Objective: To determine the current microbiological profile of chronic suppurative otitis media (CSOM), their antimicrobial sensitivity, their resistance pattern to locally available antibiotics and the appropriate antibiotic against isolated microorganisms causing CSOM.Methods: This cross-sectional study involved 91 ear swab specimens obtained from patients clinically diagnosed with active CSOM. Swabs were cultured for microbial identification according to a standard protocol. We performed antibiotic susceptibility testing, using the modified Kirby-Bauer disc diffusion method, and the diameter of the inhibition zone was interpreted based Clinical Laboratory Standards Institute guidelines.Results: Microbial growth was seen in 85 (93.4%) samples, but 6 (6.6%) samples had no growth. Among the samples with growth, 63 (69.2%) were monomicrobial, 13 (14.3%) were polymicrobial, and 9 (9.9%) were of mixed growth with more than three microorganisms. The most common bacteria isolated was Pseudomonas aeruginosa (32.6%) followed by Staphylococcus aureus (16.9%) and Klebsiella spp.(5.6%). The most sensitive antibiotics against P aeruginosa were ceftazidime, meropenem, piperacillin-tazobactam, and cefepime. S aureus showed the highest sensitivity toward rifampin, cefoxitin, and fusidic acid. Conclusions:The bacteriological profile of CSOM showed a high prevalence of P aeruginosa, followed by S aureus and Klebsiella spp. with different distributions in different age groups. We observed a declining pattern of their antibiotic sensitivity. It is important to be aware of the current trend of the bacteriological profiles and to revise the antibiotic regime according to both the sensitivity and age groups.

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Congenital high airway obstruction syndrome (CHAOS) is a rare life-threatening fetal anomaly which occurs as a result of either partial or complete obstruction of the upper fetal airway. Prenatal recognition is important for multidisciplinary team management. We present a case with CHAOS diagnosed antenatal imaging and the baby was delivered via ex utero intrapartum treatment (EXIT) procedure. The airway managed to be secured via tracheostomy while maintaining the fetus on feto-placental circulation. However, oxygen saturation started to decline despite successfully securing the upper airway.  Unfortunately, we lost the baby despite active resuscitation possibly due to insufficient lung function secondary to chronic obstruction prenatally.

Foreign body ingestion is a common, yet sometimes dangerous entity encountered in paediatric population. Depending on the type, size and location of a foreign body, it can present with variety of symptoms. The purpose of this report is to present an unexpected radiolucent oesophageal foreign body impaction in a 4-year-old boy missed by imaging, but successfully removed using rigid esophagoscopy without any complications.

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