ears ID Flashcards
what precedes otitis media
URTI
bacteria that cause acute otitis media
strep pneumo, H influenza, moraxella
symptoms acute otitis media
otalgia (ear tugging) // fever // hearing loss // corzyal
symptoms of acute otitis media if tympanic membrane perforates
purulent discharge
otoscopy acute otitis media
bulging membrane –> loss of light reflex (middle ear effusion) // red or opaque tympanic membrane //
what is required to diagnose acute otitis media
acute onset symptoms + middle ear effusion + inflammation of tympanic membrane
when should otitis media be treated
usually self limiting - come back if not better in 3 days
indication for abx acute otitis media
last 4 days // systemic unwell // immunocompromised // <2 with bilateral // perforation
indication for abx acute otitis media
last 4 days // systemic unwell // immunocompromised // <2 with bilateral // perforation
abx for acute otitis media
oral amoxicillin 5-7 days
what is chronic suppurative otitis media
perforation and discharge for 6+ weeks
complication from spread of infection acute otitis media
labryinthits // mastoiditis // meningitis // brain abscess // CNVII palsy
causes otitis externa
infection // seborrhoeic dermatitis // contact dermatitis // diabetes
bacteria in otitis externa
staph A, pseudomonas
trigger for otitis externa
swimming
symptoms otitis externa
ear pain, itch, discharge
mx otitis externa
topical antibiotic +/- steroid (gent)
when is gentamicin contraindicated in otitis externa
perforation
2nd line mx otitis externa
oral fluxclox // swab // maybe antifungal
if fungal infection otitis externa what mx
topical clotrimazole
when should otitis externa be referred to ENT
no response to topical abx
what is malignant otitis externa
extension of otitis externa to temporal bone osteomyelitis
who usually gets malignant otitis externa
diabetics
organism malignant otitis externa
pseudomonas
symptoms malignant otitis externa
diabetes // deep and painful otalgia // temporal headache // purulent discharge // dysphagia, hoarse, facial nerve involvement
invx malignant otitis externa
CT
mx malignant otitis externa
refer to ENT // IV abx for pseudomonas (cipro)
how does mastoiditis occur
infection from middle ear –> mastoid space of temporal bone
symptoms mastoiditis
otalgia (behind the ear) // recurrent otitis media // fever // systemic upset // swelling, redness, tenderness // ear discharge
invx mastoiditis
usually clinical, in unsure CT
mx mastoiditis
IV abx
complications mastoiditis
CNVII palsy, hearing loss, meningitis
