcers in the oral cavity that had developed over the course of a week. He also noted difficulty swallowing and speaking. Physical examination revealed …

FULL TEXT

http://www.nejm.org/doi/full/10.1056/NEJMicm1205661?query=TOC

PDF

http://www.nejm.org/doi/pdf/10.1056/NEJMicm1205661

 

 

February 22, 2013 at 8:42 am

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.

Source

Division of Oral Medicine, Department of Dental Sciences, Piazza dell’Ospitale 1, University of Trieste, Trieste 34100, Italy. m.biasotto@fmc.units.it.

Abstract

ABSTRACT:

INTRODUCTION:

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.

CASE PRESENTATION:

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.

CONCLUSION:

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.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3517307/pdf/1746-160X-8-28.pdf

December 27, 2012 at 8:56 am

Topical 0.5% Ivermectin Lotion for Treatment of Head Lice

N Engl J of Medic  Nov.1, 2012 V.367 P1687-1693.

David M. Pariser, M.D., Terri Lynn Meinking, Ph.D., Margie Bell, M.S., and William G. Ryan, B.V.Sc.

From the Department of Dermatology, Eastern Virginia Medical School, Norfolk (D.M.P.); Global Health Association of Miami, Coral Gables, FL (T.L.M.); ClinData Services, Fort Collins, CO (M.B.); and Ryan Mitchell Associates, Westfield, NJ (W.G.R.). Address reprint requests to Dr. Ryan at 16 Stoneleigh Park, Westfield, NJ 07090-3306, or at wgryan@yahoo.com.

BACKGROUND

The emergence of resistance to treatment complicates the public health problem of head-louse infestations and drives the need for continuing development of new treatments. There are limited data on the activity of ivermectin as a topical lousicide.

METHODS

In two multisite, randomized, double-blind studies, we compared a single application of 0.5% ivermectin lotion with vehicle control for the elimination of infestations without nit combing in patients 6 months of age or older. A tube of topical ivermectin or vehicle control was dispensed on day 1, to be applied to dry hair, left for 10 minutes, then rinsed with water. The primary end point was the percentage of index patients (youngest household member with ≥3 live lice) in the intention-to-treat population who were louse-free 1 day after treatment (day 2) and remained so through days 8 and 15.

RESULTS

A total of 765 patients completed the studies. In the intention-to-treat population, significantly more patients receiving ivermectin than patients receiving vehicle control were louse-free on day 2 (94.9% vs. 31.3%), day 8 (85.2% vs. 20.8%), and day 15 (73.8% vs. 17.6%) (P<0.001 for each comparison). The frequency and severity of adverse events were similar in the two groups.

CONCLUSIONS

A single, 10-minute, at-home application of ivermectin was more effective than vehicle control in eliminating head-louse infestations at 1, 7, and 14 days after treatment. (Funded by Topaz Pharmaceuticals [now Sanofi Pasteur]; ClinicalTrials.gov numbers, NCT01066585 and NCT01068158.)

PDF

http://www.nejm.org/doi/pdf/10.1056/NEJMoa1200107

 

EDITORIAL

Topical Ivermectin — A Step toward Making Head Lice Dead Lice?

Olivier Chosidow, M.D., Ph.D., and Bruno Giraudeau, Ph.D.

Head-louse infestation stigmatizes hundreds of millions of people worldwide, predominantly children 3 to 11 years of age of all socioeconomic levels. It is commonly perceived as a sign of poor hygiene, which often engenders excessive management responses (e.g., repeated hair shaving and improper pediculicide use). Medical consequences of infestation can include itching and scratching, which may lead to cutaneous bacterial superinfection (i.e., pyoderma and impetigo) and possible transmission of Bartonella quintana, the trench-fever pathogen that is usually transmitted by body lice and that has been isolated from head lice. The estimated annual direct and indirect cost of head-louse infestation in the United States is $1 billion….

PDF

http://www.nejm.org/doi/pdf/10.1056/NEJMe1211124

 

December 6, 2012 at 3:55 pm

Human papilloma virus: a new risk factor in a subset of head and neck cancers.

J Cancer Res Ther. 2011 Jul-Sep;7(3):251-5

Bisht M, Bist SS.

Source

Department of Pharmacology, Himalayan Institute of Medical Sciences, Himalayan Institute Hospital Trust University, Jolly- Grant, Dehradun, India. manishabisht@yahoo.com.in

Abstract

Head and neck cancer is the sixth most common malignancy worldwide. Tobacco smoking and alcohol consumption are two well known behavioral risk factors associated with head and neck cancer. Recently, evidence is mounting that infection with human papilloma virus, most commonly human papilloma virus-16 is responsible for a subset of head and neck squamous cell carcinoma especially tumors of tonsillar origin. The molecular pathway used by human papilloma virus to trigger malignant transformation of tissue is different from that of other well known risk factors, i.e. smoking and alcohol, associated with squamous cell carcinoma. Apparently, these subsets of patients with human papilloma virus positive tumor are more likely to have a better prognosis than human papilloma virus negative tumor. Considering this fact, the human papilloma virus infection should be determined in all oropharyngeal cancers since it can have a major impact on the decision making process of the treatment.

