otitis media and externa

7/31/2019 Otitis Media and Externa

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Otitis Media is aninflammation and/orinfection of the middleear


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Chronic otitis media occurs when the eustachian tubebecomes blocked repeatedly due to allergies, multipleinfections, ear trauma, or swelling of the adenoids.


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Acute otitis media(acute ear infection)occurs when there is

bacterial or viralinfection of the fluid ofthe middle ear, which

causes production offluid or pus.


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Bacteria such as Streptococcus pneumoniae

(pneumococcus), non typable Hemophilus influenzae and

Moraxella account for about 85% of cases of acute otitis

media. Viruses account for the remaining 15%. Affected

infants under six weeks of age tend to have infectionsfrom a variety of different bacteria in the middle ear.


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Children with AOM (acute otitismedia) usually present with a historyof rapid onset of signs and symptoms

such as ear Itching, pain, discharge,hearing loss, or crusting of the ear.

May be associated with fever.


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refers to an infection

of the ear canal (outer

ear), the tube leading

from the outside

opening of the ear intowards the ear drum. commonly

referred to as

swimmer's ear.


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Chronic (long-term)swimmer's ear can be caused

by a bacterial infection, a skin

condition (eczema or

seborrhea), fungus

(Aspergillosis), chronicirritation (such as from the use

of hearing aids, insertion of

cotton swabs, etc), allergy,

chronic drainage from middle

ear disease, tumors (rare), orit may simply follow from a

nervous habit of frequently

scratching the ear.
http://www.medicinenet.com/script/main/art.asp?articlekey=64425http://www.medicinenet.com/script/main/art.asp?articlekey=6748http://www.medicinenet.com/script/main/art.asp?articlekey=6748http://www.medicinenet.com/script/main/art.asp?articlekey=64425


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Malignant

otitis externa

is a disorder

involvinginflammation

and damage

of the bonesand cartilage

at the base of

the skull.


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Causes

: Swimming inpolluted water is a

common way to

contract swimmer'sear, but it is also

possible to contract

swimmer's ear from

water trapped in the

ear canal after a

shower, especially

in a humid climate
http://en.wikipedia.org/wiki/Human_swimminghttp://en.wikipedia.org/wiki/Human_swimming


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caused by streptococcus, staphylococcus,

orpseudomonastypes of bacteria


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Drainage from the ear- yellow,yellow-green, foul smelling,

persistent

Ear pain - felt deep inside the earand may get worse when moving

head

Hearing loss

Itching of the ear or ear canal

Fever

Trouble swallowing

Weakness in the face

Signs and Symtoms :
http://www.nlm.nih.gov/medlineplus/ency/article/003042.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003046.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003044.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003217.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003217.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003044.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003046.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003042.htm


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Prevention:


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MODE OF TRANSMISSION:

Direct Transmission

IndirectTransmission


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AOM is defined by convention as the first 3

weeks of a process in which the middle ear

shows the signs and symptoms of acute

inflammation.

AOM is defined as the presence of fluid in

the middle ear with accompanyingconductive hearing loss and without

concomitant symptoms or signs of acuity.

OE is classified as sub acute when it

persists from 3 weeks to 3 months after theonset ofAOM and is classified as chronic

thereafter. Though painful, otitis media

is not threatening and usually heals on

its own within 26 weeks.


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1. Pain related to inflammation and pressure ontympanic membrane.

Give analgesic such as

acetaminophen. Use analgesiceardrops.

Have the child sit up, raise head on

pillows, or lie on unaffected ear.

Apply heating pad or warm hot

water bottle. Have the child chew gum or blow

on balloon to relieve pressure in

ear.

NURSING INTERVENTION:


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Treatment for the ear

infection If a person has an upper respiratory infection causing a lot of

congestion and swelling of membranes (including the

eustachian tube), medicines which dry up the congestion may

be helpful.

if there is only an ear infection without congestion or drainage,

decongestants and antihistamines are not helpful and should

not be used to avoid possible side effects (drowsiness,

jitteriness, blurred vision).

To ease the pain of an ear infection, your doctor may

recommend a pain reliever, typically acetaminophen or

ibuprofen, which also helps reduce a fever.

For severe infection, oral antiobiotics may be prescribed. If theotitis externa infection is caused by the presence of a foreign

body in the ear, the infection will not improve until the foreign

body is removed.


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Antibiotics are recommended in children under 6 months of ageas well as patients with severe illness.Drugs that are often used are as following:

Amoxicillin (80-90 mg/kg/d) (twice/day)

Amoxicillin/clavulinate (90 mg/kg/day of amoxicillin with 6.4mg/kg/d of clavulinate)

1-nasal drop.2-dry heat to the ear.3-analgesic as aspirin or paracetamol.4-antibiotics.

Treatment for the ear infection


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Alternatives for personswith penicillin allergy:

Cefdinir (once/day) Cefurxime Cefpodoxime Azithromycin (once/day)

Clarithromycin Ceftriaxone (once/day)

If treatment fails at 48-72

hours switch to higher doseof antibiotics, such asceftriaxone or clindamycin


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otitis media and externa

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