Ear Infections

Question 1

describe what acute otitis media is

Answer 1

an upper respiratory infection involving the middle ear by extension of infection up the Eustachian tube

Question 2

what group of people does acute otitis media predominantly affect

Answer 2

infants and children

Question 3

what symptom does acute otitis media present with

Answer 3

earache

Question 4

what type of infection are often found in middle ear

Answer 4

often viral with bacterial secondary infection

Question 5

what are the most common bacteria that cause middle ear infections

Answer 5

Haemophilus influenzae, Streptococcus pneumoniae and Streptococcus pyogenes

Question 6

describe how middle ear infections are diagnosed

Answer 6

swab of pus if eardrum perforates, otherwise sample can’t be obtained

Question 7

describe the treatment for middle ear infections(acute otitis media)

Answer 7

80% resolve in 4 days without antibiotics
first line = amoxicillin
second line = erythromycin

Question 8

describe what otitis externa is

Answer 8

inflammation of the external auditory canal

Question 9

describe the clinical features associated with otitis externa

Answer 9

redness and swelling of the skin of the ear canal, may be itchy, can be sore/painful, may be discharge/increased ear wax, if canal blocked/swollen can affect hearing

Question 10

what bacterial causes are there for otitis externa

Answer 10

staphylococcus aureus, proteus spp, pseudomonas aeruginosa

Question 11

what fungal causes are there for otitis externa

Answer 11

aspergillus niger, candida albicans

Question 12

what is the most common cause of otitis externa

Answer 12

bacterial infection, caused by pseudomonas aeruginosa or staph aureus

Question 13

what precipitating factors are associated with otitis externa

Answer 13

ear trauma, excessive moisture or dermatitis

Question 14

what complications are associated with otitis externa

Answer 14

abscess, inflammation of tympanic membrane, and malignant otitis

Question 15

describe what malignant(necrotising) otitis is

Answer 15

an invasive extension of otitis externa into the bone surrounding the ear canal(ie mastoid and temporal bones)

Question 16

what symptoms are associated with malignant otitis

Answer 16

pain and headache, more severe than expected

Question 17

what signs are associated with malignant otitis

Answer 17

granulation tissue at bone-cartilage junction of ear, exposed bone in ear canal, facial nerve palsy(drooping face on side of lesion)

Question 18

what investigations are used for malignant otitis

Answer 18

plasma viscosity/CRP, radiological imaging, biopsy and culture

Question 19

what are the risk factors associated with malignant otitis

Answer 19

diabetes, radiotherapy to head and neck

Question 20

describe what happens if malignant otitis if left untreated

Answer 20

fatal, osteomyelitis will progressively involve the skull and meninges