Dicembre 2002 - Volume XXI - numero 10
Aggiornamento monografico
Key words: Mastoiditis, Otogenic meningitis, Cerebral abscess, Endocranial sinus thrombophlebitis, Orbital and periorbital cellulitis, Retropharyngeal abscess, Epiglottitis
The Author reviews the topic of septic complications in paediatric otolaryngology, which, although now rare due to improved nutrition, immunisation and case management, still represent an challenge for practicing paediatricians, also due to their increasingly insidious onset. The following conditions are included in the review: mastoiditis, otogenic meningitis, cerebral abscess, endocranial sinus thrombophlebitis, orbital and periorbital cellulitis, retropharyngeal abscess, and epiglottitis. The causative pathogens are limited in almost all instances to Streptococcus pneumoniae, Haemophilus influenzae type B - now on a sharp decrease due to immunisation - Streptococcus pyogenes and Staphylococcus aureus. Other agents such as anaerobic bacteria are occasionally implicated. Treatment nowadays tends to be more conservative, with restricted indications for surgery, empyrical treatment - at least still culture is available - with ceftriaxone, and adjunctive vancomicine when antibiotic resistance is likely.
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