Otitis Externa and Otomycosis Overview
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Questions and Answers

What is one possible consequence of osteomyelitis in Malignant Otitis Externa?

  • Sinusitis
  • Hearing loss
  • Nasal congestion
  • Facial palsy (correct)

Lower cranial nerve palsy can occur in Malignant Otitis Externa due to infection extension.

True (A)

What type of imaging is commonly used to assess the extent of infection in Malignant Otitis Externa?

CT Scan

The systemic antibiotic used for treating Malignant Otitis Externa is ______________.

<p>Ciprofloxacin</p> Signup and view all the answers

Match the following investigation techniques for Malignant Otitis Externa with their purpose:

<p>Culture and sensitivity = Confirm infection with Pseudomonas aeruginosa Fasting blood sugar = Check for diabetes or blood sugar abnormalities Bone scans = Assess bone involvement Biopsy = Exclude the possibility of a tumor</p> Signup and view all the answers

What is a primary symptom of Ramsay-Hunt Syndrome?

<p>Facial paralysis (D)</p> Signup and view all the answers

Bullous Myringitis is characterized by vesicles filled with pus on the eardrum.

<p>False (B)</p> Signup and view all the answers

What fungus is commonly associated with Otomycosis?

<p>Aspergillus Niger</p> Signup and view all the answers

Otitis Externa is the inflammation of the external __________ canal.

<p>auditory</p> Signup and view all the answers

Match the types of Otitis Externa with their descriptions:

<p>Localized OE = Infection of a hair follicle Viral Otitis Externa = Caused by viruses like herpes Otomycosis = Fungal infection in the EAC Bullous Myringitis = Blisters on the tympanic membrane</p> Signup and view all the answers

Which treatment is NOT typically used for Otomycosis?

<p>Antibiotics (B)</p> Signup and view all the answers

Herpes Simplex associated with Otitis Externa primarily causes deafness.

<p>False (B)</p> Signup and view all the answers

What is the primary treatment for Ramsay-Hunt Syndrome?

<p>Acyclovir</p> Signup and view all the answers

What is the primary cause of Localized Otitis Externa (Furuncle)?

<p>Staphylococcal infection (A)</p> Signup and view all the answers

Deafness can occur if the EAC is obstructed by the infection.

<p>True (A)</p> Signup and view all the answers

What is one predisposing factor for Localized Otitis Externa (Furuncle)?

<p>Diabetes</p> Signup and view all the answers

The treatment for Localized Otitis Externa includes administering _____ and analgesics for pain relief.

<p>antibiotics</p> Signup and view all the answers

Which of the following should be avoided when treating a furuncle in Otitis Externa?

<p>Squeezing the furuncle (C)</p> Signup and view all the answers

Match the conditions with their definitions:

<p>Localized Otitis Externa = Infection of a hair follicle in the outer EAC Diffuse Otitis Externa = Inflammation of the entire EAC Malignant Otitis Externa = Severe form that can lead to complications Furuncles = Staphylococcal infections of hair follicles</p> Signup and view all the answers

One predisposing factor of Diffuse Otitis Externa is _____ of the EAC.

<p>scratching</p> Signup and view all the answers

What is the purpose of checking blood sugar levels in recurrent cases of Localized Otitis Externa?

<p>To investigate for possible underlying diabetes</p> Signup and view all the answers

What is one of the primary symptoms of Diffuse Otitis Externa (OE)?

<p>Increased pain while chewing (A)</p> Signup and view all the answers

The primary causative organism for Malignant Otitis Externa is Escherichia coli.

<p>False (B)</p> Signup and view all the answers

What treatment is used locally for Diffuse Otitis Externa to reduce swelling?

<p>8% Aluminium acetate packing</p> Signup and view all the answers

Malignant Otitis Externa is also known as ______.

<p>skull base osteomyelitis</p> Signup and view all the answers

Which of the following is a predisposing factor for Malignant Otitis Externa?

