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Journal of Clinical Medicine Jul 2022Background: Medical versus surgical management of pediatric periorbital infection secondary to acute bacterial rhinosinusitis (ABRS) can be a dilemma for clinicians....
Background: Medical versus surgical management of pediatric periorbital infection secondary to acute bacterial rhinosinusitis (ABRS) can be a dilemma for clinicians. This study aimed to evaluate the prognostic factors related to the need for surgical drainage and to help direct management decisions. Methods: Children admitted for periorbital infection secondary to ABRS between 2001 and 2019 were retrospectively reviewed. Demographics, clinical presentations, laboratory data, comorbidities, and computed tomography results were collected from medical records. Results: A total of 141 pediatric patients were enrolled. Forty-two patients (29.8%) required surgical intervention. Multivariate logistic regression analysis identified that delayed initiation of intravenous antibiotics from the onset of periorbital swelling (odds ratio [OR] = 1.94; p < 0.001) and proptosis at initial presentation (OR = 6.63; p = 0.008) were significantly associated with the need for surgical intervention. A C-reactive protein value of > 55.73 mg/L and initiation of intravenous antibiotic treatment > 2 days from the onset of periorbital swelling showed the best predictive power for surgery. Conclusions: Pediatric patients with delayed initiation of intravenous antibiotic treatment and initial presentation of proptosis had worse outcomes and required surgical intervention.
PubMed: 35807115
DOI: 10.3390/jcm11133831 -
Cureus Oct 2023Neuroblastoma, a prevalent extracranial solid tumor commonly afflicting pediatric patients, exhibits a diverse spectrum of clinical presentations. Preseptal cellulitis,...
Neuroblastoma, a prevalent extracranial solid tumor commonly afflicting pediatric patients, exhibits a diverse spectrum of clinical presentations. Preseptal cellulitis, a childhood infectious ailment, typically demonstrates a favorable response to conservative antibiotic therapy. In this report, we present the case of a two-year-old female child with refractory preseptal cellulitis, ultimately leading to an unforeseen diagnosis of neuroblastoma. Early radiological assessment upon the onset of preseptal cellulitis serves the dual purpose of excluding severe complications and uncovering latent, rare pathologies when the initial antibiotic regimen proves ineffective.
PubMed: 38021563
DOI: 10.7759/cureus.47403 -
The Journal of International Medical... 2002The emergence of beta-lactamase-mediated resistance to established beta-lactam antibiotics prompted the development of beta-lactamase inhibitors for co-administration.... (Review)
Review
The emergence of beta-lactamase-mediated resistance to established beta-lactam antibiotics prompted the development of beta-lactamase inhibitors for co-administration. Ampicillin has been combined with sulbactam for both parenteral and oral (as the mutual pro-drug sultamicillin) administration. The combination is active in vitro against a wide variety of Gram-positive and Gram-negative pathogens, including aerobic and anaerobic organisms. In clinical trials, ampicillin/sulbactam has proved clinically and bacteriologically effective against a variety of frequently encountered pediatric infections, including mild-to-moderate upper respiratory tract infections (acute otitis media, sinusitis, pharyngitis, and tonsillitis), severe post-operative and intra-abdominal infections, periorbital infections (which, left untreated, can lead to blindness, brain abscess, or death), acute epiglottitis, bacterial meningitis, and brain abscess. Ampicillin/sulbactam has also proved effective in the prevention of post-operative surgical infections in pediatric patients. The clinical efficacy profile of ampicillin/sulbactam and sultamicillin, combined with their excellent tolerability profile, make these agents attractive options for the management of many life-threatening infections in pediatric patients.
