In the first half and in the middle of the twentieth century, tuberculosis of the larynx was almost always associated with pulmonary TB - often, with its last stage. Scientists at the time noted that the disease is most common among people aged between 20 and 30 years, and is equally common in both sexes.

At the end of the twentieth century, tuberculosis Tuberculosis - a full recovery is not guaranteed   Humanity is almost caught by surprise: a disease that commonly receded thanks to modern methods of treatment and diagnosis, re-entered the list of the most deadly infections. The blame is not only HIV, but also by factors such as an unhealthy lifestyle - smoking, alcohol and drug use, malnutrition, immigration from countries with increased risk of contracting tuberculosis, low living standards and the emergence of a growing number of bacterial strains resistant to Effects of antibiotics. This led to the fact that people were more likely to hurt not only pulmonary but extrapulmonary tuberculosis Extrapulmonary tuberculosis - many forms In particular, tuberculosis larynx. Experts say that over the past decade laryngeal manifestations of tuberculosis have changed, and this can make it difficult to diagnose the disease.

According to the results of studies conducted before 1990, the average age of a patient with tuberculosis of the larynx, was 32 years, and the number of cases of men and women was approximately equal. According to research conducted for several years after 1998, the average age of patients with this diagnosis has increased to 49.9 years, and in general, the age range of patients - from 17 to 71 years. Moreover, it was found that men became sick with tuberculosis of the larynx more often than women.

Symptoms of TB of the larynx

Clinical manifestations of laryngeal TB over the past decade have also changed. In the past, the main symptom of tuberculosis of the larynx was odynophagia - painful swelling of the oropharynx or esophagus, which sometimes causes pain when swallowing. Currently, the most common symptom of the disease - hoarseness or dysphonia. The authors of the study, for a long time to spend in one large medical center, noted that before 1990, patients with tuberculosis of the larynx usually complained of odynophagia, severe night sweats Sweating at night - what is the cause and how to get rid of it   and weight loss. After 1998, at 71.4% of patients had dysphonia (no sore throat), and only 21.4% had symptoms such as sweating, weight loss or fever.

This is not the only change of the manifestations of tuberculosis of the larynx. In the mid-twentieth century, tuberculosis lesions in this disease often appear in the epiglottis, now in 57% of cases the disease affects the vocal cords.

In addition, if before a substantial portion of patients with tuberculosis of the larynx revealed tuberculous lung disease, now more than half of the patients did not show signs of pulmonary tuberculosis. This suggests that in such cases, the infection of the larynx was the primary or mycobacteria fall into the larynx through the blood of unknown fire. Many experts also note that more than half of patients diagnosed in recent years, tuberculosis of the larynx, smoke and / or consume alcohol regularly; many of them are suffering from alcoholism. Repeatedly emphasized that smoking and alcohol abuse for a long time increases the risk of TB in the throat several times - compared to people who do not have these bad habits.

Diagnostics

Because of the changing clinical manifestations of laryngeal TB possibility of incorrect diagnosis of this disease is very high. There are many cases where patients with tuberculosis of the larynx wrongly diagnosed with cancer of the larynx, vocal cord polyps, papillomas of the larynx, vocal cords, or a cyst.

In addition to the typical diagnostic procedure used to detect tuberculosis (Mantoux skin test, blood tests, x-ray), with suspected tuberculosis of the larynx can be used videostroboskopiya larynx, laryngoscopy, and / or biopsy.

Treatment of tuberculosis of the larynx

Tuberculosis of the larynx treated successfully with anti-TB drugs. Typically, the disease is prescribed receiving four drugs - rifampicin, isoniazid, pyrazinamide, and ethambutol or streptomycin. The course of treatment may last from six months to a year. Admission pyrazinamide, ethambutol or streptomycin is usually stopped after two months, and the other two take the medication throughout the course of therapy.

Pregnant women, as well as all other patients as soon as possible to undergo treatment of tuberculosis Treatment of tuberculosis - a lengthy process and requires constant monitoring   larynx, even if the disease has been diagnosed in the early stages of pregnancy. The approach to treatment of this disease in pregnant women has some differences in different countries. For example, in the United States expectant mothers prescribed isoniazid, rifampicin and ethambutol, and pyrazinamide is used only in cases where tuberculosis of the larynx caused by drug-resistant strains of mycobacteria. In most other countries pyrazinamide part of the standard treatment regimen for pregnant women. Streptomycin during pregnancy is not indicated, as established that it could have a negative impact on fetal development.

One of the most common complications of the common cold - is otitis. The most common ear infections occur in young children, but can also develop in adults. The majority of ear infections can be treated easily with antibiotics, or without them, but repeated infections can sometimes lead to hearing loss.

Most often, otitis media occurs when the middle ear fluid accumulates and pus. This type of infection is called otitis media. Another type of infection develops when inflammation of the outer ear. It otitis externa Otitis externa - all the dangers of the disease , Better known as "swimmer's ear".

