ENT infections Flashcards
what are oppourtunistic pathogens?
Opportunistic pathogen are members of the normal commensal bacteria that can cause disease when they find themselves in the wrong place
Most human infections are caused by opportunist pathogens
What is otitis externa (swimmers ear) and how can it be difined?
Localsied otitis externa
diffuse ottis externa
<3 weeks- acute
>3 week chronic
what are the signs and symptoms of otitis externa
signs
- ear canal/external ear- red and swollen
- discharge
- swelling
- inflammed ear drum
symptoms
- itch
- sevre ear pain
- pain whene ar is moved
- tenderness when moving the ear
describe incidence of otitis externa
1% diagnosed each year
peak inciden at 7-12 years
prevalence increases at the end of summer
what is occuring here?
localised otits media
Localised foliculutis- can progress to become a furnucle
extremely painful
What is this?
more reddening and swelling
inflamamtion of the skin and subdermis of the external ear canl
can expan to external ear canal and the tympanic emebrane
what is this
Malignnat otits externa
infection that spreads deeply to the tissues and bones of the external ear
what is this? and what is the most likely causativer agent?
Fungal otitis Externa
Aspergillus species or Canddia albicans
cans see the spores/sprouting bodies
what is the most common causative bacteria agent of localised Acute otitis externa
- Staphylococcus aureus
what is generally the causative agent of acute diffuseotitis externa ?
Staphylococcus aures
and
Pseudomonas aeruginosa
what is the Treatment for Localised and diffuse acute otttis externa (bacteria cause)
evidence shows Abx rarely need
only give for those at high risk or severe infection
Flucloxacillin
Treatment for fungal infections in chronic otits externa?
clotrimazole 1% solution
acetic acid 2% spray
what is acute Otits media
Acute otitis Media is inflammation in the middle ear with effusion and accompanied by a rapid onset of symptoms and signs of an ear infection
symptoms of acute otitis media?
- ear pain
- dulled hearing- present for a few days
- fever
- ittitabel babay
- performated ear drum
Prevalence of otits media?
mostly in young children- less common ina adults
1/2 million PC consultations per anum
what is happening on the right image?
acute otitis media in 3 year old- swollen tympanic membrane
what are the most common bacteria causes of acute Otitis Media
- streptococcus Pyrogenes
- Morezxella catarhallis
- streptococcus pneumoniae
- haemophillis influenzae
Viral pathogens associated with Otitis Media?
RSV, rhinovirus, adenovirs, Influenza virus
describe the treatment and management of AOM
- specialists if sevre or below 3 months
- if systetmically unwell
- 5-7 day of amoxicillin
- hosptial if worse
- generally most improve within 24 hours (60% of children) with AOM
what is Otitis media with effusion (glue ear)
Similar to AOm but not acute inflaamtion
low grade chronic bacteria or viral infection
80% by age of 10
generally resolves within 6-10 weeks
what is happening in the belwo image
otitis media with effusion- Glue ear
describe the occurence of Otitis media and Measles
measles common cause of Profounf hearing loss in areas with low vaccination.
typically bilateral- modertae to prodund Sensorineural Hearing loss may follow Measles Encephalitis
bacterial infection associated to measles infection may also cause hearing loss
What is difference between Labrythinthis and Vestibular neuritis? what do they cause
same thing- inteerchangabel
cause- sudden , spontaneous, sevre and often incpasciitng vertigo and nausa (vomiting frequently)
infection of inner ear
causes of Labyrinthis/ VN
mostly viral and generally URTI though
HSV1 reactivation in the vestibular ganglion may be a cause
bacterial labyrinthinits more serious
what is Sinusitis
Sinusitis is define as symptomatic inflammation of the paranasal sinuses
Acute sinusitis refers to sinusitis that completely resolves within 12 weeks
reccurent (4 or more ananula episdoes) or chornic ( more than 12 weeks
what is acute sinusitis caused by?
normally caused by viral URTI
rhinovirus, RSV< parainfluenxa, influenza- rarely bacterial
if bacterial
Streptococcus pneumonia
Haemophilus influenza
Moraxella catarhallis
Staphylococcus aureus
Treatment for sinusitis
- majority no Abx
- high risk or systemically unwell—–>phenoxymethylpenicllin
what is this ?
pus exudate and swollen- tonsilitis/ acute pharyngitis
cause of sore throats- acute upper respiraotry tract infection affects mucosa of the throst
what are the most common causes of sore throats in adults, childre, children bewlo 5
virus- 85-95% of throat infections adults
virus- 705 in children aged 15-16
virus 95% cases under 5
rhinovirus
coronavirus
parainfluenza virus
influenza type A and B
what is the most common cause of bacterial sore throat?
Group A BH strep (GAHBS)
rare causes of sore throat to consider
epstein bar- (gglandular fever)
Haemophilus influenza type b — can cause epiglottitis
Rare, vaccination
Candida albicans — causes pharyngitis.
Neisseria gonorrhoeae — can cause gonococcal pharyngitis
Treatment ofr viral sore throat?
generally viral infection (can be bacterial) resolve within 2 weeks, self-limiting
spontaneosu reolve in 3 days in 40% of people
by 1 week 85% are symptom free
Fever pain score for antibitoics- Fever, purelnce, attend rapdily,s everely infallmed tonsi, no cough or coryza
likelihood of siolating strept- 4-5 prescrtibe AB
common cause of Qunisy/peritosillar abscess
streptoccocus pyrogens
Staph aurea
haemophilus ifluenza
what is this?
qunisy
what is this and how is it detected? who is it seen in
inflammation of the epiglottis
stridor in chilren ()nosiey breathing ) emergency
usuall age 2-5 years- becoming rarer
main causes of epilgotitis
β-haemolytic streptococci (groups A, B, and C)
Staphylococcus aureus
Streptococcus pneumoniae
