patients have reportedly returned to normal after four weeks of successful therapy. This patient was initially treated with ciprofloxacin for external otitis and developed NOE while on the drug. A recent report by Lang et al. described encouraging results with this quinolone in 23 patients with NOE, although non had AIDS. Other therapeutic alternatives include extended spectrum penicillins, some third generation cephalosporins, aztreonam and aminoglycosides. Perhaps additional therapeutic valve can be gleaned in HIV+ persons by adding granuloctye-macrophage colonystimulating factor to enhance neutrophil function. Further observations are necessary to establish the frequency of this association of NOE with HIV infection and optimum therapy.
Bibliography Baldwin CiC, Gasson JC, Quan SG, Fleischmann J, Weisbart R, Oette D, Mitsuyasu RT, Golde DW: Granulocytemacrophage colony-stimulating factor enhances neutrophil function in acquired immunodeficiency syndrome patients. Pro Nati Acad Sci 85:2763-2766, 1988. Barrow HN, Levenson MJ. Necrotizing “malignant” external otitis caused by staphylococcus epidemidis. Arch OtolaryngolHeadNeck Surg118: 94-96,1992. Byrd RG, ConeLA, WoodardDR, Schultz P,StoneRA: Communityacquired Pseudomonas aeruginosa bacteremia (CAPB) in patientswith AIDS. Clin Res 108A(Abst.), 1993.
ChandlerJR: Malignantexternalotitis. Laryngoscope 78:1257-1294,1968. ConeLA, Byrd RB, Thind D, WoodardDR, FialaM, Cassarelle D: Normal neutrophilephagocytosis, but impaired chemotaxisin homosexual menwith AIDS, ARC andneitherdisorder.Abst Third InternationalConferenceonAIDS, Washington DC, 1987. DanielsDG, NelsonMR. BartonSE, GazzardBG: Malignantotitis extemain a patientwith AIDS. Int J STDAIDS 3:214,1992. FitchtenbaumCJ,WoeltjeKF, Powderly WG: SeriousPseudomonas aeruginosa infectionsin patientsinfectedwith humanimmunodeficiency virus: A casecontrolstudy.Clin Infect dis19:417-422, 1994. GiamarellouH: Malignantotitis extema: the therapeuticevolutionof a lethal infection.J AntimicrobChemother 30:745-751,1992. KielhofnerM, Atmar RL, HammillRJ, MusherDM: Life threatening Pseudomonas aeruginosa infectionsin patientswith humanimmunodeficiency virusinfection.Infects14403-411, 1992. KrausDH, RehmSJ,Kinney SE:The evolving treatmentof necrotizingexternalotitis.Laryngoscope 98:924-939,1988. LangR, GoshenS,Kitzes-CohenR, SadEJ: Successful treatmentof malignantexternalotitis with oral ciprofloxacin:report of experiencewith 23 patients.J Infect Dis 161537-540,1990.
Levin WJ, SharyJH, NicholsLT, Lucente FE: Bonescanningin severeexternal otitis. Laryngoscope 96:1193-l195, 1986. LucenteFE, ParisierSC, SomPM: Complications of the treatmentof malignantexternalotitis. Laryngoscope 93:279-281,1983. McElroy EA Jr., MarksGL: Fatalnecrotizing otitis ectemain a patientswith AIDS. Rev Infect Dis 13:1247-1427,1991. Meltzer PE,KelemanG: Pycocyaneous osteomelitisof thetemporalbone, manidibleandzygoma.Laryngoscope 69:1300-1306,1959. MendelsonMH, GurtmanA, SzaboS, Neibarte,MeyersBR, PolicareM, CheungTW, Lillienfeld D, HammerG, ReddyS,Choi K, HirschmanSZ: Pseudomonas aeruginosa bacteremia in patientswith AIDS. Clin Infect Dis 18:886-895,1994. Mowat AG, BaumJ: Chemotaxisof polymorphonuclear leukocytesfrom patients with diabetesmellims.N Engl J Med 284:621-627,1971. Scott GB, Buck BE, LetermanJG, Bloom FL, ParksWP: Acquiredimmunodeficiencysyndromein infants.N Engl J Med 310:76-81,1984. StrashunAM, NejatheimM, GoldsmithSJ: Malignantexternalotitis: early scintigraphicdetection.Radiology150:541545,1984. ToulmoucheMA: Observationsd’otorhee cerebrale:suivisdesreflexions.Gazett MedicaldeParis6:422-426,1838.
Pan American Society for Clinical Virology http://www.virology.org Society Information The PanAmerican Society for Clinical Virology (PASCV) was founded in 1977 asthe Pan American Group for Rapid Viral Diagnosis (PAG-RVD). It was founded to help raisethe standards of diagnostic virology in the Americas asthe “European Group for Rapid Viral Diagnosis“(now titled: EuropeanSociety for Clinical virology, http://www.eur.nl/ FGGNIRO/ESCV) hasdone elsewhere. The name was changed in 1995 to reflect the expanding role of the society in all areasof clinical virology, includ-
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ing diagnostics,manifestationsof viral diseasesand viral pathogenesis,prevention of and therapy for viral diseases and the improved understandingof all of these.The PASCV sponsorssymposia, workshopsand annualawardsin clinical virology. Currently, two awardsare presentedannually: The Clinical Virology Award (sponsoredby Bion Enterprises) and the Diagnostic Virology Award (sponsoredby Becton Dickinson). The Society alsoprovides several$600 travel grantsto the Annual Clinical Virology Symposium for students,postdoctoral
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Members include practicing physicians, laboratory directors, researchvirologists and laboratory technologistsand technicians. If you would like more information about joining the PASCV, you may contact Steven Specter by e-mail:
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