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S3 IDIS CP > Ear infections > Flashcards

Flashcards in Ear infections Deck (21):
1

benign otitis externa bugs

pseudomonas, staph epi, staph aureus, candida, aspergillus, anaerobes

2

BOE keys for diff

mobile TM (compare to OM), no ear tug

3

BOE presentation

itching and otalgia
scant white exudate
edema of ear canal
aural fullness
palpable lymph nodes

4

MOE bugs

95% pseudomonas

also staph aureus, proteus, actinomyces, entero, candida, aspergillus

5

MOE keys for diff

CT shows erosion of temporal bone
MRI shows soft tissue involvement
**elderly diabetics, IC

6

MOE presentation

purulent ear discharge, erythema
granulation tissue in post/inf of external canal
severe, unrelenting pain
temporal headaches
trismus, dysphagia, facial paralysis

7

AOM bugs

preceded by URTI

1/3 strep pneumo
H flu
moraxella

<6w
gram negs like ecoli, klebsiella, enterobacter, pseudomonas

8

AOM keys

TM: opaque, bulging/retracting, erythema, effusion, decreased mobility
moderate leukocytosis

9

AOM presentation

abrupt onset
otorrhea with purulent discharge
aural fullness
vertigo
nystagmus
tinnitus
fever
ear tugging, V/D

10

OME bugs

effusions may be sterile

if signs of infxn, treat like AOM

11

OME keys

serous OM, no signs of infxn
self limiting and resolve without treatment
when OME follows AOM, may persist for months with loss of hearing and language skills

if >3mo, Abx, tubes

12

OME presentation

clear fluid for an extended period

13

recurrent OM presentation

3+ episodes within 6 months or 4+ in 12 months

14

recurrent OM key

risk: cleft palate, day care, bottle feeding, 2nd hand smoke, family history, IC

15

recurrent OM bugs

**strep pneumoniae

also Hflu, moraxella

16

chronic suppurative OM presentation

weeks of purulent otorrhea, tm perf, hearing loss, *** cholesteatoma

17

chronic suppurative OM keys

peripheral TM perf can lead to **cholesteatoma which can erode bone, promote infxn= meningitis, abscess, FN paralysis

18

chronic suppurative OM bugs

**strep pneumoniae

also, h flu, moraxella

19

mastoiditis presentation

redness, swelling, tenderness, fluctuation over mastoid process

displaced pinna (late/inf)

persistant/throbbing pain

babies refuse to feed

bulging immobile TM

20

mastoiditis keys

leukocytosis, elevated ESR

culture blood, ear fluid, air cells

spinal tap if suspected CNS involvement

CT shows abscess like cavities
MRI shows soft tissue involvement
CN7 may present as Bell's

21

mastoiditis bugs

same as AOM
Strep pneumoniae, Hflu, Moraxella

severe: pyogenes, aureus, pseudomonas, G-
Chronic: polymicrobial with anaerobes, fungi