ATI 37 - Otitis Media + Conjunctivitis + Cellulitis Flashcards
Otitis Media
infection of structures in middle ear
Otitis Media w Effusion
collection of fluid in middle ear
-no infection
otitis media is usually triggered by…
bacterial infection
strep.pneumoniaie, h.influenzae, moraxella
viral infectoin
RSV or influenza
allergies
enlarged adenoids
lower incidence of otitis in…
infants that are breastfed
acute otitis media signs
- tugging at ears
- red, bulging, nonmobile tympanic membrane
- fussy
- freq crying
- acute onset of changes in behavior
otitis media w effusion signs
- orange discoloration of TM w decr mvmt
- fluid line or air bubbles
- difficulty hearing
recurrent otitis media or with effusion for more than 3 months…
consider ENT referral or tympanostomy tube placement
Tx for non-severe UNILATERAL
abx or 2-3day observation
Tx for non-severe BILATERAL or severe w fever + pain
abx
if observing for 2-3 days…
must have follow up after
vaccination risk factor for otitis media
not being immunized to Haemophilus influenzae (2 mo) or streptococcus pneumonia (2 mos)
risk factors for hearing impairment
down syndrome or extended NICU stay
tx for ruptured tympanic membrane
systemic abx
-cover ear loosely w sterile cotton or gauze
do not try to remove foreign body w…
tweezers
types of Conjunctivitis [4]
1 Bacterial
2 Viral
3 Allergic
4 Chemical
Chemical Conjunctivitis
mild lid edema
non purulent discharge
Bacterial Conjunctivitis
symptoms
- usually starts UNILATERALLY
- mucoid or mucopurulent drainage w mattering
- incr tears
- redness + swelling
- itching/burning
- mild photophobia
Viral Conjunctivitis
symptoms
- serous drainage
- usually starts BILATERALLY
- milder incr in tears, rednss, swellng, itchng, burng
Viral Conjunctivitis caused by Herpesvirus
Treatment
aggressive IV acyclovir (>14dy)
+ topical meds [trifluderine, iodeoxyuride, vidarabine]
Viral Conjunctivitis NOT caused by Herpesvirus
Treatment
comfort measures
clean eyes
prophylactic abx
if pt has vesicular lesions anywhere positive fr herpes…
assume conjunctivitis is fr herpes
Allergic Conjunctivitis
symptoms
- intense itch
- water drainage
- starts BILATERALLY
- cobblestone appearance of conjunctiva
w bacterial conjunctivitis, mattering could be from ______, and _____ may present discharge
blocked lacrimal ducts;
gentle pressure to inner corner of eye
Conjunctivitis
diagnosis
hx + assessment
culture or gram is suspicious of bacteria or herpes
treat conjunctivitis empirically
broad spectrum abx while waiting for results
how to prevent spread of conjunctivitis
- dont rub eyes
- mittens over hands
- distract toddlers
- wash hands
- DONT share towels
- NO SCHOOL FOR 24 HOURS AFTER STARTING ABX
Periorbital [Preseptal] Cellulitis
bacterial infection of eyelid + surrounding tissue
Periorbital [Preseptal] Cellulitis is usually caused by…
streptococcus or staphylococcus
Periorbital [Preseptal] Cellulitis
symptoms
- swollen, tender, red eyelids
- restricted, painful mvmt of eye
- fever
Periorbital [Preseptal] Cellulitis can lead to…
orbital cellulitis
bacterial meningitis
