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S3B1 IDIS > Infectious Diseases of the Ear > Flashcards

Infectious Diseases of the Ear Flashcards

(51 cards)

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1
Q

Describe the location affected by each of the following conditions:

otitis externa

otitis media

mastoiditis

A
  • otitis externa: outer ear (ear canal & pina)
  • otitis media: middle ear
  • mastoiditis: mastoid process
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2
Q

What is pruitis?

A

itching of the ear

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3
Q

What is otalgia?

A

ear pain

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4
Q

What is otorrhea?

A

discharge from the ear

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5
Q

What is tinnitus?

A

ringing of the ear

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6
Q

What is the most common form of otitis externa?

Etiological causes?

How is it frequently initiated?

Onset?

A

Swimmer’s ear / benign otitis externa / acute diffuse otitis externa

Pseudomonas & Staphylococcus aureus

seen in swimmers - initiated by moisture

onset ~ 48 hrs

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7
Q

What demographic is most commonly affected by malignant otitis externa?

Etiological agent?

A

necrotizing otitis externa / invasive otitis externa

immunocompromised, elderly & diabetic

Pseudomonas aeruginosa

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8
Q

What is acute locatlized otitis externa?

Etiological agent?

A

furunculosis

infection of a hair follicle of the outer ear

Saphylococcus aureus

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9
Q

Waht is the cause of eczematous otitis externa?

A

various allergic & autoimmune dematologic conditiosn that affect the external ear

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10
Q

What is herpes zoster oticus?

This can lead to what complicaiton?

This can be prevented by what vaccine?

A

varicella-zoster infection of the face & ear

painful rash of blisters in ear, mouth & throat

Can cause Ramsay Hunt syndrome: muscles of the face paralyzed

Vaccine: VZV & zoster vaccines

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11
Q

What is otomycosis & what are the common etiological causes?

A

fungal infection of the ear canal, usually caused by Aspergillus or Candida

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12
Q

What is a differentiating factor between otitis externa caused by bacteia & otomycosis?

A

more intense itching in otomycosis

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13
Q

What are the symptoms of otitis externa?

A
  • itching progressing to otalgia
  • edema & erythema of ear canal
  • otorrhea
  • tenderness of tragus & pinna
  • aural fullness
  • palpable periauricular & cervicl lymph nodestympanic membrane moves well w/ puff of air
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14
Q

How could you differentiate between otitis externa & otitis media?

A

kids with otitis externa will not be pulling on their ears

tympanic membrane will move from a puff of air with otitis externa but will not with otitis media

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15
Q

Otorrhea is most common in otitis externa from what etiological agents?

Describe the individual characteristics of the otorrhea.

A
  • Pseudomonas*: purulent otorrhea that may be green or yellow
  • Aspergillus*: fine white fuzzy mat topped by black spheres
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16
Q

What can you do to prevent otitis externa?

A

Keep ear canal clean & dry

after water sports, apply to ear canal 1 part white vinegar, 1 part water, 2 parts rubbing alcohol

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17
Q

What is the treatment for otitis externa?

A

eardrops w/ acetic acid, antiseptics, antimicrobials & corticosteroids

analgesics

if chronic, also use selenium sulfide to kill mites

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18
Q

What is malignant otitis externa?

Most common etiological causes?

A

an infection that begins as an external otitis that progresses to osteomyelitis of the temporal bone

Causes: Pseudomonas aeruginosa, Aspergillus

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19
Q

What group of people are particularly susceptible to malignant otitis externa?

A

elderly diabetics

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20
Q

Complication of malignant otitis externa?

A

cellulitis & osteomyelitis of surroundign tissue and bone

TMJ involvement (trimus from masseter)

Bell’s palsy

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21
Q

Symptoms of malignant otitis externa?

Study These Flashcards
A

purulent ear discharge, erythema & edema of ear canal

severe pain our of proportion to ear exam

temporal headache, trimus, dysphagia, hoarseness

granulation tissue in external auditory canal

Bell’s palsy

22
Q

What is the typical fever & WBC in malignant otitis externa?

How is a diagnosis made?

Study These Flashcards
A

usually not fever & WBC is usually normal

biopsy granulation tissue for culture & antimicrobial sensitivity

bone scanning, CT & MRI

23
Q

Treatment for malignant otitis externa?

Study These Flashcards
A

antibiotics

aggressive glycemic control

surgery

hyperbaric oxygen

24
Q

What is acute otitis media?

Study These Flashcards
A

inflammatory disease of hte middle ear

abrupt onset & is associated iwth one or more systemic signs of disease ie. headache, fever, vomiting, or diarrhea

