Ear infections

Question 1

Bacteria of otitis externa

and fungal

Answer 1

pseudomonas aeruginosa - green
staph epidermidis - yellow
staph aureus - yellow

fungal
asperigillus niger or candida albicans - fluffy white or black

Question 2

Management of bacterial otitis externa

Answer 2

Cortisporin otic(polymixin B, neomycin and hydrocortisone)
** AVOID if suspected or known TM perforation
floxin otic ** for perforated TM
ciprodex or ciproHC better relief for edema/inflammation

otic suspension ph5 are less acidic than solution (ph3-4) and cause less irritation to infected tissues

Question 3

fungal otitis externa management

Answer 3

meticulous cleaning of EAC and Clotrimazole 1% solution BID x 10-14 days

Question 4

treatment of malignant OE

Answer 4

admit to hospital
c and s of ear discharge
IV anitbiotic- CIPROFLOXACIN
then oral cipro when stabilized or decreased ESR CRP

Question 5

etiology of AOM

Answer 5

streptococcus pneumoniae 50%
haemophilus influenzae 40%
moraxella catarrhalis 10%

Question 6

treatment of AOM

Answer 6

amoxicillin is antibiotic of choice unless
high dose 90mg/kg/day divided q12 7-10 d
pt received within 30 days
pt has concurrent purulent conjunctivitis
pt has history of recurrent aom
pt is allergic to penicillin

2nd line
amoxicillin/clavulanate (augmentin)
90mg/kg amoxi and 6.4 mg/kg clavu
beta lactamase inhibitor

Question 7

when tympanostomy tubes

Answer 7

greater than or equal to 3 episodes less than 6m

greater than or equal to 4 episodes in 12m

Question 8

complications AOM

Answer 8

conductive hearing loss
tm perforation
chronic otitis media
tympanosclerosis
cholesteatoma
mastoiditis
acute labrinthitis