TABLE 1 Clinical Manifestations in Wegeners Granulomatosis

Prevalence during course of disease ( ) lubrication and immunity. Consequently, patients frequently suffer from recurrent infections. Collapse of the nasal bridge (saddle nose deformity) may occur due to nasal chondritis (Fig. 2). Nasal examination typically reveals crusting, discharge, friable erythematous mucosa, and granulation tissue. Nasal septum perforation may occur. The paranasal sinuses, most commonly the maxillary and ethmoid sinuses, are affected in at least two-thirds of patients....

References

Epstein-Barr virus infection. N Engl J Med 2000 343(7) 481-492. 2. Ebell MH. Epstein-Barr virus infectious mononucleosis. Am Fam Physician 2004 70(7) 1279-1287. 3. Johnsen T, Katholm M, Stangerup SE. Otolaryngological complications in infectious mononucleosis. J Laryngol Otol 1984 98(10) 999-1001. 4. Straus SE. The chronic mononucleosis syndrome. J Infect Dis 1988 157(3) 405-412. 5. Corey L, Spear PG. Infections with herpes simplex viruses (1). N Engl J Med 1986 314(11) 686-691. 6....

Epidemiology

Although dizziness can be seen in almost any age group, the probability of suffering some form of vertigo, disequilibrium, and or lightheadedness increases with age. Roughly 30 of patients over the age of 65 complain of dizziness (1), and dizziness accounts for 2 of all chief complaints of elderly patients (2). In a review of several studies of patients with dizziness, just under half of the patients had peripheral vestibulopathy, while cerebrovascular disease was responsible for 6 , cardiac...

Clinical Manifestations

The clinical manifestations of AIED are a consequence of injury to the delicate inner ear structures. As the inner ear is injured, patients sustain fluctuating or rapidly progressing sensorineural hearing loss, tinnitus, aural fullness, and vertigo attacks. Patients often complain of a decrease in hearing acuity or difficulty in understanding words. They may also have difficulty with balance. The pattern of sensorineural hearing loss can vary, but the most common finding is a loss across all...

Part D Other Systemic Disorders

Crohn's Disease and Ulcerative Colitis 297 Maria T. Abreu and Junsuke Maki 21. Paget's Disease of Bone and Fibrous Dysplasia 307 Edwin M. Monsell and Geetha Subramanian 22. Systemic Allergic Disorders IgE-Mediated Disorders, Angioedema, Nonsteroidal Anti-Inflammatory Drug Sensitivity, and Stevens-Johnson Syndrome 315 Michelle Hernandez and Stephen I. Wasserman 23. Migraine Syndrome 333 Robert W. Baloh 24. Pseudotumor Cerebri and Jugular Foramen Syndrome 343 Aristides Sismanis and David R....

Treatment

Treatment of primary HSV-1 infection is well established however, treatment of muco-cutaneous, recurrent HSV-1 infection is less well defined, and treatment of polyganglionitis is controversial (8). Symptomatic and asymptomatic recurrent disease accompanied by viral shedding is self-limited therefore, therapy is designed to reduce severity, duration, and frequency of symptoms. In general, early treatment achieves the best therapeutic response. Acyclovir binds viral DNA and ends viral...

Secondary Syphilis

Tertiary Syphilis Gums

Approximately eight weeks after the initial presentation of a chancre, a generalized infection ensues. This is a result of proliferation and systemic dissemination of T. pallidum and persists until a sufficient immune response develops. Constitutional symptoms including fever, headache, arthralgias, malaise, pharyngitis, and generalized lymphadeno-pathy are common. The dominant feature of secondary syphilis is a mucocutaneous rash, which appears in 90 of patients. While there is significant...

Neurofibromatosis

Also known as Von Recklinghausen's disease, neurofibromatosis is an autosomal-dominant hereditary disorder that causes CNS tumors and cutaneous neurofibromata. The most common manifestation of this disease that is encountered in the practice of otolaryngology is the acoustic neuroma. Occasionally, a lesion involves the larynx (13). Figure 6 depicts a very large lesion in the posterior glottis of an infant. Treatment is difficult because complete removal of such a lesion in the larynx is usually...

Lightheadedness

The primary systemic conditions causing lightheadedness affecting the heart and cere-brovascular circulation are related to anxiety or other psychiatric disorders. Sometimes, reproduction of a patient's symptoms during hyperventilation is indicative of anxiety-related dizziness these patients will often admit to generalized anxiety or even panic attack. When accompanied by horizontal nystagmus, however, the presence of cerebellopontine angle tumor must also be considered (19). A positive...

Head and Neck

A plethora of head and neck symptoms and signs are associated with GCA. These are summarized in Table 3. TABLE 1 The Initial Clinical Manifestations in 100 Consecutive Patients with GCA TABLE 1 The Initial Clinical Manifestations in 100 Consecutive Patients with GCA Abbreviation GCA, giant cell arteritis. Source From Ref. 7. Abbreviation GCA, giant cell arteritis. Source From Ref. 7. TABLE 2 Prevalence of Selected Clinical Features in 100 Patients with GCA TABLE 2 Prevalence of Selected...

Head and Neck Manifestations

Painless enlargement of the salivary glands occurs in 4 to 6 of patients with sarcoidosis. The parotid glands are most commonly enlarged, but any of the salivary glands can be affected. Sarcoidosis may mimic Sjogren's syndrome by causing symptoms and signs of dry eyes and mouth. The constellation of parotid enlargement with facial palsy, fever, and anterior uveitis is called Heerfordt's syndrome 30,33 . Sarcoidosis targets the upper respiratory tract in up to 18 of patients and is probably more...

Herpes Zoster Oticus Varicella Zoster Chicken

The varicella-zoster virus is a neurotropic DNA virus. Initial infection with the varicella-zoster virus is commonly known as chicken pox and displays a very characteristic vesicular cutaneous eruption. The virus can remain dormant in ganglion cells for many years, with subsequent reactivation of the dormant virus resulting in shingles. Neurologic involvement has been found in chicken pox and includes encephalitis, myelitis, and cerebellar ataxia. Chicken pox has very rarely been associated...