Pathogens and treatments of conditions

Question 1

Auricular perichondritis

Answer 1

Pathogens: pseudomonas aeruginosa, staphylococcus aeurus, strep pyogenss

Antibiotic: cipro BID x 7 days

Question 2

Acute Otitis Media

Answer 2

Pathogens: strep pnuemonia, h. influenza, moraxella catarrhalis
viral: RSV, rhonovirus, flu, adenovirus

Antibiotic/ treatment: analgesics possible topical if the child is older than 2 and there is no TM perf.

Abx: amoxicillin (first line) or augmentin
for PCN allergy: cefdinir, z-pack, clarithromycin

kids under two 10 days
over two 5-7days

Question 3

Malignant otitis externa

Answer 3

pathogen: pseudomonus is the most common causitive organism.

Abx: poss admission for IV if systemically ill.
Cipro IC 400 mg IV or imipenem .5 mg or Ceftazidime 2.0 grams IV + Cipro 750 BID (maybe up to 4 weeks)

consult ENT

Question 4

Chronic AOM

Answer 4

pathogens: Pseudomonas aeruginosa, proteus, S. aureus

ABX/ treatment: aural toilet: suction, dry mopping, earwicking to gently remove drainage

ofloxacin otic sln or cipro otic sln 14 days

Question 5

Bullous Myringitis

Answer 5

pathogens: Mycoplasma
abx: Emycin 400 mg QID x 7 days

Question 6

Mastoiditis

Answer 6

pathogens: strep pneumo, strep pyogenes, s.aureus

abx:
emperically treat with vanco or linezolid

IV- cefotaxime 50 to 180 mg/kg/day up to 1 gram IV or Rocephin 50 to 75 mg/kg/day up to 1 gram iv”

Question 7

Bacterial rhino sinusistis

Answer 7

Pathogens: strep pnuemo. H. influenza, M. Catarrhalis, Staph aureus

abx:
ABX:
first line: Amoxicillin/ clavulanate 500/ 125mg PO TID or 875/125 PO QD
Second line:
amox/clav 2000/125 PO BID or Doxy 100 mg PO BID or 200 mg daily
5-7 days

Question 8

Oral Candidiasis

Answer 8

tx: nystatin oral suspension

fluconazole

Question 9

Group a-b hemolytic streptococcal pharyngitis

Answer 9

pathogen: group a-b hemolytic strep

abx: PCN-VK
amoxicillin for kids
z-pack (pcn allergy)

Question 10

retropharyngeal abscess

Answer 10

pathogens: beta hemolytic streptococci, staph aeureus , H. Flu

ABX:
Broad spectrum Clindamycin 900 mg IV + flagyl 500 mg IV
piperacilian/ Tazobactam

Question 11

Peritonsilar abscess

Answer 11

pathogens: group a strep, staph aureus, H. Flu

abx:
PO abx: augmentin 875 mg BID 7-10 days or clindamycin 300 mg 7-10days
secure airway tx pain and fever
IV abx: clind. 900mg IV or unasyn 3 gm IV

Question 12

Epiglottitis

Answer 12

pathogens: H. Influenzae type B or viral
abx: begin emperic abx: IV abc (3rd gen cephalosporin) + vanco