Llucia Alòs | PubMed Health

PubMed2005

Epiglottitis and necrotizing fasciitis: a life-threatening complication of infectious mononucleosis.

Life-threatening cervical complications associated with infectious mononucleosis are rare. The combination of acute epiglottitis and subsequent necrotizing fasciitis of the head and neck in a patient with infectious mononucleosis has not been reported to date.A 47-year-old female with infectious mononucleosis and epiglottitis was admitted to hospital for i.v. therapy. Owing to her poor clinical condition and the spread of the infection to the throat and superior mediastinum, as evidenced by CT, a cervical debridement was performed. After cervical debridement, histological findings were consistent with necrotizing fasciitis. The bacteria identified were Streptococcus viridans, Veilonella spp. and Capnocytophaga spp. The patient was hospitalized for 33 days.Mononucleosis, usually a benign condition, may be associated with life-threatening septic complications in the neck and chest. Serial CT or MRI scans are necessary to assess the development of the infection in the deep layers of the neck. Rapid medical treatment, extensive surgical debridement and intensive care are vital.

Capnocytophaga↗

PubMed2004

Particulate silicone for vocal fold augmentation: morphometric evaluation in a rabbit model.

To study the augmentation of the paralyzed vocal fold in response to the injection of particulate plastics in a rabbit model, we performed a prospective, experimental, and controlled study in 45 New Zealand rabbits with surgical vocal fold paralysis. We compared a control group (acute unilateral recurrent nerve section) with a group that underwent polytetrafluoroethylene (PTFE) injection and with another group that underwent polydimethylsiloxane (PDMS) injection. Equal volumes of implant material were injected. The animals were killed either 6 weeks or 6 months after intervention and compared by histomorphology using a digital measuring system. The injection sites showed a substantial foreign body giant cell reaction against the PDMS and PTFE, surrounded by a light, fibrous stroma. No differences in the frequency of displacement or disaggregation of implants were observed. No extrusion to the laryngeal lumen, signs of migration outside the larynx, or malignant changes were seen. No differences were found in the length of the vocal fold between the PDMS group and the PTFE group. The vocal fold was thicker in the PDMS group than in the PTFE group, but a statistically significant difference was found only for the anterior and middle thirds at 6 weeks. In the PDMS sample, the thicknesses were similar in the 6-week and 6-month subgroups. The group with injection of PDMS yielded histologic images compatible with greater and more stable medialization than did the group with injection of PTFE.

Animals↗