Ear Infections. Pdf by David kulapini from KUHeS

Ear infection pptxx from Kamuzu university of health sciences to nursing and doctors students

1. Ear Infections
David Kulapani

2. Otitis Media
•Common in pediatricpopulations
•Presents with middle ear fluid, hearing loss
•Ear pain, rubbing of the ear, mild bulging of tympanic membrane, intense
erythema of the tympanic membrane, fever
•Complications include suppurative intracranial infection and CSOM

3. Risk factors
•Age 6-12 months, 5-6 years
•Family history
•Day care
•Tobacco smoke and air pollution
•Pacifier use
•Limited resource
•*Breastfeeding reduces the risk of AOM

5. Aetiology
•Streptococcus pneumoniae, nontypeableHaemophilus
influenzae (NTHi), or Morexallacatarrhalis
•In the era of vaccines , serotypes have changed for AOM
•GAS, S. aureus, Mycoplasma pneumoniae, E.coli and viruses
like RSV, rhinoviruses and enteroviruses

6. Pathogenesis

7. Patient has prior URTI while colonised with otopathogens
Inflammatory oedenmaof Eustachian
Tube,pharynx
Obstructs the isthmus leadimgto poor ventilation
and negative middle ear pressure
Accumulation of secretions
Organisms in the URT enter the middle ear via aspiration or
efflux
Microbial growth leads to suppuration. Effusion may persist for weels/months

8. Treatment
•Manage the pain
•Analgesics with or without myringotomy
•Antimicrobials
•Reduce complications
•Reduce time to resolution

9. COMPLICATIONS
•Hearing loss
•Balance and motor problems
•Perforation
•Myringosclerosis
•CSOM
•Mastoiditis
•Intracranial complications like meningitis, epidural abscesses and
brain abscesses

10. Otitis externa
•AKA swimmer’s ear refers to inflammation of the external auditory
canal
•10% of people develop during their lifetime

11. Anatomu

12. Pathogenesis and risk factors
•Tragus and conchalcartilage help prevent foreign body
•Hair follicles and the isthmus
•Cerumen helps create an acidic canal environment
•Breakdown of skin-cerumen in the first step in the pathogenesis

13. Pathogenesis
Breakdown
pruritus Scarcthing
Further injury
Quality of cerumen
decrease
Increase in pH
Warm, dark, alkaline moist ear
leads to growth of org

14. Risk factors
•Swimming
•Trauma, cotton swabs
•Devices
•Allergic contact dermatitis
•Dermatologic conditions e,gpsoriasis
•Prior radiation

17. Management
•Clinical features: pain, discharge, pruritus, oedema, tympanic
membrane erythema
•Rapid onset withing 48 hrs
•Cultures: swabs of within external canal
•Reserved for specific patients