ENT infections Flashcards
What are the common ENT infections?
Tonsillitis, Otitis media, Rhinitis, Sinusitis
Definitions: Tonsillitis is an infection of the tonsils; Otitis media is an infection of the middle ear; Rhinitis is inflammation in the nose; Sinusitis is inflammation of the paranasal sinuses.
What is the most common cause of ear, nose, and throat infections?
Viruses
These infections usually resolve without treatment within 1-3 weeks.
When are antibiotics recommended for ENT infections?
Immunocompromised patients, Significant comorbidities, Severe infections, Infections that fail to resolve
Antibiotics are not typically used for viral infections.
What is the most common bacterial cause of tonsillitis?
Group A Streptococcus (Streptococcus pyogenes)
What are the other common bacterial causes of otitis media, sinusitis, and tonsillitis (not caused by GAS)?
Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus
What are the Centor criteria used for in tonsillitis?
Estimate the probability of bacterial tonsillitis
A score of 3 or more indicates a 40-60% chance of bacterial tonsillitis. Criteria include: Fever over 38°C, Tonsillar exudates, Absence of cough, Tender anterior cervical lymph nodes.
What is the FeverPAIN score used for?
Estimate the likelihood of bacterial tonsillitis
Score of 2-3 = 34-40% probability; Score of 4-5 = 62-65% probability. Criteria include: Fever during the past 24 hours, Purulence (pus on tonsils), Attended within 3 days of symptoms, Inflamed tonsils, No cough or coryza.
What is the typical first-line antibiotic for bacterial tonsillitis?
Penicillin V (phenoxymethylpenicillin) for a 10-day course
Alternative for penicillin allergy: Clarithromycin.
What are the complications of tonsillitis?
Peritonsillar abscess (quinsy), Otitis media, Scarlet fever, Rheumatic fever, Post-streptococcal glomerulonephritis, Post-streptococcal reactive arthritis
How does otitis media typically present?
Reduced hearing and ear pain, Bulging red tympanic membrane, Perforated tympanic membrane may lead to ear discharge
What is the first-line treatment for otitis media?
Amoxicillin for 5-7 days
Alternatives include: Clarithromycin (if penicillin allergic), Erythromycin (in pregnant women allergic to penicillin), Co-amoxiclav if infection is not responding to amoxicillin.
What is the typical course of sinusitis?
Usually viral, resolves in 2-3 weeks without treatment
Only around 2% of acute sinusitis is bacterial.
What is recommended for patients with sinusitis that does not improve after 10 days?
High-dose steroid nasal spray (e.g., mometasone) for 14 days, Backup antibiotic prescription (e.g., phenoxymethylpenicillin) if symptoms worsen or don’t improve within 7 days.
What are the treatment options for chronic sinusitis (lasting more than 12 weeks)?
Saline nasal irrigation, Steroid nasal sprays (e.g., mometasone or fluticasone), Functional endoscopic sinus surgery (FESS)
