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array:22 [ "pii" => "S0025775318304378" "issn" => "00257753" "doi" => "10.1016/j.medcli.2018.06.017" "estado" => "S300" "fechaPublicacion" => "2019-05-03" "aid" => "4587" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2018" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2019;152:e53" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 12 "formatos" => array:2 [ "HTML" => 8 "PDF" => 4 ] ] "itemAnterior" => array:19 [ "pii" => "S002577531830527X" "issn" => "00257753" "doi" => "10.1016/j.medcli.2018.08.011" "estado" => "S300" "fechaPublicacion" => "2019-05-03" "aid" => "4623" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2019;152:375" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 24 "formatos" => array:2 [ "HTML" => 18 "PDF" => 6 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen médica</span>" "titulo" => "Mixedema pretibial" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "375" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Pretibial myxedema" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 822 "Ancho" => 900 "Tamanyo" => 97289 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Elisabeth Gómez Moyano, Alberto Andamoyo, Alexandra Perea Polak, Leandro Martínez Pilar" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Elisabeth" "apellidos" => "Gómez Moyano" ] 1 => array:2 [ "nombre" => "Alberto" "apellidos" => "Andamoyo" ] 2 => array:2 [ "nombre" => "Alexandra" "apellidos" => "Perea Polak" ] 3 => array:2 [ "nombre" => "Leandro" "apellidos" => "Martínez Pilar" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020619301251" "doi" => "10.1016/j.medcle.2019.02.022" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020619301251?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S002577531830527X?idApp=UINPBA00004N" "url" => "/00257753/0000015200000009/v1_201904130623/S002577531830527X/v1_201904130623/es/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen médica</span>" "titulo" => "Tuberculous otitis media" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "e53" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Satvinder Singh Bakshi, Ramiya Ramachandran Kaipuzha" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Satvinder Singh" "apellidos" => "Bakshi" "email" => array:1 [ 0 => "saty.bakshi@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Ramiya Ramachandran" "apellidos" => "Kaipuzha" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Department of ENT and Head & Neck Surgery, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pillaiyarkuppam, Pondicherry, 607402, India" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Otitis media tuberculosa" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 684 "Ancho" => 850 "Tamanyo" => 54054 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 56-year-old man presented with complaints of decreased hearing and purulent discharge from the left ear since 2 months. He had a previous history of pulmonary tuberculosis 12 years back for which he had taken medication for 6 months. Examination of left ear showed purulent ear discharge and multiple perforations of the tympanic membrane (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Pure tone audiometry assessment showed a profound hearing loss. The pus obtained from external auditory canal was positive for AFB staining with Zielh–Neelson stain and the histopathological examination of the pale granulation obtained from the middle ear showed granulomas with caseating necrosis, epitheloid (lower arrow) and multinucleated giant cells (upper arrow) (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). He was started on anti-tubercular drugs and at the end of 6 months, complete resolution of the condition was noted. Tuberculosis of the middle ear was first demonstrated by Eschle in 1883. The incidence has been in constant decline and it is rarely encountered today. Patients present with painless otorrhea and hearing loss with examination findings of multiple tympanic membrane perforations and exuberant granulations. Complications occur mostly when diagnosis is delayed, and include facial paralysis, labyrinthitis, meningitis, and subperiosteal abscesses. Anti-tubercular drugs should be given for a period of 6 months for complete cure of this and surgical treatment should be added to medical therapy in cases with complications.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Source of financial support or funding</span><p id="par0010" class="elsevierStylePara elsevierViewall">None.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Source of financial support or funding" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Institution where the work was done—MGMCRI.</p>" ] ] "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 684 "Ancho" => 850 "Tamanyo" => 54054 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 882 "Ancho" => 850 "Tamanyo" => 184518 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00257753/0000015200000009/v1_201904130623/S0025775318304378/v1_201904130623/en/main.assets" "Apartado" => array:4 [ "identificador" => "64289" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Imágenes médicas" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00257753/0000015200000009/v1_201904130623/S0025775318304378/v1_201904130623/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775318304378?idApp=UINPBA00004N" ]
