Infectious mononucleosis is often observed in otolaryngology as well as in other areas. Most symptoms remit in one or two weeks. In this study, we report a case of hemophagocytic syndrome caused by infectious mononucleosis, detailing the clinical course and treatment along with bibliographical considerations. A 5-year-old b oy, scheduled to undergo tonsillectomy following persistent tonsillitis, visited the Nakatsugawa City Hospital with the chief complaints of sore throat and fever. Initial examination revealed red tonsils with a coating and swollen cervical lymph nodes. The patient also had ingestion difficulty, and was admitted to the hospital. Since the blood test revealed liver function failure, treatment was started with a diagnosis of infectious mononucleosis. In spite of fluid replacement and the administration of antibiotics, her fever did not decline, her liver function failure persisted, and pancytopenia developed. The patient was transferred to the Department of Pediatrics for further close examination and treatment. Furthermore, as the patient's conditions worsened and hemophagocytic syndrome was suspected, the patient was transferred to onother hospital. The patient was discharged after the symptoms subsided following the administration of a large amount of γ-glovenin.
Acute otitis media (AOM) caused by beta-lactamase negative ampicillin-resistant Haemophilus influenzae (BLNAR) is an urgent problem. This study analyzes recent trends in infant AOM due to BLNAR in a community hospital. The percentage of BLNAR among all H. influenzae specimens in 2002 was 40%, and the susceptibility to penicillins and cefems remarkably deteriorated. The 25case osf infant AOM caused by BLNA tRended to have long period osf otorrhea and lowers, horter fevers. Of these cases,50% had been administered antimicrobials showing high susceptibility to BLNAR. An appropriate administration of antibiotic is required.
We report three cases of laryngeals tridor that required operativ e treatment. Case 1 is a laryngomalaciath at needed partial resection of the residual aryepiglottic fold mucosa, case 2 is a subglottic hemangioma with tracheostoma, and case 3 is a cleft larynx closed by an endoscopic operation. Laryngeal diseases that cause stridor are often found when patients have respiratory infections. Sometimes they are treated on the basis of erroneous presumptive diagnoses such as upper respiratory infections or bronchial asthma. Stridor is not a diagnosis, but a symptom. It is important for otolaryngologiststo establish a precise diagnosis.
We examined the level of urinary growth hormone (GH) in children with obstructive sleep apnea hypopnea syndrome (OSAHS). All of the 7 cases received an adenoidectomy and palate tonsillectomy. The level of urinary GH was measured preoperatively and on the 4thand 7thpostoperative days. The degree of apnea was evaluated by AI and SpO2. The level of GH was higher in cases with severe apnea than that of the control on the 4thday after surgery. Further examination is be needed to evaluate the relationship between the level of GH and severity of sleep apnea.