<p>Low immunity (A)</p> Signup and view all the answers

Match the following conditions with their symptoms:

<p>Diffuse Otitis Externa = Pain with mastication and scanty discharge Malignant Otitis Externa = Severe, prolonged pain Both = Purulent discharge and deafness Neither = Balanced hearing</p> Signup and view all the answers

Both Diffuse Otitis Externa and Malignant Otitis Externa can cause deafness if the ear canal becomes obstructed.

<p>True (A)</p> Signup and view all the answers

What is a common clinical sign observed with Diffuse Otitis Externa when pulling the auricle?

<p>Tenderness</p> Signup and view all the answers

Flashcards

What is Otitis Externa?

Inflammation of the external auditory canal (EAC) caused by viral, fungal, or bacterial infection.

What is Herpes Simplex Otitis Externa?

A type of viral Otitis Externa characterized by fever and vesicles.

What is Herpes Zoster Otitis Externa?

A type of viral Otitis Externa caused by the chickenpox virus, characterized by painful vesicles.

What is Ramsay-Hunt Syndrome?

A specific type of Herpes Zoster oticus characterized by vesicles around the ear, otalgia (ear pain), facial paralysis (7th cranial nerve involvement), SNHL (sensorineural hearing loss), and vertigo (involvement of the 8th cranial nerve).

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What is Bullous Myringitis?

Characterized by bullae (blisters) filled with serous fluid or blood, located on the outer layer of the eardrum (tympanic membrane).

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What is Otomycosis?

A fungal infection of the external auditory canal (EAC), often caused by fungi like Aspergillus Niger and Candida albicans.

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What is Localized Otitis Externa (Furuncle)?

Infection of a hair follicle in the EAC.

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What is Diffuse Otitis Externa?

Inflammation of the entire external auditory canal, often involving the skin.

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What is one predisposing factor for Localized Otitis Externa (Furuncle)?

Diabetes is a key predisposing factor for furunculosis, leading to recurrent and multiple furuncles in diabetic patients.

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What are the symptoms of Localized Otitis Externa (Furuncle)?

Pain while chewing, scanty and cheesy discharge from the ear, and deafness if the EAC is blocked by the infection.

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What are the clinical signs of Localized Otitis Externa (Furuncle)?

Tenderness when pulling the earlobe or pressing on the tragus, internal swelling in the EAC that's reddish (outer third only), and external swelling with tender lymph nodes.

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How can you investigate Localized Otitis Externa (Furuncle) if it's recurrent?

Blood sugar levels should be checked to assess for underlying diabetes, especially in recurrent cases.

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What is the treatment for Localized Otitis Externa (Furuncle)?

Cleaning the EAC with suction (no ear wash), 10% Glycerin Ichthyol drops, packing with antibiotic/steroid cream, and incision/drainage for abscesses.

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What should be avoided when treating Localized Otitis Externa (Furuncle)?

Squeezing a furuncle can worsen the infection and lead to perichondritis, an infection of the cartilage surrounding the ear.

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What is Malignant Otitis Externa (MOE)?

A severe infection that starts in the external auditory canal (EAC) and spreads to the skull base, causing osteomyelitis.

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What are the symptoms of Diffuse Otitis Externa (OE)?

Pain that increases with mastication (chewing), scanty purulent discharge, and deafness if the EAC becomes obstructed by swelling or discharge.

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What are the clinical signs of Diffuse Otitis Externa (OE)?

Tenderness when pulling the auricle or applying pressure to the tragus, internal swelling of the EAC (red and edematous), and external swelling with enlarged, tender pre- and post-auricular lymph nodes.

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How is Diffuse Otitis Externa (OE) investigated?

Blood sugar testing for diabetes, especially in recurrent cases, and culture and sensitivity of the discharge, particularly if the condition is resistant to initial treatments.

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What is the treatment for Diffuse Otitis Externa (OE)?

Antibiotics and analgesics for pain relief and infection treatment, local cleaning of the EAC using suction, 8% Aluminum acetate packing (astringent), and packing the EAC with a cream containing an antibiotic and a steroid.

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What is the causative organism for Malignant Otitis Externa (MOE)?

Pseudomonas aeruginosa, a type of bacteria.

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What are the predisposing factors for Malignant Otitis Externa (MOE)?