Topics: Ampicillin; Bacterial Infections; Brain Abscess; Diabetic Foot; Drug Therapy, Combination; Epiglottitis; Humans; Meningitis, Bacterial; Orbital Diseases; Postoperative Complications; Respiratory Tract Infections; Safety; Sulbactam; Urethritis
PubMed: 11921491
DOI: 10.1177/14732300020300S104 -
Indian Journal of Ophthalmology Jan 2014
Topics: Animals; Dirofilariasis; Eye Infections, Parasitic; Female; Helminths; Humans; Ultrasonography; Zoonoses
PubMed: 24492509
DOI: 10.4103/0301-4738.126191 -
Mycopathologia Jun 2022The recent increase of COVID-19-associated mucormycosis (CAM) has been commanding global attention. However, basic epidemiologic characteristics have not firmly been... (Meta-Analysis)
Meta-Analysis Review
The recent increase of COVID-19-associated mucormycosis (CAM) has been commanding global attention. However, basic epidemiologic characteristics have not firmly been established. In this systematic review and meta-analysis, we sought to determine the clinical manifestations, potential risk factors, and outcomes of CAM. Observational studies reporting CAM were searched with PubMed and EMBASE databases in January 2022. We collected data on comorbidities and treatment for COVID-19, and performed a one-group meta-analysis on the frequency of orbital exenteration procedure and mortality of CAM using a random-effect model. Fifty-one observational studies, including a total of 2,312 patients with proven CAM, were identified. Among the 51 studies, 37 were conducted in India, 8 in Egypt, and 6 in other countries. The most common comorbidity was diabetes mellitus (82%). While 57% required oxygenation, 77% received systemic corticosteroids. Among CAM, 97% were rhino-orbital-cerebral (ROCM), and 2.7% were pulmonary mucormycosis. Usual presentations were headache (54%), periorbital swelling/pain (53%), facial swelling/pain (43%), ophthalmoplegia (42%), proptosis (41%), and nasal discharge/congestion (36%). Regarding the outcomes, orbital exenteration was performed in 17% (95% CI: 12-21%, I = 83%) of the COVID-19-associated ROCM patients. The mortality of CAM was 29% (95% CI; 22-36%, I = 92%). In conclusion, this systematic review and meta-analysis indicated that the most prevalent type of CAM was ROCM, and most CAM patients had diabetes mellitus and received systemic glucocorticoids. Clinicians in the endemic areas should have a high index of suspicion for this invasive fungal complication of COVID-19 when a diabetic patient who received high-dose systemic glucocorticoids developed rhino-orbital symptoms.
Topics: COVID-19; Diabetes Mellitus; Glucocorticoids; Humans; Mucormycosis; Nose Diseases; Orbital Diseases; Pain; SARS-CoV-2
PubMed: 35312945
DOI: 10.1007/s11046-022-00627-8 -
Journal of AAPOS : the Official... Feb 2022We present the case of an 8-year-old girl with chronic recurrent multifocal osteomyelitis (CRMO) involving the orbit and facial bone and causing left optic neuropathy....
We present the case of an 8-year-old girl with chronic recurrent multifocal osteomyelitis (CRMO) involving the orbit and facial bone and causing left optic neuropathy. She presented with intermittent left periorbital swelling and a history of CRMO diagnosed 5 years earlier. Her disease responded well to adalimumab; however, delayed presentation resulted in permanent unilateral optic nerve atrophy and reduced vision. Orbital inflammatory disease is a rare manifestation of CRMO, and early recognition of the disease and treatment may prevent irreversible vision loss.
Topics: Child; Chronic Disease; Female; Humans; Optic Nerve; Optic Nerve Diseases; Osteomyelitis; Rare Diseases
PubMed: 34813967
DOI: 10.1016/j.jaapos.2021.09.003 -
Journal of Stomatology, Oral and... Feb 2022To execute a review answering the following question: "Among novel coronavirus disease (COVID19) patients, what are craniomaxillofacial (CMF) manifestations?" based on... (Review)
Review
PURPOSES
To execute a review answering the following question: "Among novel coronavirus disease (COVID19) patients, what are craniomaxillofacial (CMF) manifestations?" based on the RAMESES and the German Association of Scientific Medical Societies (AWMF)'s S2e guidelines.
METHODS
We performed a realist synthesis and meta-narrative review extracting data in English, French, German and Thai from PubMed/Medline, Embase, Biomed Central, Cochrane Library, and Thai Journals Online, until 1 January 2021. The primary outcome variable was CMF manifestations grouped into 5 categories: (1) mouth and throat, (2) nose, paranasal sinus, and skull base (3) ocular/orbital and periorbital tissue, (4) ear, and (5) craniofacial skin. Appropriate statistics was computed.
RESULTS
Thirty-seven original articles meeting the inclusion criteria were analysed; all were in English and indexed in PubMed/Medline. Hand searches of their references yielded a total of 101 articles for the review. Most data were in low level of evidence and focused on smell and taste disturbances and non-specific orofacial lesions. Iatrogenic complications may occur in this body region. Conservative measures remained effective and were usually enough for patient care.
CONCLUSION
Because SARS-CoV-2 infection is new and becomes the stringent worldwide pandemic within a short time period, most of the data on CMF symptoms are of low level evidence. Apart from taste and smell dysfunctions, non-specific CMF lesions can be found and treated conservatively. Treatment complications are possible. Dentists and CMF surgeons are privileged to examine the orofacial region and work closely with colleagues in other specialities to combat this pandemic.
