Lugol's solution and Gentian violet eradicate methicillin-resistant Staphylococcus aureus biofilm in skin wound infections

The study aimed to evaluate the antibacterial efficacy of Lugol's solution 5% and Gentian violet 1% against methicillin-resistant Staphylococcus aureus (MRSA) biofilm in vivo. The bactericidal efficacy for treatment of MRSA-biofilm skin wound infection was tested in a murine model. Luciferase-tagged S. aureus Xen31, a MRSA-strain derived from S. aureus ATCC-3359130, was used for infection. Wounds were made in the skin of mice and infected with MRSA. The mice were treated with Lugol's solution and Gentian violet. Application of the antimicrobial agents started 24 hours post infection and was repeated daily for five-days. The antimicrobial effect on the biofilm bacteria was evaluated by measuring bioluminescence from MRSA daily for seven-days. Lugol's solution and Gentian violet showed a significant reduction in luminescent signals from the first assessment day to all subsequent days (P < .001). Lugol's solution and Gentian violet effectively eradicated MRSA in biofilm in vivo and could be alternatives or in addition to topical antibiotics when MRSA-biofilm wound infection is suspected.publishedVersio

Congenital mastoid cholesteatoma in an 87-year-old lady treated by watchful waiting

ongenital cholesteatoma (CC) of the ear is a benign, slow-growing epidermoid cyst consisting of keratinized squamous epithelium, which may expand and destroy surrounding tissues. For a clinical case to be considered as a CC, there should be no previous history of tympanic disease, such as tympanic membrane retractions or ear discharge, and no previous ear surgery. This occurs most commonly in the middle ear, and because it typically causes ossicular erosion with hearing impairment, detection tends to occur relatively early.1 Congenital mastoidal cholesteatomas (CMCs; ie, CC originating from the mastoid process) are rarer, and because they cause few early symptoms, they tend to go undetected for many years. Thus, they are often detected in adulthood.2 The diagnosis is confirmed with radiology, which is conclusive when applying current technologies. This includes computed tomography (CT) and magnetic resonance imaging (MRI) with a cholesteatoma protocol. High-resolution CT displays a nonspecific soft-tissue mass without connection to the tympanic membrane or to the external ear canal. On MRI, the cholesteatoma appears hypointense on T1-weighted images and hyperintense on T2-weighted images.3 The current standard of treatment is surgical eradication