Ear infections Flashcards
benign otitis externa bugs
pseudomonas, staph epi, staph aureus, candida, aspergillus, anaerobes
BOE keys for diff
mobile TM (compare to OM), no ear tug
BOE presentation
itching and otalgia scant white exudate edema of ear canal aural fullness palpable lymph nodes
MOE bugs
95% pseudomonas
also staph aureus, proteus, actinomyces, entero, candida, aspergillus
MOE keys for diff
CT shows erosion of temporal bone
MRI shows soft tissue involvement
**elderly diabetics, IC
MOE presentation
purulent ear discharge, erythema granulation tissue in post/inf of external canal severe, unrelenting pain temporal headaches trismus, dysphagia, facial paralysis
AOM bugs
preceded by URTI
1/3 strep pneumo
H flu
moraxella
<6w
gram negs like ecoli, klebsiella, enterobacter, pseudomonas
AOM keys
TM: opaque, bulging/retracting, erythema, effusion, decreased mobility
moderate leukocytosis
AOM presentation
abrupt onset otorrhea with purulent discharge aural fullness vertigo nystagmus tinnitus fever ear tugging, V/D
OME bugs
effusions may be sterile
if signs of infxn, treat like AOM
OME keys
serous OM, no signs of infxn
self limiting and resolve without treatment
when OME follows AOM, may persist for months with loss of hearing and language skills
if >3mo, Abx, tubes
OME presentation
clear fluid for an extended period
recurrent OM presentation
3+ episodes within 6 months or 4+ in 12 months
recurrent OM key
risk: cleft palate, day care, bottle feeding, 2nd hand smoke, family history, IC
recurrent OM bugs
**strep pneumoniae
also Hflu, moraxella
