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American Academy of Otolaryngology: head and neck surgery foundation clinical practice guideline on acute otitis externa 2014
This American guideline updates previous 2006 recommendations providing guidance for primary care and specialist clinicians for treating children of 2 years and older with acute otitis externa (AOE): a diffuse inflammation of the external ear canal±pinna and tympanic membrane.1 2 Key points: what should I be doing? Distinguish diffuse AOE from other causes of otalgia and otorrhoea, for example, dermatitis (inflammatory, contact, allergic), viral infections, furunculosis and referred pain from other sites Appropriately assess pain and treat with analgesia such as non-steroidal anti-inflammatories. There are no s...
Source: Archives of Disease in Childhood - Education and Practice - July 17, 2015 Category: Pediatrics Authors: Prentice, P. Tags: Oncology, Journalology, Immunology (including allergy), Drugs: infectious diseases, HIV/AIDS, Otitis, Pain (neurology), Child health, Pain (palliative care), Sexual health, Dermatology, Ear, nose and throat/otolaryngology, Competing interests (ethics), Tr Source Type: research

Fever and confusion in a returning soldier
A 36–year–old army engineer returned from a 6–week deployment in Afghanistan. He had complained of upper respiratory tract infection even before his travel. On return he was found to be increasingly sleepy and later developed unsteadiness, slurred speech and confusion. His initial blood tests were normal, with CSF and MRI suggesting signs of encephalitis. He continued to deteriorate, requiring intubation and ventilation. Several bacterial, viral, protozoal and fungal tests were negative. He developed pancytopenia requiring frequent packed red cell and platelet transfusions. Spleen was found to be marginal...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Chandratheva, A., Singh, A. R., Sturman, S., Chaganti, S., Jacob, S. Tags: Immunology (including allergy), HIV/AIDS, Tropical medicine (infectious diseases), Drugs: CNS (not psychiatric), Epilepsy and seizures, Infection (neurology), Memory disorders (psychiatry) Association of British Neurologists (ABN) joint meeting with the Source Type: research

A fatal case of 'primary' headache
We describe a case of a 33 year old caucasian male with a subacute history of headaches presenting to the medical team with pyrexia, confusion and hallucinations. He subsequently became disorientated, agitated and initially needed sedation and ventilation after becoming acutely hypoxic with autonomic instability. He was subsequently found to have dense, pre–geniculate blindness and generalised arreflexia. Magnetic resonance imaging demonstrated normal brain parenchyma but diffuse nodular thickening and enhancement of the basal leptomeninges in the brain and throughout the entire spinal cord. Lumbar puncture revealed ...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: Dayanandan, R., Bindman, D., Chhetri, S. K., Jacob, J., Mathur, S., Mills, R. J. Tags: Immunology (including allergy), HIV/AIDS, Meningitis, Headache (including migraine), Infection (neurology), Neurooncology, Pain (neurology), CNS cancer, Ophthalmology, Radiology, Surgical diagnostic tests, Radiology (diagnostics) Association of British Source Type: research