Low immunity, such as that seen in diabetes.

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How do the symptoms of Malignant Otitis Externa differ from those of Diffuse Otitis Externa?

The pain in MOE is severe, prolonged, and deeply seated. Unlike diffuse otitis externa, it's much more intense and persistent.

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What is Malignant Otitis Externa?

A serious ear canal infection caused by Pseudomonas aeruginosa, often occurring in people with diabetes, leading to complications beyond the ear canal.

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What is a common complication of Malignant Otitis Externa?

Facial paralysis is a common complication due to nerve compression at the bony-cartilaginous junction of the ear canal.

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What type of scan is used to assess the extent of Malignant Otitis Externa?

This type of scan is used to determine the extent of infection and identify any bone involvement.

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Which antibiotic is essential for treating Malignant Otitis Externa?

This antibiotic is often prescribed for Malignant Otitis Externa because it effectively targets Pseudomonas aeruginosa.

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What type of surgical intervention may be required for Malignant Otitis Externa?

This procedure may be necessary to remove dead tissue and drain any abscesses in the infected ear canal.

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Study Notes

Otitis Externa (OE)

  • Otitis externa is inflammation of the external auditory canal (EAC) caused by viral, fungal, or bacterial infection.
  • Two main types of viral OE:
    • Herpes simplex: Characterized by vesicles and often accompanied by fever.
    • Herpes zoster (Ramsay-Hunt): Characterized by painful vesicles, otalgia (ear pain), facial paralysis (7th cranial nerve involvement), and sensorineural hearing loss (SNHL) with vertigo (8th cranial nerve involvement).
  • Ramsay-Hunt Syndrome treatment: Analgesics and acyclovir (locally and systemically).
  • Bullous myringitis involves blisters (bullae) filled with fluid on the eardrum (tympanic membrane).
  • Bullous myringitis treatment: Analgesics and antibiotics to prevent secondary infections.

Otomycosis

  • Fungal infection of the external auditory canal (EAC), often caused by Aspergillus Niger and Candida albicans.
  • Common symptoms: itching in the EAC, deafness (if EAC is obstructed by fungal growth).
  • Treatment: local cleaning using suction, antifungal ear drops (e.g., nystatin), or packing with antifungal cream if resistant.

Bacterial Otitis Externa

  • Localized (Furuncle): Infection of a hair follicle, commonly in the outer third of the EAC.
    • Predisposing factors: Diabetes.
    • Symptoms: pain worsening with chewing, scanty pus-like discharge.
  • Diffuse: Entire EAC inflammation.
    • Predisposing factors: scratching, swimming in infected pools, seborrhea, diabetes.
    • Symptoms: pain worsening with chewing, scanty purulent discharge, potential deafness if EAC is swollen.
  • Malignant OE: Severe form, potentially involving skull base osteomyelitis.

Diffuse Otitis Externa (OE)

  • Diffuse OE involves inflammation of the entire external auditory canal (EAC).
  • Predisposing factors: scratching, swimming in infected pools, seborrhea, diabetes.
  • Symptoms: pain worsening with chewing, scanty purulent discharge, potential deafness if EAC is swollen.
  • Treatment: antibiotics, analgesics, local cleaning, potential packing with antibiotics/steroids.

Malignant Otitis Externa (MOE)

  • Severe form extending to the skull base, potentially causing osteomyelitis.
  • Causative organism: Pseudomonas aeruginosa.
  • Predisposing factors: low immunity (e.g., diabetes).
  • Symptoms similar to diffuse OE but more intense pain, prolonged pain, deeply seated, possible facial nerve palsy.
  • Investigations: culture and sensitivity, blood sugar test, CT scan, gallium/technetium bone scans.
  • Treatment: hospitalization, systemic antibiotics (quinolones), local cleaning, local antibiotics (ciprofloxacin drops), and possibly surgical debridement.

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Description

This quiz covers the key aspects of Otitis Externa and Otomycosis, including symptoms, causes, and treatments. Focused on the types of infections and their management, it provides a comprehensive overview for students in healthcare. Test your knowledge on these important topics in otology.

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