ENT Flashcards
What can cause the inflammation in otitis externa? (5)
- bacterial infection
- fungal infection
- eczema
- seborrhoeic dermatitis
- contact dermatitis
What can predispose someone to otitis externa? (3)
- swimming
- trauma (cotton buds, earplugs)
- removal of ear wax (wax protects against infection)
What are the two most common bacterial causes of otitis externa?
- pseudomonas aeruginosa
- staphylococcus aureus
How is mild otitis externa treated?
acetic acid 2% (OTC as EarCalm) - has antifungal and antibacterial effects
How is moderate otitis externa treated?
topical antibiotic and steroid - e.g. neomycin, dexamethasone and acetic acid (Otomize spray)
What must you exclude before prescribing aminoglycosides (neomycin etc) for ear infections?
perforated tympanic membrane - aminoglycosides are potentially ototoxic and can in rare cases cause hearing loss
Tx for fungal otitis externa?
clotrimazole ear drops
What virus causes most infectious mononucleosis/glandular fever cases?
epstein-barr virus (human herpesvirus 4)
What is the classic triad seen with mono/glandular fever?
- sore throat
- lymphadenopathy
- pyrexia
How is mono/glandular fever diagnosed?
heterophil antibody test (Monospot test)
Mono/glandular fever management
- rest, plenty fluids, avoid alcohol
- simple analgesia for any aches/pains
- consensus to avoid contact sports for 4wks after to reduce risk of splenic rupture
How does otitis media occur?
bacteria enter from the back of the throat through the eustachian tube - a viral urti often precedes OM
What are the most common bacterial causes of otitis media?
- streptococcus pneumoniae (most common)
- haemophilus influenzae
- moraxella catarrhalis
- staph aureus
How does otitis media present?
- ear pain
- reduced hearing in affected ear
- feeling unwell, poss fever
- sx of URTI
- if affects vestibular system, balance and vertigo
- if tympanic membrane perfed, discharge from ear
How will otitis media look on otoscopy?
bulging, red, inflamed tympanic membrane, if perfed a hole and/or discharge
What is the primary complication of otitis media?
mastoiditis
Management of otitis media
- self-resolve in 3 days-1 wk
- abx have little effect on sx/complications
- simple analgesia
When would you consider immediate abx for otitis media?
- pt has significant co-morbids
- systematically unwell
- immunocompromised
What is first line if abx are required for otitis media?
amoxicillin (clarithro if allergic, erythro if pregnant)
