Lao tai: Hình thái lâm sàng và những tiến bộ trong chẩn đoán hiện nay

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Tác giả: Hồng Anh Đoàn, Thị Hồng Hoa Đoàn, Thị Phượng Hoàng, Thị Tố Uyên Nguyễn, Văn Hưng Nguyễn, Viết Nhung Nguyễn, Công Cương Tôn

Ngôn ngữ: vie

Ký hiệu phân loại: 617.8 Otology and audiology

Thông tin xuất bản: Y học Việt Nam, 2017

Mô tả vật lý: 230-235

Bộ sưu tập: Metadata

ID: 535775

Thêm vào giỏ

Mô tả 31 ca lao tai nhằm chia sẻ kinh nghiệm trong việc lấy bệnh phẩm để chẩn đoán lao tai. Khi gặp trong hợp viêm tai giữa không điển hình trước tiên phải nghĩ đến lao tai. Có nhiều sự tương đồng giữa lao tai và lao phổi về lâm sàng và tiến triển. Khi làm mô bệnh học, phỉ lấy tối đa bệnh phẩm mới có thể tìm thấy vùng tổn thương lao, và khi lấy mủ làm vi khuẩn học như BAETEC và Xpert để tăng độ tập trung của vi khuẩn phải ủ và lấy dịch tai.The tuberculous otitis media (TOM) is a rare extra-pulmonary localization which is accounted for 0.04% to 0,9% of CSOM in developed countries. In recent years, TB patients has an increasing trend, including TOM patients specially m the developing countries, Vietnam ranked 15/30 highest TB burden countries and ranked 14/27 MDR-TB burden countries. The study describes a retrospective series of 31 cases which suggest a new perspective in diagnostic by revealing sample collections for histopathology and bacteriology. In literature, it used to present as the triad: pain-free ear discharge, multiple perforations of tympanic membrane and penpheral facial palsy. The clinical features of TOM changed over the years. The new clinical pattern of TOM should be recognized by clinicians. The study releaved average of 30 years old with the range of ages from 16 months to 65 years. Based on the analysis of the cases, it is suggested that TOM should be entertained as a possible diagnosis in patients with atypical OM. There are many similarities existing between TOM and pulmonary tuberculosis. Firstly, the dinical presentation of TOM today is polymorphic, which can be acute or sub-acute or chronic form. Secondly, they are both the respitory tuberculosis. In this regard, whenever a TOM is diagnosised, lung CT scan is recommended, even when routine chest radiograph is considered normal. The third, TOM can develop into adhesif OM with hearing loss even after anti-tuberculosis therapy. There should be a close cooperation between the otologistes and the pneumologistes, early diagnosis ans search for other TB sites. To Impove TOM diagnosis, the samples need to be taken maximum amount to perform histopathology. Beside, the technique of incubation and ECA lavage fluid collection need to be conducted to perform Xpert MTB/RIF and BACTEC.

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