25
What is otitis media with effusion?
(serous otitis media) inflammatory disease of the middle ear clear fluid in the middle ear for extended period but w/o ear pain or systemic signs of infection tinnitus, vertigo & hearing loss are common often follows acute otitis media
26
Why is it important to distinguish acute otitis media with otitis media with effusion?
otitis media with effusion does not respond to antibiotic treatment
27
What is chronic suppurative otitis media?
inflammatory disease of the middle ear persists for 6 weeks+ & purulent otorrhea, tympanic membrane perforation, some hearing lost & often a cholesteatoma
28
What is a cholesteatoma?
mass of keratinaceous debris
29
What is adhesive otitis media?
inflammatory disease of the middle ear occurs when the retracted tympanic membrane becomes aspirated into the middle ear space & gets stuck there
30
What is the definitio of recurrent otitis media?
greater than or equal to 3 episodes of acute otitis media within 6 months, or 4 or more episodes within 12 months
31
Symptoms of otitis media?
abrupt-onset otorrhea w/ purulent white to yellow discharge otalgia, aural fullness, tinnitus headache infancy: fever, ear tugging, irritability, vomiting, diarrhea, anorexia
32
What are the exam findings of the tympanic membrane?
middle-ear effusion opacity bulging erythema decreased mobility with pneumatic otoscopy
33
What demographic is most commonly affected by otitis media? Why?
children b/c have shorter & more horizontal eustachian tubes children under 2 cannot generate antibodies to polysaccharide capsules that protect manyof the bacterial etiologies of OM from phagocytosis
34
What are the most common etiologial causes of otitis media?
* Streptococcus pneumoniae* * Haemophilus influenzae* * Moraxella catarrhalis*
35
Describe the pathophysiology of bacterial otitis media
Viral infection causes the middle ear cavity to thicken, which creates a negative pressure & the formation of a sterile transudate bacterial from nasopharynx contaminate this fluid, create pus &cause tympanic membrane to bulge as the middle ear cavity fills with fluid
36
What is the treatment for otitis media? What are the specific guidlines regarding antibiotic use?
clean ear canal & treat pain and fever with ibuprofen/acetaminophen * Receive antibiotics * patients \< 6 months * Children under 2 with _bilateral_ acute otitis media * anyone with moderate to severe otalgia or otalgia for 48 hrs * temp over 39 degrees C * tympanic membrand perforation * immunocompromised * uncertain about follow-up * DO NOT receibe antibiotics * patients over 6 months with mild to moderate unilateral acute otitis media * patients 2 years+ with mild to moderate acute otitis media in one or both ears
37
What is the OMM technique to treat acute otitis media?
Galbreath technique manipulating mandible to press on pterygoid plexus & lymphatics that mainly drain the middle ear
38
What is the treatment for recurrent otitis media?
tympanostomy tubes will eventually fall out & the membrane will heal
39
Under what conditions would a physician perform a tympanocentesis?
to releive pressure on the eardrum to determine etiology of an immunocompromised patient / not responding to antibiotics most appropriate in infants less than 2-3 months
40
What are the possible complications from otitis media with effusion following a bout of acute otitis media? How is this treated?
if persists for months can lead ot significnat hearing loss & impaired language skills typanostomy tubes
41
How long do most cases of otitis media with effusion last? Treatment?
usually self-limiting & resolve within 2-4 weeks
42
What can happen if there is a perforation in the tympanic membrane during chronic suppurative otitis media? Why is this a problem?
can lead to the formation of a cholesteatoma (mass or keratinaceous debris) can erode bone & promote infection lead to meningitis, brain abscess or facial nerve paralysis
43
What are the most common etiologial causes or chronic suppurative otitis media?
*P. aeruginosa, S. aureus, Klebsiella pneumoniae, & Corynebacterium*
44
What is the usual cause of adhesive otitis media? What are the typical complications? treatment?
occurs after prolonged period of negative middle ear pressure complications are retraction pocket & cholesteatoma treatment: tube or grommett to normalize pressure
45
What are the vaccines that help to prevent otitis media? When should each be administerd?
* Streptococcus pneumoniae * PCV13 & PCV23 - diptheria toxin * 2 mo., 4 mo., 6 mo., 12-15 mo. * \>65 years * Hib * conjugate * 2 mo., 12-15 mo. * Influenza * LAIV (live attenuated) * 2-49 yrs * IIV4 (inactivated) * 6 mo. +
46
What is mastoiditis?
inflammation / bacterial infection of mastoid process that results in coalescence of the mastoid air cells acute -- ususally associated with acute otitis media chronic -- usually associated with chronic supparative otitis media
47
What are the most common etiological causes of mastoiditis?
Acute*: S. pneumoniae, H. influenzae*, group A streptococci (*S. pyogenes*) Chronic: *gram negatives* (pseudomonas) & *S. aureus* Also: *Fusobacterium necrophorum, Nocardia asteroides, Aspergillus, Mycobacterium* spp.
48
What are possible complications of mastoiditis?
deep neck or brain abscesses, septic thrombosis of sigmoid or lateral sinus, CNVII involvement
49
What are the signs & symptoms of mastoiditis?
redness, swelling, tenderness & fluctuation over mastoid process pinna displaced laterally & inferiorly exacerbation aural pain, fever & creamy otorrhea bulging & immobility of tympanic membrane
50
Diagnosis of mastoiditis?
Leukocytosis & elevated erythrocyte sedimentation rate CT - abscess-like cavities in mastoid process & indistinct air cell partitions MRI- intracranial soft tissue involvement
51
What is the treatment for mastoiditits?
antimicrobial therapy & drainage of middle ear and mastoid cells possivle mastoidectomy (osteitis, abscess, intracranial involvement, or no improvement 24-48 hrs after antibiotics)

S3B1 IDIS (2 decks)

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