Otalgia

Question 1

Ddx of Otalgia in children?

Answer 1

Otitis media
Otitis media with effusion
Otitis externa

Question 2

Otalgia presentation in children?

Answer 2

Tugging/pulling on ear
hearing loss
crying
complaining of painful ear

Question 3

What is malignant otitis externa?

Answer 3

Uncommon type of otitis externa that is found in immunocomprimised individuals

Question 4

What is the most common at risk group for otitis externa?

Answer 4

Diabetics

Question 5

What pathogen causes malignant otitis externa

Answer 5

Pseudomonas aeruginosa

Question 6

What is the course of malignant otitis externa?

Answer 6

Infection commences in the soft tissues of the external auditory meatus, then progresses to involve the soft tissues and into the bony ear canal
Progresses to temporal bone osteomyselitis

Question 7

Presentation of malignant otitis externa?

Answer 7

Severe, unrelenting, deep seated otalgia
Temporal headaches
Purulent otorrhea
Possibly dysphagia, hoarseness and/or facial nerve dysfunction
Fever
as progresses possible VII, VI and IX-XII nerve palsy

Question 8

Investigations for malignant otitis externa?

Answer 8

CT to assess the extent of the infection

Question 9

Management of malignant otitis externa?

Answer 9

Admission to hosp under ENT
IV abx against pseudomonas aeruginosa

Question 10

Complications of malignant otitis externa?

Answer 10

Facial N damage and palsy or other cranial N involvement
Meningitis
Intracranial thrombosis
Death