Sinusitis/ Tonsillitis/ Otitis Media/ Otitis Externa Flashcards
What are guideline for use of antibiotics in sinusitis?
Consider for severe cases displaying at least 3 of the following
- persistent mucopurulent discharge (>7-10 days)
- facial pain
- poor response to decongestants
- tenderness over sinuses
- tenderness on percussion of maxillary molar and premolar teeth that cannot be attributed to a single tooth
What symptoms support a diagnosis of viral tonsillitis?
coryza prodromata, hoarseness, cough, conjunctivitis, nasal stuffiness
what is the presentation of haemophilus influenzae epiglottis?
usually children aged 2-4\short febrile illness, respiratory difficulty (no cough), unable to swallow
What are symptoms of streptococcal throat?
Constitutional symptoms (fever >38c, toxicity)
Tender anterior cervical lymphadenopathy
Tonsillar swelling and exudate
Absence of cough
Difficulty swallowing
Significant pain including pain on talking
Foul smelling breath
Pharynx inflamed and oedematous
Tonsils swollen with pockets of yellow exudate on surfaces
What are the indications for antibiotic treatment of sore throat?
Symptoms of group a beta haemolytic streptococcal infection
Excising rheumatic heart disease at any age
Scarlet fever
Quinsy
Patients aged 3-25 with presumptive strep from special communities (eg remote aboriginal) with high incidence of acute rheumatic fever
What are the possible indications for antibiotics in children with painful otitis media?
Sick child with fever Vomiting Red- yellow bulging TM Loss of TMT landmarks Persistent fever and pain after 3 days conservative approach
What are common organisms responsible for otitis externa?
- bacteria Pseudomonas E. coli S aureus Proteus Klebsiella
- fungi
Candida albicans
Aspergillus
What cases of otitis media should you refer?
Incomplete resolution of otitis media Persistent middle ear effusion for 3 months Persistent deafness Acute mastoiditis Frequent recurrences Craniofacial abnormalities
