Otitis externa

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Otitis externa

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High Yield Notes

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▪ Examine for abnormality (e.g. retraction, effusion, perforation) ▫ Dull bluish-gray/yellowish coloration denotes effusion behind membrane; reddish coloration, engorged vessels signal inﬂammation ▪ Pneumatic examination ▫ Fluid-ﬁlled ear minimizes tympanic membrane excursion with insufﬂation OTHER DIAGNOSTICS ▪ Hearing tests for conductive hearing loss ▫ Weber test: sound lateralized to affected ear ▫ Rinne test: BC > AC TREATMENT MEDICATIONS ▪ Dilatory dysfunction ▫ Upper respiratory tract inﬂammation (viral infection, allergy) → short intranasal/systemic decongestant, corticosteroid course ▪ Patulous dysfunction ▫ Avoid decongestants/corticosteroids SURGERY ▪ Dilatory dysfunction ▫ Tympanostomy tubes: hollow tubes inserted into eardrum → create direct opening between middle, outer ear → allow easy pressure equilibration, accumulated debris drainage OTHER INTERVENTIONS ▪ Patulous dysfunction ▫ Hydration, nasal saline drops/irrigation OTITIS EXTERNA osms.it/otitis-externa PATHOLOGY & CAUSES ▪ AKA “swimmer’s ear” ▪ Outer ear canal irritation CAUSES ▪ Outer ear canal microbial infection (primary cause) ▫ Bacterial (90%): Pseudomonas aeruginosa, Pseudomonas vulgaris, E. coli, S. aureus ▫ Fungal: Candida albicans, Aspergillus niger ▪ Dermatological conditions ▫ Allergic contact dermatitis, psoriasis, atopic dermatitis 566 OSMOSIS.ORG RISK FACTORS ▪ Frequent swimming ▪ Mechanical cleaning/irritation (cotton swabs/scratching) ▪ Ear canal occlusion (hearing aid, headphone) ▪ Diabetes SIGNS & SYMPTOMS ▪ Acute (< six weeks) ▫ Pinna traction → aggravated pain ▫ Otorrea: sticky yellow discharge) ▫ Swelling, purulent debris → external canal obstruction → conductive hearing loss, +/- aural fullness ▫ Posterior auricular lymphadenopathy

Flashcards

Otitis externa

8 flashcards

Questions

USMLE® Step 1 style questions USMLE

2 questions

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A 66-year-old woman goes to the emergency department for evaluation of a painful left ear. She was evaluated one week ago for her symptoms by her primary care physician, who prescribed otic ofloxacin drops. The patient has been taking her medication as prescribed without relief of symptoms and now has worsening discharge from the ear and pain with chewing. Medical history is notable for hypertension, hyperlipidemia, and insulin-dependent diabetes. The patient's temperature is 38.7°C (101.7°F), pulse is 110/min, respirations are 18/min, and blood pressure is 168/75 mmHg. Physical examination reveals the following finding:

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Which of the following pathogens is most likely responsible for this patient’s condition?

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