PDF

http://www.cancerjournal.net/temp/JCanResTher73251-5234511_143225.pdf

October 24, 2012 at 3:52 pm

Streptococcus pneumoniae serotype 19A in Latin America and the Caribbean: a systematic review and meta-analysis, 1990-2010.

BMC Infect Dis. 2012 May 28  V.12  N.1  P.124.

Castañeda E, Agudelo CI, De Antonio R, Rosselli D, Calderón C, Ortega-Barria E, Colindres RE.

ABSTRACT:

BACKGROUND:

Pneumococcal conjugate vaccines (PCVs) are in the process of implementation in Latin America. Experience in developed countries has shown that they reduce the incidence of invasive and non-invasive disease. However, there is evidence that the introduction of PCVs in universal mass vaccination programs, combined with inappropriate and extensive use of antibiotics, could be associated to changes in non-PCV serotypes, including serotype 19A. We conducted a systematic review to determine the distribution of serotype 19A, burden of pneumococcal disease and antibiotic resistance in the region.

METHODS:

We performed a systematic review of serotype 19A data from observational and randomized clinical studies in the region, conducted between 1990 and 2010, for children under 6 years. Pooled prevalence estimates from surveillance activities with confidence intervals were calculated.

RESULTS:

We included 100 studies in 22 countries and extracted data from 63. These data reported 19733 serotyped invasive pneumococcal isolates, 3.8% of which were serotype 19A. Serotype 19A isolates were responsible for 2.4% acute otitis media episodes, and accounted for 4.1% and 4.4% of 4,380 nasopharyngeal isolates from healthy children and in hospitalbased/ sick children, respectively. This serotype was stable over the twenty years of surveillance in the region. A total of 53.7% Spn19A isolates from meningitis cases and only 14% from non meningitis were resistant to penicillin.

CONCLUSIONS:

Before widespread PCV implementation in this region, serotype 19A was responsible for a relatively small number of pneumococcal disease cases. With increased use of PCVs and a greater number of serotypes included, monitoring S. pneumoniae serotype distribution will be essential for understanding the epidemiology of pneumococcal disease.

PDF

http://www.biomedcentral.com/content/pdf/1471-2334-12-124.pdf

August 27, 2012 at 8:26 am

Actinomycosis of the paranasal sinuses.

Acta Otorrinolaringol Esp. 2012 Jun 13.

Sánchez Legaza E, Cercera Oliver C, Miranda Caravallo JI.

Servicio de ORL, Hospital de Algeciras, Cádiz, España.

La actinomicosis es una enfermedad granulomatosa crónica supurada específica de tejidos blandos, producida por Actinomyces Israelii, bacteria Gram positiva anaerobia muy difícil de cultivar, y comensal saprofito de la cavidad oral (criptas amigdalares, saliva y surcos gingivodentales) y tracto gastrointestinal, que se hace patógeno ante erosiones de mucosa orofaríngea como los traumas maxilofaciales, caries dental, microtraumatismos gingivales y extracciones dentales.

Presenta varias formas anatomoclínicas: cervicofacial: (50%) de tipo ósea, localizada preferentemente a nivel submandibular o parotídeo, siendo excepcional la sinusal; y otras: abdomino-pélvica (23%), y torácico-pulmonar (17%)

Es una patología rara en la actualidad, describiéndose en los últimos 25 anos  una disminución considerable de su incidencia, atribuyéndose a la mejor higiene dental, fluorización del agua, y sobre todo, al empleo generalizado de antibióticos. No suele sospecharse inicialmente, de hecho, la mayoría de los casos publicados en la literatura se diagnosticaron tras resecciones quirúrgicas, probablemente por el bajo índice de sospecha junto con las dificultades que conlleva el diagnóstico microbiológico ….

PDF

http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=15556&pident_usuario=0&pcontactid=&pident_revista=102&ty=166&accion=L&origen=elsevier&web=www.elsevier.es&lan=es&fichero=S0001-6519(12)00052-0.pdf&eop=1

 

August 19, 2012 at 4:29 pm

Actinomicosis cervicofacial

Dermatología Rev Mex   NOV-DIC 2007 V.51  N.6 P.224-227

Caso clinico

María del Carmen Padilla,* Lourdes Alonzo,** Gisela Navarrete,*** Ana Cecilia Arias****

La actinomicosis es un proceso fistuloso de origen endógeno, cuyo agente causal más frecuente es Actinomyces israelii, un actinomiceto anaerobio. Desde el punto de vista clínico sus características sobresalientes son nódulos y fístulas supurativas. Su aspecto morfológico puede causar confusión con otras dermatosis e, inclusive, con neoplasias. Se comunica el caso de un hombre de 40 años de edad, con actinomicosis cervicofacial, tratado previamente en forma quirúrgica, con diagnóstico de mixoma mandibular.

PDF

http://www.nietoeditores.com.mx/download/Dermatologia/Nov-Dic2007/Derma224-27.pdf

August 16, 2012 at 3:23 pm

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