Gradenigo’s syndrome and thrombosis of the cavernous sinus secundary to acute otitis media

[ES] El síndrome de Gradenigo se caracteriza por dolor facial en la zona inervada por el trigémino y una oftalmoplejía externa unilateral (parálisis del VI par craneal) secundaria a petrositis apical aguda, por complicación evolutiva de una otitis media. Se trata de una complicación grave que requiere de un tratamiento inmediato para evitar secuelas permanentes y puede asociarse a otras complicaciones intracraneales como la trombosis del seno cavernoso. Presentamos el caso de un varón de 4 años que consulta por fiebre, cefalea y parálisis ocular externa en el curso de una otitis media aguda. [EN] Gradenigo’s syndrome is characterized by facial pain in the area supplied by the trigeminal nerve and a unilateral external ophthalmoplegia (paralysis of VI cranial nerve) secondary to acute apical petrositis for evolutionary complication of otitis media. This is a serious complication that requires immediate treatment to prevent permanent damage and may be associated with other intracranial complications such as thrombosis of the cavernous sinus. We report a 4 year old male who complains of fever, headache and external ocular paralysis in the course of acute otitis media

Impact of Pneumococcal Vaccination in the Nasopharyngeal Carriage of Streptococcus pneumoniae in Healthy Children of the Murcia Region in Spain.

An epidemiological study of Streptococcus pneumoniae nasopharyngeal carriage in healthy children was carried out five years after the introduction of the 13-valent pneumococcal conjugate vaccine (PCV13). Study the impact of pediatric vaccination with PCV13, and other associated epidemiological factors on the status of nasopharyngeal carriage, the circulating pneumococcal serotypes, and the antibiotic susceptibility to more frequently used antibiotics. A multi-center study was carried out in Primary Health Care, which included 1821 healthy children aged 1 to 4 years old. All isolates were sent to the Spanish Pneumococcal Reference Laboratory for serotyping and antimicrobial susceptibility testing. At least one dose of PCV13 had been received by 71.9% of children and carriage pneumococcal prevalence was 19.7%. The proportion of PCV13 serotypes was low (14.4%), with an observed predominance of non-vaccine serotypes, 23B, 11A, 10A, 35B/F, and 23A were the five most frequent. A high rate of resistance to penicillin, erythromycin, and trimethoprim sulfamethoxazole was found. A low proportion of PCV13 serotypes were detected, confirming the impact of pediatric vaccination for reducing the serotypes vaccine carriage. High resistance rates to clinically important antibiotics were observed.This work was supported by Ministerio de Economía, Industria y Competitividad (MINECO)[grant SAF2017-83388].S