Ear Infections Flashcards
what is otitis externa
inflammation of the external ear canal
presentation of otitis externa
ear pain
redness
itch
discharge
most common infective organisms in otitis externa
staph aureus
pseudomonas – purulent discharge
fungal - aspergillus niger / candida
what is malignant otitis externa
rare type of otitis externa caused by pseudomonas infection in diabetics / immunocompromised
infection begins in soft tissues and progresses to involve the bony ear canal
presentation of malignant otitis externa
constant, severe ear pain
purulent discharge
temporal headache
facial nerve dysfunction
complication of malignant otitis externa
temporal lobe osteomyelitis
tx malignant otitis externa
IV ciprofloxacin
tx of bacterial otitis externa
topical antimicrobial +/- corticosteroid
- neomycin
- acetic acid (otomize)
- ciprofloxacin for pseudomonas
tx of fungal otitis externa
clotrimazole
what it acute otitis media
inflammation of the middle ear
what usually precedes otitis media
URTI
- extension of infection up the Eustachian tube
symptoms of otitis media
ear pain
fever
inflamed, bulging ear drum seen with otoscope
– discharge + resolution of pain if eardrum bursts
what type of hearing loss can you get with acute otitis media
conductive hearing loss
- fluid build up in middle ear impairs sound conduction to cochlea
organisms in acute otitis media
mostly viral – H.Influenzae
secondary bacterial infection
– step pneumonia, strep pyogenes
management of acute otitis media
80% resolve within 4 days and do not need antibiotics
use amoxicillin if
- symptoms persist >4 days
- if TM perforated
- bilateral OM <2 years old
what is otitis media with effusion
build up of fluid behind the ear in the absence of infection
- know as ‘glue ear’
appearance of ear drum in otitis media with effusion
retracted
symptoms of otitis media with effusion
conductive hearing loss
behaviour problems / impaired speech in children
tx of otitis media with effusion
watchful waiting - many will resolve
Grommet insertion to ventilate middle ear cavity + equalise pressure
what is mastoiditis a complication of
acute otitis media
presentation of mastoiditis
severe pain, tender, erythematous boggy mass overlying mastoid, protrusion of ear forwards
why is mastoiditis an emergency
risk of meningitis
management of mastoiditis
antibiotics
- mastoidectomy if no response
management of a perforated tympanic membrane following otitis media
antibiotics
management of perforated tympanic membrane following trauma
should heal within 6-8 weeks
- reassure patient
surgical procedure if tympanic membrane fails to heal on its own
myringoplasty
