Ear Infections

Question 1

What is otitis media? What are the sx?

Answer 1

• Self limiting inflammation of the middle ear that mainly affects children.
• It is typically caused by bacteria or viruses
• Sx: otalgia, bulging tympanic membrane, irritability, fever, previous URTI, sleep intolerance

Question 2

How would you manage otitis media?

Answer 2

1. Analgesics: paracetemol +/- ibuprofen
2. Delayed Abx prescription:
   
   1. Amoxicillin/ clarithromycin 5-7 days
   2. Co-amoxiclav 2-3 days

Question 3

What is Glue ear? How does it present differently to otitis media?

Answer 3

• Otitis Media with effusion: cloudiness behind the tympanic membrane (otitis media the ear drum would be red and inflamed)
• More likely to get hearing loss.

Question 4

What is otitis externa? How does it present?

Answer 4

• Condition of the outer ear, inflammation of the skin in the ear canal (the tube connecting the outer ear and the ear drum)
• Presents: itching, discomfort, otorrhoea (discharge), dry flakey skin, tragal tenderness

ear canal swelling and erythema

Question 5

How is otitis externa managed?

Answer 5

1. Antibacterial otic drops: ciprofloxacin and dexamethasone
2. Analgesia: paracetemol + ibuprofen
3. If immunocompromised: topical + systemic antibacterial therapy: ciprofloxacin or amoxicillin

Question 6

How is glue ear managed?

Answer 6

• Same as otitis media
• But if complications persist observe 6-12 weeks: if persistent refer for further tests
  
  • Surgical management in children (grommets)