The Ear, Nose, and Throat Infectious Diseases Flashcards
UR bacteria
Hemo, S pneumo, moraxella
Above and below gingival line
Above - facultative
Below - anaerobes
Rhinorrhea
Facial pain and fullness
Mouth and tongue pain
Max tooth tenderness
Nasal mucos
Paransal sinusitis
Somtatitis, glossitis
Max sinusits/effusion
Ear fullness and apin
Vertigo and tinnitus
Hoarseness and voice change
Dysphage
MIddle ear, aud canal, ET
Inner ear or CN 8
Larynx and peri-laryngeal tissue
Anywhere from oral cavity to distal esophagus
Eaustachai tube
Maintains ATMP pressure of middle ear
Young children more horizontal
Purulent otitis media
Much more in childrne than adults
Ear pain, spontaineous rupture with drainahe
S. pneumo abd HIb
Conductive hearing loss, mastoitidis, meningitis
Serous otitis media
More in children but more in adults (comp to purulent)
Usually virus or allergic
Ear fullness, popping iwth jaw, decreased hearing
Otitis externa
Skin infection of ear canal
Bacteira (acute)
Chronic (fungal and allergic)
Ear pain and discharge
Inflamed canal..positive pinna and tragus signs
Malignant otitis externa is a comp
Malignant otitis externa
Severe cellulitis
Immunocompromised, diabetics, transplant
P aeru, and auueus
Systemic AB
Systemic infection and osteomyelitis are comps
Occams razor
New onset seizrue plus chornic left ear pain…think brain process instead of ear and be careful with LP
What drains into the meati
Sup - sphenoid and post ethmoid
Middle - frontal, max, and anterior ethmoid
inf - lacrimal duct
Sinus transillumination
Opacified sinus does not transluminate wlell
Good sensitivyt
Acute sinusitis
Sinus ostia obstruction
Facial, maxially tooth pain with sinus c ongestion
Facial and max tooth tenderness with abnormlal illumination
Worry baout periorbital ceullitis, meningitis, subdural empyema, cranial sinus thrombosis
Pott’s puffy tumor
Osteomyelitis of the calvarium as a result of frontal sinusitis
Subdural empyema is a comp
Rhinocerebral mucor
Look for necrotic eschar, cranial nerve palsies, and facial assymmety
Lung abscess
Think poor dentition plus aspiration
May rupture into pleural space to produce empyema
Orofacial actinomycosis
Think sulfur granules
Jaw abscness complicating tooth abscess for 3 mos
Candidiasis
Thrush
painless unless moving to pharynx and esophagus
Steroids, diabetes, IC
Kaposi sarcoma
Raised red-purple lesion
IC due to HHV 8
Usually extraoral involvement
Leukoplakia
Oral - white plaques anywhere…response to chronic irritation - premalignant…need to biopsy
Hairy - corrugated white lesion on lateral aspect of tonuge…from EBV induced epithelial hyperplasia…suspect HIV/AIDS
Acute epiglottisi
Usually Hib
Emergency
DO not swab or manipulate…call surg
Acute pharyngitis
Sore throad, possibly fever, pain swallowing
GAS, fusobacterium (cololege)
Look for cervical adenopathy that is tender
Comps - peri-tons abscess, superinfection, rheumatic fever
Lemierre’s syndrome
Begins as pharyngitis due to fuso
Extends into carotid sheath producing septic thrombosis of IJB
Fever, SCMoid, and jaw angle tenderennss, neck stiffness, dysphagia
Thromboemboli travel to lung s
Tx with ABs
Submand
Retropharyng
Danger space
Ludwig-s angina
Compromise airway
Can extends into mediastinum
Ludwig’s angina
Odontogenic infection
Involves submandibular space
Compromises swalling and may progress to airway obstruction with elevation of the tongue
Tx - airway management, surgery, ABs
Diptheria
Parhynx and nasal mucosa
Pseudomembrane
Sore throat, fever, malaise, hoarseness
Bull neck
Parotitis
Bilateral - viral or inflammatory
Unilateral - Staph aureus