Small Group 2 - Bacterial Respiratory Infections 1

Question 1

Acute sinusitis
2 most prevalent causative organisms
4 predisposing factors
Associated with?
When are cultures done?

Answer 1

Caused by Strep pneumonia and Haemophilus influenzae
Factors: impaired mucociliary function, obstruction, immune deficiency, and local insult.
Associated w/ allergies (may cause obstruction)
Cultures NOT done for acute b/c a hole would need to be punctured to access the sinus. Culture is done for chronic sinusitis though.

Question 2

Acute Otitis Media
2 most prevalent causes
Complications
AB guidelines

Answer 2

Caused by Strep pneumoniae and Haemophilus influenza
Complications - hearing loss, facial nerve palsy, tympanic membrane rupture, tympanosclerosis, and mastoiditis.
Often clears on own. Wait 48 hrs before prescription is filled if px is > 2 y/o.

Question 3

Middle Ear Effusion
Due to?
Characteristics
Tx

Answer 3

Occurs after AOM
Serous fluid builds up due to blocked Eustachian tube.
No eardrum inflammation. Infection is long gone.
Wait 8-12 weeks. If still present, consider inserting tubes.

Question 4

Otitis externa
AKA
Signs / sxs
Which organisms?
Virulence factors of main organism

Answer 4

Swimmer’s Ear
Signs / sxs - Redness / swelling of external ear canal. May cause pain, itching, or yellow discharge.
Mainly caused by Pseudomonas aeruginosa. Sometimes Staph aureus.
Pseudomonas virulence factors - adhesins and exotoxins.

Question 5

Malignant otitis externa
Population
Sxs
Dignosis
Tx

Answer 5

Most common in diabetics, elderly, and immunocompromised
Sxs include tissue destruction, hearing loss, or intracranial spread
Diagnose w/ culture and radiology
Tx w/ AB and debridement

Question 6

Ways to prevent middle ear infections (6 things)

Answer 6

Pneumococcus vaccine, avoid daycare, breastfeed at least 6 months, restrict pacifier use, bottle-feed upright, don’t smoke in house.