Otitis media

• What is the second line treatment for otitis externa?


  Oral fluclox (if spread)

  Swab

  Emirical antifungal
• What happens if a patient fails to respond to topical antibiotics in otitis externa?


  ENT referral
• WHat are some features of acute otitis media?


  Otalgia

  Fever

  Hearing loss

  Ear discharge

  Recent viral URTI
• What might you see on otoscopy for otitis media?


  Bulging tympanic membrane

  Loss of light reflex

  Purulent otorrhoea

  Decreased mobility
• What is otalgia?


  Ear tugging/rubbing
• What criteria is used to diagnose otitis media?


  Acute onset of symptoms

  Inflammation of tympanic membrane

  Presence of middle ear effusion
• Which organisms usually cause otitis media?


  Strep pneumoniae

  H. influenzae

  Moraxella catarrhalis
• Why do viral URTIs often precede acute otitis media?


  Disturb normal nasopharyngeal biome

  Allows bacteria to infect middle ear via eustachian tube
• What are some complications of otitis media?


  Mastoiditis

  Meningitis

  Brain abscess

  Facial nerve paralysis
• What are common sequelae of otitis media?


  Labrynthitis

  Hearing loss

  Perforation of tympanic membrane
• When are antibiotics prescribed immediately in otitis media?


  >2 bilateral otitis media

  Perforation/discharge in canal

  Symptoms lasting 4+ days

  Systemically unwell

  Immunocompromise
• What antibiotics are given in otitis media?


  7 days - amoxicillin
• How is otitis media managed?


  Usually self-resolves

  Analgesia to otalgia

  Seek help if no improvement in 3 days
• What are some signs and symptoms of otitis externa?


  Ear pain

  Itch

  Discharge
• What is seen on an otoscopy for otitis externa?


  Red, swollen eczematous canal
• What are causes of otitis externa?


  Infection

  Suborrhoeic dermatitis

  Contact dermatitis

  Recent swimming
• What organisms commonly cause otitis externa?


  Staph aureus

  Pseudomonas aeruginose

  Fungus
• What is initial management for otitis externa?


  Topical antibiotics with steroid

  Removal of canal debris

  Ear wick