MDT Ear Otitis Media/ Externa

Question 1

Acute otitis media is a bacterial infection of the what?

Answer 1

mucosal lined air-containing spaces of the temporal bone

Question 2

Otitis Media

Purulent material forms not only within the middle ear, but also within the _____ and the ____.

Answer 2

mastoid air cells and petrous apex

Question 3

Acute otitis media is usually precipitated by a WHAT that causes eustachian tube obstruction.
-This results in accumulation of fluid and mucus, which becomes secondarily infected by bacteria.

Answer 3

viral upper respiratory tract infection

Question 4

What are the most common pathogens for otitis media?

Answer 4

Streptococcus pneumoniae,
Haemophilus influenzae,
Streptococcus pyogenes.

Question 5

What would you suspect?
1) Otalgia, aural pressure, decreased hearing, and often fever and history of
an upper respiratory tract infection.
(2) Erythema and hypomobility of tympanic membrane.
(3) Severe: Tympanic membrane bulging (rupture is imminent), mastoid tenderness
(presence of pus within the mastoid air cells).

Answer 5

Otitis Media

Question 6

What antibiotic therapy would you give for this?
1) Otalgia, aural pressure, decreased hearing, and often fever and history of
an upper respiratory tract infection.
(2) Erythema and hypomobility of tympanic membrane.
(3) Severe: Tympanic membrane bulging (rupture is imminent), mastoid tenderness
(presence of pus within the mastoid air cells).

Answer 6

(a) Amoxicillin 1000mg TID x 5-7 days
OR
(b) Amoxicillin/Clavulanate (Augementin) 2000mg/125mg PO BID x 5-7 days

Question 7

What antibiotic therapy would you give for this IF your patient has a PCN allergy?
1) Otalgia, aural pressure, decreased hearing, and often fever and history of
an upper respiratory tract infection.
(2) Erythema and hypomobility of tympanic membrane.
(3) Severe: Tympanic membrane bulging (rupture is imminent), mastoid tenderness
(presence of pus within the mastoid air cells).

Answer 7

1) Ceftriaxone 1-gram IM one dose
OR
2) Doxycycline 100mg PO BID x10 days

Question 8

True/False
Surgical drainage of the middle ear (myringotomy) is reserved for patients with severe otalgia or when complications of otitis (eg, mastoiditis, meningitis) have
occurred.

Answer 8

True

Question 9

True/False

Nasal Decongestants are contraindicated for Otitis Media

Answer 9

False

Question 10

F/u and initial care for Otitis media

Answer 10

(1) Follow up in 1 week to be reevaluated
(2) Consult to ENT as needed
(3) Refer for sudden worsening with fever or marked swelling.

Question 11

What the complications for otitis media?

Answer 11

(1) Cholesteatoma
(2) Mastoiditis
(3) Central Nervous system infection