Ear Infections Overview

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.

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.