The symptoms of a brain infection resemble a stroke, but the operation found that the cotton swab was left behind!

▎The editor of WuXi AppTec's content team feels good for a while, but if it causes an accidental brain infection, it will be really miserable
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This is not sensational
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Recently, the medical journal CHEST published such a case where the residual cotton swab eventually caused a brain infection
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Moreover, the patient admitted afterwards that he really liked it very much and often used cotton swabs to dig out his ears
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This case was published in the medical journal CHEST under the title "Cotton Swab Today, Brain Infection Tomorrow".
This is a 47-year-old man with a history of hypertension
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When he came to see the doctor, he showed symptoms similar to stroke-weakness and numbness in his left arm, and drooping left face
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The imaging examination revealed that the patient had a brain subdural abscess, accompanied by associated middle ear mastoiditis and intracranial thrombosis
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A CT scan of the brain revealed an unclear, low-density mass of 3.
4 cm in the posterior part of the right parietal lobe
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Further MRI scan revealed acute/subacute subdural empyema 2.
8 cm x 3.
1 cm x 2 cm with extraaxial mass, thrombosis in the transverse and sigmoid sinuses on the right side of the brain, and mastoid process in the right middle ear Inflammation and erosion of the medial air sac
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In addition, MRI also observed a chronic left occipital abscess
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The patient received empiric treatment with antibiotics in the case of septic shock and entered the intensive care unit
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Considering the cause of infectious disease, there is a high risk of bleeding, and no anticoagulation therapy is performed
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Subsequently, the patient underwent a right craniotomy to remove the abscess and undergo radical mastoidectomy
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During the operation, the doctor found residues of cotton swabs on the granulation tissue passing through the ear drum near the mastoid
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Although the patient is not sure how long these cotton swabs have "stayed" in his ear, according to the judgment of the otolaryngologist, based on the amount of granulation tissue, it is likely that the cotton swabs have been there for a long time
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Pathogen testing indicated that the patient was infected with Gram-positive cocci and anaerobic cocci
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The author team of the case report pointed out that brain abscess is usually caused by predisposing factors, such as HIV or other immunosuppressive status (the patient has a negative HIV test), systemic infection, or due to trauma, surgery, mastoiditis, sinusitis, etc.
Etc.
destroyed the protective barrier around the brain
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In the case of continuous spread of the middle ear, sinus or mastoid infection, the most common pathogen is Streptococcus, but also by the anaerobic microbes, bacteria and other infections caused by gram-negative coverage
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Image source: The pathogen and severity of this case of 123RF are indeed unusual, but it also highlights the risk of ear extraction
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In fact, it is not uncommon for injuries caused by the use of cotton swabs and other tools to dig out the ears
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Speaking of this case, Dr.
Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City, said, “It is common for adults and adolescents to come to the emergency department because a foreign body enters the ear
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The
most common, That is, the cotton swab breaks in the ear canal when the ear is pulled out, and even gets stuck in the ear canal
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"Pulling out ears at will may also cause the embolism of the cerumen (that is, earwax) to worsen, thinking that the ears are cleaned, it may actually push the earwax deep into the ear canal; the skin inside the ear canal is also very fragile, even if you use a cotton swab, There is also the risk of damaging the skin inside the ear canal; in addition, it also brings risks such as rupture of the tympanic membrane
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Source: 123RF ear wax actually has a physiological effect and can protect the ears, and most people do not recommend it
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American Ear, Nose and Throat Society also stressed that earwax should adopt a "laissez-faire" attitude, if there is no harm (such as earwax embolism) on the ear, Qutao is not recommended
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even earwax embolism does appear abnormal, should also be timely medical examination, the doctor The professional treatment methods such as earwax removal, rinsing or professional tool gripping can be used to clean the ear canal in a safe and controllable manner
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"My first advice to patients is to never use cotton swabs to remove earwax
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"Dr.
Robert Glatter emphasized
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"In case (nothing to stop) causing a foreign body to remain in the ear, the foreign body should be removed as soon as possible
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The longer the swab is left in the ear canal or on the eardrum, the greater the risk of infection and the more difficult it is to remove it
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"Recommended reading is too rare, mother-to-child transmission of cancer! NEJM reported that mothers with cervical cancer gave birth to two cases of pediatric lung cancer and nasal cancer.
Two cases of HPV-related lesions and nasal cancer repeated for many years.
After bone marrow transplantation, the disease healed! Sleeping, after 3 years of treatment, it turned out that there was a tumor in the brain! I was born with a stroke, the cerebral cortex was missing 1/4, but lived a normal life for 22 years.
.
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"The Lancet" sub-Journal reported that the rare brain "remodeling" has symptoms of dementia for 5 years After returning to normal, what kind of magic operation is this? Reference [1] Carmel B, et al.
, (2021).
Cotton swab today, brain abscess tomorrow.
CHEST, DOI: https://doi.
org/10.
1016/j.
chest.
2021.
07.
911[2] Beware the Cotton Swab.
Retrieved October 23, 2021, from https:// Disclaimer: WuXi AppTec's content team focuses on introducing global biomedical health research Progress
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