Topics: COVID-19; Humans; Pandemics; SARS-CoV-2; Societies, Medical
PubMed: 33524604
DOI: 10.1016/j.jormas.2021.01.012 -
Revue Scientifique Et Technique... Aug 2004Leishmanioses are a group of parasitic diseases that affect man and other mammals. They are caused by different species of trypanosomatids of the genus Leishmania Ross,... (Review)
Review
Leishmanioses are a group of parasitic diseases that affect man and other mammals. They are caused by different species of trypanosomatids of the genus Leishmania Ross, 1903 and have tegumentary and/or visceral manifestations. The distribution of this re-emerging disease, which is found throughout the world (except in Antarctica), is influenced by various factors linked to both human activity and climatic change. The heteroecious life cycle of the Leishmania includes an invertebrate host (sandflies of the Phlebotomidae family). The dog is the main reservoir for many of the Leishmania species, simultaneously presenting both cutaneous and visceral clinical signs. The most frequent signs are skin abnormalities (dry exfoliative dermatitis, ulcers, periorbital alopecia and onychogryphosis), but ocular signs (keratoconjunctivitis and uveitis) and lymphadenomegaly are also common. Clinical diagnosis is difficult because of the great variety of symptoms and should, therefore, be confirmed by parasitological, serological and molecular methods. Several strategies are used to control the disease, including the treatment of infected animals. However, treatment failure is common and there is a risk that drug resistance will develop.
Topics: Animals; Communicable Diseases, Emerging; Disease Reservoirs; Drug Resistance; Humans; Leishmania; Leishmaniasis; Treatment Failure; Zoonoses
PubMed: 15702726
DOI: No ID Found -
Indian Journal of Otolaryngology and... Mar 2020To study the clinical presentation and management outcomes in a series of patients with invasive rhino-orbital-cerebral mucormycosis presenting to a tertiary care center...
To study the clinical presentation and management outcomes in a series of patients with invasive rhino-orbital-cerebral mucormycosis presenting to a tertiary care center in central India. Medical records of eleven consecutive cases of invasive rhino-orbital-cerebral mucormycosis were reviewed. All clinically diagnosed cases, confirmed on microbiological examination were included. Their demographic data, clinical manifestations, underlying systemic conditions, microbiological and radiological reports, medical treatments, and surgical interventions were recorded and analyzed. There were nine male and two female patients with mean age of 46.8 years. Uncontrolled diabetes mellitus was noted in all patients. One patient had history of renal transplantation. The common presenting features were-ophthalmoplegia (73%), diminution of vision, (64%) proptosis (36%) and periorbital swelling (27%). CT scan/MRI revealed sino-orbital involvement in eight cases and rhino-orbital-cerebral involvement in three cases. Ethmoid sinus (100%) was the commonest paranasal sinus involved. KOH preparation and histopathology revealed broad aseptate filamentous fungi branching at right angles with tissue invasion. Culture on sabouraud's dextrose agar showed growth of mucor species. All patients received intravenous amphotericin B and had undergone radical debridement of involved sinuses. The mean duration of follow up was 13 months. All survived except three, who developed cerebral mucormycosis. Rhino-orbital-cerebral mucormycosis is a fetal fungal infection requiring multidisciplinary approach. Uncontrolled diabetes mellitus is the main predisposing factor. Early diagnosis, reversal of predisposing co-morbidities, aggressive medical and surgical management are vital in managing this highly aggressive disease.
PubMed: 32158665
DOI: 10.1007/s12070-019-01774-z -
American Family Physician Nov 2002Herpes zoster ophthalmicus occurs when the varicella-zoster virus is reactivated in the ophthalmic division of the trigeminal nerve. Herpes zoster ophthalmicus... (Review)
Review
Herpes zoster ophthalmicus occurs when the varicella-zoster virus is reactivated in the ophthalmic division of the trigeminal nerve. Herpes zoster ophthalmicus represents up to one fourth of all cases of herpes zoster. Most patients with herpes zoster ophthalmicus present with a periorbital vesicular rash distributed according to the affected dermatome. A minority of patients may also develop conjunctivitis, keratitis, uveitis, and ocular cranial-nerve palsies. Permanent sequelae of ophthalmic zoster infection may include chronic ocular inflammation, loss of vision, and debilitating pain. Antiviral medications such as acyclovir, valacyclovir, and famcidovir remain the mainstay of therapy and are most effective in preventing ocular involvement when begun within 72 hours after the onset of the rash. Timely diagnosis and management of herpes zoster ophthalmicus. with referral to an ophthalmologist when ophthalmic involvement is present, are critical in limiting visual morbidity.
Topics: Acyclovir; Antiviral Agents; Blepharitis; Corneal Diseases; Herpes Zoster Ophthalmicus; Humans; Uveitis
PubMed: 12449270
DOI: No ID Found