Causes of otitis

The causes of otitis media may be viruses, bacteria, fungal organisms, as well as exposure to allergens. In any case, in the outer or inner ear structures begin inflammatory processes, and this leads to the characteristic symptoms of otitis. Some people due to the structural features of the eustachian tube more than others prone to develop otitis media. As a rule, such people suffer from early childhood otitis more often their peers.

Viral otitis media may be caused by a different influenza virus and viruses that cause the common cold, tonsillitis, and other common ailments. Among bacterial pathogens of various types of otitis media may be, for example, Staphylococcus aureus, Streptococcus, Streptococcus pneumoniae, and other bacteria.

The following factors increase the chance of developing otitis media:

• Children's age;
• The birth of premature and / or low birth weight;
• Immune deficiency;
• Neuromuscular diseases;
• Allergies;
• Feeding formula milk Dairy mixture - selection of useful power   instead of breast milk;
• Smoking (including passive smoking);
• Living in areas with high levels of air pollution;
• Water sports;
• Accommodation in warm and humid regions.

Signs of otitis

Almost all types of otitis media is characterized by pain in the ears and a more or less significant hearing loss. Depending on the type of disease, it can also cause noise or ringing in the ears, fever, headache, nausea, dizziness, poor appetite. Sometimes, a few days before the beginning of the acute phase of the disease there are early signs of otitis media as itching in the ear canal, ear and nasal sensation of mild discomfort in the ears.

Restoration of hearing after otitis media in the vast majority of patients is quick, as a rule - no more than 7-10 days after the first symptoms. In some cases, after nasal otitis ear may persist for some time, but it usually does not cause significant discomfort.

For adults and older children, the most obvious sign of infection is a pain in the ears. The children in the development of otitis sometimes fever. These symptoms usually appear after the patient suffered a cold or runny nose.

In very young children may also have pain in the ears, but they can not tell their parents about their concerns. But you can guess about the disease on other grounds, such as:

• The baby pulls ear
• Crying more than usual
• Can not sleep
• From ear fluid flows
• The child is difficult to keep his balance, he is hard of hearing
• Unexplained fever

Diagnosis of otitis

Usually diagnosed otitis media on the results of the survey, which is carried out using a special tool - the otoscope. Change the color of the tympanic membrane or the external auditory canal skin, swelling, severe skin peeling, separation - that the signs by which a doctor can determine that the patient has otitis. To determine the cause of otitis media can be analyzed discharge from the ears, or a procedure in which the cavity of the middle ear fluid is pumped for further laboratory analysis. If you suspect that some of the complications of otitis media may also need a CT scan.

Treatment of otitis

In the past, the standard treatment of otitis was a plurality of absorption of antibiotics. However, in recent years there has been a sharp jump in antibiotic resistance. For this reason, it is not necessary to ask the doctor to prescribe antibiotics over the phone without an inspection. Furthermore, as a result of a number of studies have shown that many otitis tested by themselves in 2-3 days without any treatment.

This does not mean that if you or your child otitis media, you do not need to take antibiotics. But it says that should definitely visit the doctor and by inspection to determine which course of treatment would be.

Children under 6 months is acceptable to give antibiotics in the event of an inspection by a doctor who has diagnosed or strongly suspected infection based on symptoms and how the disease occurs.

Children from 6 months to 2 years can be treated with antibiotics if the diagnosis is confirmed or there are severe symptoms, which for some time were monitored and, quite obviously, become even more pronounced. If the diagnosis can not be confirmed, it may be recommended that treatment. Antibiotics are prescribed to children from 2 years old when the diagnosis is confirmed, and when the child is very sick. In addition, antibiotics can be used in other cases where the symptoms of the disease in children is very difficult and eventually become more serious.

Complications of otitis

Since then, both were first widely available antibiotics, otitis media has become much less likely to cause complications than it was before the discovery of these drugs. However, the likelihood of complications still exists. Despite the fact that most people otitis ear - though unpleasant, but quite harmless disease, in some cases it causes violations such as mastoiditis, intracranial asbtsess, encephalocele, facial paralysis The facial nerve when a person loses symmetry . Hearing loss with otitis is rare and usually temporary. However, in some cases, this complication of otitis media can lead to a delay of speech development Delayed speech development - when to sound the alarm   in young children. Hearing impairment and paralysis of the facial nerve - complications that often occur after otitis inner ear.

Serious complications of otitis media in adults with generally good health, occur less often. Especially severe are the effects of otitis media in infants and people with weakened immune systems. These patients are in any case should not be treated at home: perhaps it will be enough and popular OTC drugs, but the treatment must necessarily take place under the supervision of a physician.

Important information about treatment

If the treatment is still needed antibiotics, it is important to remember that within 24-48 hours there will be no change in symptoms. That is, during this time you still feel pain in your ears, and you will have a fever. This does not mean that the drugs do not work, just not enough time has passed that the symptoms began to subside.

It is also very important to take all medications prescribed by your doctor. If you do not complete the full course of treatment with antibiotics, the bacteria can acquire resistance to the drug. Even if you do better, it does not mean that the infection is completely defeated. Undertreated disease can flare up anew and successfully resist the action of drugs.