zithromax and Orbital-Diseases

In this study, we aimed to evaluate the role of azithromycin in the treatment of acute infraorbital space infection.. Sixty patients (39 men and 21 women; age range, 18 to 47 years) who had acute infraorbital space infection with pain, swelling, and general malaise were included in the study. After initial surgical therapy, patients were randomly allocated to receive either 500 mg azithromycin once daily for 3 days, 250 mg erythromycin stearate every 6 hours for 3 days, or no antibiotic. Patients were assessed at the time of admission and after 1, 2, 3, and 7 days. Pain, swelling, cervical lymphadenopathy, and sublingual temperature were assessed at each visit. Data were collected, and all groups were compared for differences in pain and swelling using the Mann-Whitney U test and for differences in lymphadenopathy and sublingual temperature using Fisher's exact test.. At the time of admission, no 2 groups were statistically different at the.05 level in relation to age, gender, and presenting clinical signs or symptoms. At days 2 and 3, patients who received azithromycin had a significant reduction in pain (P =.002 and P =.02, respectively) and swelling (P =.001 and P =.013, respectively) compared with those who received no antibiotic. At day 3, patients who received erythromycin had a significant reduction in pain (P =.03) and swelling (P =.046) compared with those who received no antibiotic. In a comparison of the patients who received azithromycin with those who received erythromycin, there was no significant difference (P >.05) in the reduction of pain at any time of the study. However, at day 2, patients who received azithromycin had a significantly greater reduction in swelling (P =.002) than those who received erythromycin. In relation to the percentage of the patients with cervical lymphadenopathy and raised sublingual temperature (>37.2 degrees C), no 2 groups were statistically different at any time of the study. After 3 days of treatment, patients who received the antibiotics were clinically improved, and all patients (n = 60 patients) reviewed after 7 days had resolution of their clinical signs and symptoms.. This study emphasizes the importance of surgical drainage and proves that both azithromycin and erythromycin are effective adjunctive treatments in the therapy of relatively mild odontogenic orofacial infections.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Chi-Square Distribution; Drainage; Erythromycin; Eye Infections, Bacterial; Female; Focal Infection, Dental; Humans; Male; Middle Aged; Orbital Diseases; Statistics, Nonparametric; Tooth Extraction; Treatment Outcome

Myiasis is the feeding of fly larvae on vertebrates. The sheep bot fly larva of Oestrus ovis is a mammalian parasite of the skin, nose, ears, and eyes. When the larvae infest and feed on the structures of the eye, the condition is termed ophthalmomyiasis. Most often this infestation is limited to the external structures of the eye and is referred to as ophthalmomyiasis externa. The features of this condition are severe local inflammation, positive foreign body sensation, erythema, and lacrimation. Vision may or may not be reduced, depending on involvement of the cornea. A 20-year-old white male soldier sought treatment for an inflamed eye and an irritated cornea OS. His eyelids were swollen with marked periorbital edema and conjunctival erythema OS. On slitlamp examination, small whitish organisms were viewed on the conjunctiva OS. The organisms were removed, preserved, and sent to Nova Southeastern University where they were identified as O. ovis first-stage larvae. The patient was treated with antibiotic ointment, and the inflammation resolved within 1 week. O. ovis has a worldwide distribution, and although sheep are the preferred host, humans may also serve as an intermediate host in the organism's life cycle. This case represents one of several reports of ophthalmomyiasis in the Middle East caused by O. ovis. U.S. troops stationed in Iraq and surrounding areas are vulnerable to eye infestation by fly larvae, and health care providers need to include this condition in their differential diagnosis of anterior segment inflammatory disorders.

Topics: Adult; Animals; Anti-Bacterial Agents; Azithromycin; Blepharitis; Conjunctivitis; Diptera; Edema; Erythromycin; Eye Infections, Parasitic; Humans; Iraq; Larva; Male; Military Medicine; Military Personnel; Myiasis; Orbital Diseases