– Ear Disorders –
Otitis Externa
Malignant Otitis Externa
Otitis Externa
More in young poeple —- r/t swimming, ear cleaning, moisture
Causative pathogens —- Bacterria, Virus, Fungus —- Pseudomonas a., Candida, Enterobacteriaceae, others
Hallmark S/S —- pain on tragus on palpation (pain on palpation = tenderness)
other S/S —- itching, erythematous, edematous, exudate, cerumen
Treatment —- topical ABT (mild case), oral ABT, there are more tx regimens.
ABT choice —- fluoroquinolone (ofloxacine, ciprofloxacin) —- covering causative pathogens empirically, safe to use for patients with non-intact TM.
Neomycin + Polymyxin B hydrocortisone (Cortisporin) – A/E: ototoxicity – can’t use if TM is not intact.
Irrigation is NOT recommended
Acute Otitis Externa vs. Chronic Otitis Externa —- Chronic otitis externa S/S: severe itching, no cerumen, dry, excoriations due to scrathing to relieve itching.
Otitis Externa
Malignant Otitis Exgterna
More in older people —- diabetes, immunocompromised
Malignant otitis externa = Necrotizing otitis externa = Osteomyelitis of the ear
Most common causative pathogen —- P. aeruginosa
High risk population —- immunocompromised, Hx of skull radiotherapy, osteomyelitis of temporal bone
S/S —- severe pain, fever, facial paralysis, CN abnormality
Dx —- CT scan, redionucleotide bone scanning (detects malignant “bone” tumor), gallium scanning (detects cells that devide quickly = cancer cells)