查詢結果分析
相關文獻
- 嬰幼兒急性外耳道炎
- 嬰幼兒的意外傷害
- 3D Helical CT and MR Imaging of the Pediatric Airway
- 嬰幼兒的感覺統合
- 嬰幼兒之雙側聲帶麻痺
- Comparison of Once Daily Cefpodoxime Proxetil Suspension and Thrice Daily Cefaclor Suspension in the Treatment of Acute Otitis Media in Children
- 加味麻杏石甘湯治療嬰幼兒病毒性肺炎之臨床療效評估
- 發展遲緩及障礙嬰幼兒語言能力之評量及介入
- 嬰幼兒期與其特徵--依賴性
- 嬰幼兒保育方式與性格形成
頁籤選單縮合
題名 | 嬰幼兒急性外耳道炎=Acute Otitis Externa in Infants |
---|---|
作者 | 李國熙; 蕭安穗; | 書刊名 | 中華民國耳鼻喉科醫學雜誌 |
卷期 | 34:2 民88.03-04 |
頁次 | 頁125-129 |
分類號 | 417.6814 |
關鍵詞 | 外耳道炎; 嬰幼兒; 流膿耳; Otitis externa; Infant; Otorrhea; |
語文 | 中文(Chinese) |
中文摘要 | 背景:急性外耳道炎為一外耳道的急性發炎,常由病菌感染所致。其致病菌於文 獻記載中以金黃色葡萄球菌為最多,而綠膿桿菌也佔一席之地。本篇目的乃針對造成嬰幼兒 流膿耳的急性外耳道炎,分析其致病菌及其治療方法。 方法:採回朔式統計法,時間從 1996 年 1 月至 1998 年 3 月,因流膿耳、耳血膿、或併 發高燒而求助於本科及小兒科的嬰幼兒病人(小於 1 足歲)共 21 人次。 將膿液做細菌培 養,分析致病的種類,並統計各抗生素之敏感率及治療結果。 結果:致病菌以單獨金黃色葡萄球菌為最多共 14 例( 66.7% ), 單獨革蘭式陰性桿菌感 染共 2 例(嗜血桿菌、綠膿桿菌各 1 例)佔 9.5%。 3 例為混合感染佔 14.2%。 MRSA ( Methicillin Resistant Staphlococcus aureus ) 1 例佔 4.8%。 常用之抗生素如 penicillin, ampicillin, chloramphenicol, erythromycin 及 clindamycin 敏感率小於 40%。 cephazolin, oxacillin 及 trimethoprimsulfamethoxazole 等敏感率約 60%。第二 、三代 cephalosporin 及 quinolone 等敏感率最高,達 80% 以上。 以局部抗生素耳滴劑 如 cortimycin 加上口服抗生素如 cephazolin 或 prostaphillin,7 到 10 天多半均能改 善。 少數如 MRSA 及綠膿桿菌感染或罹患組織細胞增生症( histiocytosis )者,病程會 延長並且需要用到第二線抗生素或靜脈注射抗生素才能達到療效。 結論:在造成嬰幼兒流膿耳的原因中,急性外耳道炎是相當常見的,有時會被誤認為是急性 中耳炎,可併發發燒等類似新生兒敗血症的症狀。致病菌以金黃色葡萄球菌為主,雖然多具 抗藥性,然而其病程較為良性,以耳滴劑局部治療加上適當的口服抗生素的使用,效果常是 令人滿意的。 |
英文摘要 | Background: Acute otitis externa (AOE) can occur in all age groups. However, it is relatively uncommon in infants. The major symptom of AOE is otorrhea which is similar to that of acute otitis media. In this report, we studied the AOE in infants (less than 1 year old) and analyzed the bacteriologic results. Materials and method: From January 1996 to March 1998, 19 infant patients with AOE with sysptoms of otorrhea were entolled in this study. Two of them had recurrent diseases one month after complete remission of previous AOE. Samples of ear discharge were obtained and sent for bacterial cultures. Integrity of ear drums was confirmed with otoscopes and/or video otoscope. Suspicious cases of infection of middle ears were excluded. The patients were requested to be followed up weekly for at least one month. The conditions of the discharge and ear drums were recorded. The results of bacterial cultures and the sensitivity rates of antibiotics were analyzed. Result: S. aureus alone was isolated in 67% of infections. Gram negative bacillus alone, such as H. influenza and P. aeruginosa, accounted for only 10% of infections. Fourteen percent of infections were mixed type and 10% of infections were culture-negative. Most bacteria were resistant to first-line antibiotics such as penicillin, ampicillin, clindamycin and chloramphenicol, and the rates of positive sensitivity tests were less than 20%. Cephazolin, oxacillin, gentamycin and trimethoprim-sulfamethoxazole had sensitivity rates of approximately 60%. The most sensitive antibiotics were the second and third generation of cephalosporins and quinolones. The positive sensitivity rates were 80% or even higher. First-line oral antibiotics and compound-formula topical ear solutions were prescribed in the first week. If no improvement was noted, sensitive antibiotics such as second-generation cephalosporins or quinolone ear drops were prescribed for the next week. Sixty percent of the patients responded well within 7 to 10 days, and 20% of the patients resolved 10 days later. The remaining patients lost of follow-up. Recurrent or prolonged infections occurred in cases of more toxic causative agents such as P. aeruginosa and MRSA (Methicillin-resistant Staphylococcus aureus) , or in cases of underlying systemic diseases such as histiocytosis. Conclusion: The most common pathogen isolated in AOE of the infants is S. aureus. Cephazolin, oxacillin, gentamycin and trimethoprim-sulfamethoxazole are the medication of choice before the results of the sensitivity tests of bacteria cultures are obtained. Ear drops improve the local hygiene of the ear canal and play a role in healing. The disease usually resolves within one week to 10 days. The patients usually recover without serious sequelae. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。