Ear Infections Overview

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Questions and Answers

What is the primary causative organism for localized otitis externa?

Bacteroides fragilis

Staphylococcus aureus (correct)

Pseudomonas aeruginosa

E. Coli

Which of the following is a characteristic presentation of diffuse otitis externa?

Localized severe pain without discharge

Initial thin serous discharge followed by purulent discharge (correct)

Fever with swollen lymph nodes only

Thick purulent discharge with minimal pain

What treatment is recommended for perichondritis?

Oral antifungal medications

Systemic broad spectrum antibiotics (correct)

Surgical drainage only

Topical antiseptics only

Which type of otitis externa is characterized by its occurrence in humid climates and among swimmers?

Diffuse otitis externa Signup and view all the answers

What might result if localized otitis externa is left untreated?

Cauliflower ear deformity Signup and view all the answers

What is a common sign of perichondritis?

Hot, painful, and swollen pinna Signup and view all the answers

Which treatment is NOT recommended for diffuse otitis externa?

Surgical drainage Signup and view all the answers

Which of the following treatments is typically administered for a furuncle in localized otitis externa?

Local/systemic antibiotics and anti-inflammatory drugs Signup and view all the answers

What is the primary organism associated with malignant otitis externa?

Pseudomonas aeruginosa Signup and view all the answers

Which of the following presents with intense itching and a sensation of fullness in the ear?

Otomycosis Signup and view all the answers

What is the recommended treatment for otomycosis?

Anti-fungal drops Signup and view all the answers

What may be a complication of malignant otitis externa in terms of neurological effects?

Multiple cranial nerve palsies Signup and view all the answers

Which management strategy is NOT typically recommended for otomycosis?

Immediate surgical intervention Signup and view all the answers

What percentage of patients with Herpes Zoster Oticus recover their pre-morbid facial function?

50-80% Signup and view all the answers

What is a common causative agent of otitis media?

Moraxella Catarrhalis Signup and view all the answers

Which condition is characterized by a herpetic vesicular rash on the external ear?

Herpes Zoster Oticus Signup and view all the answers

Which of the following is NOT a clinical feature of acute otitis media?

Hearing loss Signup and view all the answers

What is the primary management approach for chronic otitis media?

Aural toilet and antibiotic ear drops Signup and view all the answers

Which pathogen is commonly associated with chronic otitis media?

Pseudomonas aeruginosa Signup and view all the answers

What can be considered a predisposing factor for both acute and chronic otitis media?

Low socio-economic status Signup and view all the answers

Which type of otitis media is characterized by the presence of granulation tissue in the middle ear?

Chronic Otitis Media Signup and view all the answers

In the context of otitis media, what does the term 'tubo-tympanic' refer to?

A safe classification of chronic otitis media Signup and view all the answers

What is a common complication of acute otitis media?

Hearing impairment Signup and view all the answers

Which method is essential for the clinical evaluation of chronic otitis media?

Otoendoscopy Signup and view all the answers

Study Notes

Ear Infections: An Overview

Ear infections are broadly classified as otitis externa (external ear infections) and otitis media (middle ear infections).

Otitis Externa

Perichondritis
- Inflammation of the cartilage of the ear.
- Commonly caused by Staph aureus, pseudomonas, and mixed bacterial flora.
- Often caused by ear piercings, lacerations, or surgical procedures.
- Presents with a hot, painful, swollen pinna, potentially leading to abscess formation, cartilage necrosis, and cauliflower deformity.
Localized Otitis Externa (Furuncle)
- Staphylococcal infection of the hair follicle in the ear canal.
- Typically presents as a single, but may be multiple and recurrent, especially in those with weakened immune systems.
- Can be associated with habitual ear cleaning.
- Characterized by severe pain, exacerbated by jaw movements, and minimal or no ear discharge.
Diffuse Otitis Externa ("Swimmer's Ear")
- Inflammation of the skin in the canal along with the outer layer of the tympanic membrane.
- Common in warm, humid climates or after swimming.
- Commonly caused by S.aureus, P.pyocyaneus, B.proteus, and E.Coli.
- Presents with a hot, painful ear, initially with thin serous discharge later becoming purulent.
- Pain is worsened by jaw movements and accompanied by intermittent itching.
Otomycosis
- Fungal infection most commonly caused by Aspergillus or Candida.
- Presents with intense itching, pain, fullness, ear blockage, and a watery discharge.
- May require extended treatment due to its tenacious nature.
Malignant Otitis Externa
- Also known as necrotizing otitis externa.
- An aggressive infection of the ear and skull base.
- Occurs predominantly in elderly diabetics and those with weakened immune systems.
- Primarily caused by Pseudomonas aeruginosa, but can involve other organisms.
- Presents with intense pain, typically nocturnal, and multiple cranial nerve palsies (VII, V, IX, X, XI, XII).
Herpes Zoster Oticus (Ramsay Hunt Syndrome)
- Reactivation of the varicella zoster virus in the geniculate ganglion of the facial nerve.
- Presents with otalgia, facial weakness, and an ear rash.
- 50-80% of patients recover pre-morbid facial function.

Otitis Media

Acute Otitis Media (AOM)
- Inflammation of the middle ear mucosa.
- Typically arises after infections of the upper respiratory tract.
- Commonly caused by Streptococcus pneumoniae, Hemophilus influenza, and Moraxella catarrhalis, but can be caused by viruses such as RSV, rhinovirus, or coronavirus.
- Predisposing factors include low socioeconomic status, breastfeeding in a recumbent position, exposure to indoor smoke, allergies, and recurrent upper respiratory infections.
Chronic Otitis Media (COM)
- Persistent middle ear inflammation with permanent damage to the tympanic membrane and/or the presence of granulation tissue.
- Often a consequence of poorly managed AOM.
- Major cause of childhood hearing loss in Sub-Saharan Africa.
- Classified into different types based on location.
- Caused by bacteria such as P.aeruginosa, E.Coli, P.mirabilis, S, aureus, and B.fragilis.

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Description

This quiz covers the classification and types of ear infections, including otitis externa and otitis media. Learn about the causes, symptoms, and risks associated with different forms of ear infections like perichondritis and swimmer's ear. Test your knowledge to enhance your understanding of these common conditions.