phenylephrine-hydrochloride and Osteomyelitis

Clival osteomyelitis is a life-threatening complication of untreated malignant otitis externa or paranasal sinus infection. Although various pathogens have been implicated, to our knowledge, primary nocardial clival osteomyelitis has never been reported. We describe a 74-year-old woman who presented with headaches, abducens and hypoglossal nerve palsies, facial numbness, photophobia, and neck stiffness. Imaging revealed a heterogeneous mass within the sphenoid sinus with clival extension. The lesion was extirpated via a binostril endoscopic endonasal transsphenoidal approach. Histopathological and microbiological examination revealed a nocardial source. Clival osteomyelitis associated with sphenoid sinusitis should be included in the differential diagnosis of progressive skull base lesions in the setting of an underlying infection. Early recognition and intervention with antibiotics and surgical debridement is essential in the management of this rare entity.

Topics: Aged; Debridement; Female; Humans; Natural Orifice Endoscopic Surgery; Nocardia Infections; Nose; Osteomyelitis; Skull Base; Sphenoid Sinusitis

We have developed a multiplex PCR procedure to determine the distribution of nine adhesin genes in Staphylococcus aureus isolates. Only genes encoding bone sialoprotein binding protein and fibronectin binding protein B were significantly associated with hematogenous osteomyelitis/arthritis and native-valve endocarditis, respectively, suggesting their involvement in hematogenous tissue infections.

Topics: Adhesins, Bacterial; Arthritis, Infectious; Bacterial Proteins; Carrier Proteins; Coagulase; Endocarditis, Bacterial; Humans; Nose; Osteomyelitis; Polymerase Chain Reaction; Sensitivity and Specificity

Topics: Drainage; Humans; Maxillary Diseases; Mouth; Nose; Osteomyelitis; Therapeutic Irrigation

Following a consequent outline of his communication, the author subsequently describes his experiences, the possibilities of managing and personal techniques available in case of operative problems or postoperative complications such as bleeding, haematoma, dermal necrosis or scar formation or infection. The nasal physiology and its relation to the operative treatment, and the importance of a thoroughly preoperative evaluation of certain tissue characteristics are discussed. Postoperative skeletal alterations, such as insufficient or excessive removal of humps, cartilages and soft tissues as well as their surgical management are pointed out. Remarks about nasal tip correction conclude the presentation of the subject.

Topics: Adolescent; Adult; Dermatitis, Contact; Female; Hemorrhage; Humans; Male; Necrosis; Nose; Nose Diseases; Osteomyelitis; Postoperative Complications; Rhinoplasty; Surgical Wound Infection; Tissue Adhesives

A patient is described with an orbital fistula complicating frontal sinusitis and osteomyelitis of the frontal bone. The fistula was excised, but a fortnight later an acute exacerbation occurred. From the discharging pus a Staphylococcus aureus was cultured and from mucosa obtained during surgery a microaerophilic Streptococcus. These findings led to the diagnosis: synergistic bacterial inflammation of the frontal sinus, with osteomyelitis and orbital cellulitis.

Topics: Adult; Fistula; Fractures, Bone; Frontal Sinus; Humans; Male; Nose; Orbital Diseases; Osteomyelitis; Radiography; Sinusitis; Skin Diseases; Staphylococcal Infections; Streptococcal Infections

Topics: Adolescent; Cartilage; Child; Child, Preschool; Female; Growth; Humans; Hypertelorism; Male; Mandible; Nose; Nose Deformities, Acquired; Osteomyelitis; Ribs; Surgery, Plastic; Transplantation, Homologous

Topics: Adolescent; Adult; Carcinoma, Squamous Cell; Connective Tissue; Edema; Ethmoid Sinus; Female; Frontal Sinus; Humans; Male; Methods; Middle Aged; Nasal Polyps; Nasal Septum; Nose; Nose Neoplasms; Osteomyelitis; Scalp; Sinusitis; Skull

Topics: Female; Humans; Infant, Newborn; Maxillary Diseases; Nose; Osteomyelitis; Tooth Eruption, Ectopic; Tooth Extraction

Topics: Adult; Atrophy; Cerebral Ventriculography; Cerebrospinal Fluid; Cerebrospinal Fluid Rhinorrhea; Child; Coloring Agents; Female; Fistula; Follow-Up Studies; Humans; Hydrocephalus; Male; Middle Aged; Nose; Nose Neoplasms; Osteomyelitis; Postoperative Complications; Pressure; Radionuclide Imaging; Serum Albumin, Radio-Iodinated; Skull; Sphenoid Sinus

Topics: Adolescent; Calculi; Child; Cuspid; Dental Enamel Hypoplasia; Dental Pulp Calcification; Humans; Incisor; Infant; Infant, Newborn; Maxilla; Molar; Nose; Odontogenic Tumors; Osteomyelitis; Radiography, Dental; Tooth; Tooth Abnormalities; Tooth Abrasion; Tooth Calcification; Tooth, Deciduous

Topics: Extremities; Humans; Nasal Septum; Nose; Osteomyelitis