Term
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Definition
| escape of pus, serum, blood, lymph, or other fluid into a body cavity as a result of inflammation or presence of excess blood or tissue fluid in an organ or tissue |
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Term
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Definition
| pus that is characterized by a creamy or thick yellow or white fluid in middle ear |
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Term
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Definition
| a pale yellow or amber-colored fluid which is much less viscous |
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Term
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Definition
| presence of fluid in middle ear caused by infection, allergy, or functional alterations of middle ear or eustachian tube |
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Term
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Definition
| middle ear effusion which persists for longer than 2-3 months |
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Term
| Factors increasing likelihood of OM |
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Definition
age related (peak: 6 months - 18 months);
Males > females;
Winter > any other time of year;
> Native American, Eskimo, & Caucasian;
poorer populations; |
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Term
| Environmental or Host Factors increasing risk for OM |
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Definition
mother who smokes;
Down's Syndrome;
recurrent or concurrent URI or nasal congestion;
age at 1st episode;
day care;
HIV;
# of family members in household;
absence of breast feeding |
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Term
| Bacterial Pathogens associated w/ AOM |
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Definition
Strep. pneumoniae;
Haemophilus influenzae;
Moraxella catarrhalis;
Sterile or nonpathogenic organisms |
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Term
| Most Common Bacterial Pathogen associated w/ AOM |
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Definition
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Term
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Definition
onset after "head cold";
rhinitis;
cough;
ear pain (otalgia) & ear pulling/rubbing;
vomiting &/or diarrhea;
fever;
transient hearing loss?? |
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Term
| Appearance of Tympanic Membrane due to AOM |
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Definition
| red, bulging, impaired mobility |
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Term
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Definition
measures compliance of tympanic membrane;
lack of movement indicates OM |
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Term
| Intracranial Complications of AOM |
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Definition
meningitis;
extradural & subdural abscesses;
otitic hydrocephalus;
lateral sinus thrombosis;
focal encephalitis; |
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Term
| Extracranial Complications of AOM |
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Definition
tympanic membrane perforation;
mastoiditis;
facial paralysis;
hearing loss; |
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Term
| Children at highest risk for MDRSP |
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Definition
children < 4 yrs w/ recurrent AOM;
children treated w/ multiple antibiotics;
children who attend large day care centers;
- START w/ HIGH DOSE Amoxicillin for ALL pts |
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Term
| Beta-Lactamase production |
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Definition
Children on Amoxicillin prophylaxis or frequent antibiotics are at highest risk;
Primary change in therapy: use an anti-Beta-Lactamase antibiotic |
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Term
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Definition
| MUST be treated w/ macrolides or tetracyclines |
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Term
| acetaminophen dosing for AOM |
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Definition
10-15 mg/kg/dose q4-8 hrs prn;
NO MORE than 6 doses OR <2600 mg/day |
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Term
| ibuprofen (Motrin or Advil) dosing for AOM |
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Definition
5-10 mg/kg/dose q6-8 hrs PRN;
Give w/ food; helps w/ pain but does not completely take it away |
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Term
| Antihistamines & Decongestants |
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Definition
| NOT SHOWN to be of benefit in tx of AOM |
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Term
| antipyrine/benzocaine (Auralgan or Tympangesic) |
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Definition
analgesic/anesthetic ear drops utilized for 1-2 days for mild pain;
use cautiously, will NOT cure condition;
- will completely mask pain, taking away a Sx that can be easily monitored |
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Term
| Step 1 - Determine if Observation Option is acceptable (age dependent) |
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Definition
< 6 months:
- Certain Diagnosis: antibacterial therapy;
- Uncertain Diagnosis: Antibacterial therapy;
6 months - 2 yrs:
- Certain Diagnosis: Antibacterial therapy;
- Uncertain Diagnosis: Antibacterial therapy if SEVERE ILLNESS, observation therapy if NON-SEVERE illness;
>2 yrs:
- Certain Diagnosis: Antibacterial therapy if SEVERE illness, observational therapy if NON-SEVERE;
- Uncertain Diagnosis: Observational therapy for 48-72 hrs |
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Term
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Definition
meets all 3 of following:
- rapid onset
- S/Sx of middle ear inflammation;
AND
- signs of middle ear effusion |
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Term
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Definition
moderate-severe otalgia
or
fever >39 C |
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Term
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Definition
Mild otalgia;
&
fever <39 C in past 24 hrs |
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Term
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Definition
INITIAL DRUG OF CHOICE;
Dose: 90 mg/kg/day divided BID to TID |
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Term
| Amoxicillin/clavulanic acid (Augmentin) |
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Definition
| If ESBLs are suspected, start on HIGH-DOSE: 90 mg/kg/day divided BID to TID |
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Term
| Pts at Risk for Treatment Failure |
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Definition
age <2 yrs;
age <6 months at 1st onset of AOM;
recurrent AOM;
bilateral disease;
receiving continuous antimicrobial therapy;
large group day care centers; |
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Term
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Definition
Dose: 90 mg/kg/day divided BID-TID
- considered 1st line for Tx Failure UNLESS pt has been started on it as 1st antibiotic |
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Term
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Definition
| lack of clinical response within 72 hrs |
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Term
| cefuroxime axetil (Ceftin), ceftriaxone (Rocephin), azithromycin (Zithromax) |
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Definition
| alternative options for Treatment Failure behind Augmentin |
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Term
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Definition
| deliberate puncture of tympanic membrane to allow for culture of fluid & decrease pressure/pain |
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Term
| Assume same organism & tx w/ different antibiotic |
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Definition
| for recurrent OM, if S/Sx occur within 1 month |
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Term
| Assume new infection & treat as such |
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Definition
| for recurrent OM, if S/Sx occur after 1 month |
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Term
| Myringotomy or Chemoprophylaxis |
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Definition
| for chronic OM, if >4 episodes of AOM in 6 months or >6 episodes in 12 months |
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Term
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Definition
use in pts who fail antibiotic thearpy or those w/ hearing loss;
- allows drainage of eustachian tube & middle ear;
- reduces recurrent episodes of AOM by 50% with an ear infection free period for 3 months |
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Term
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Definition
13-valent immunization against STREP PNEUMONIAE MENINGITIS!!!
- NOT for ear infection;
- may have effect on ear infections but DOES NOT PREVENT it OVERALL!!! |
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Term
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Definition
| infection of the external ear canal |
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Term
| Conditions that produce favorable environment for Otitis Externa |
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Definition
introduction of sharp object into ear canal (hair clip, paper clip, Q-Tip);
Introduction & accumulation of moisture in ear canal (i.e. Swimmer's Ear) |
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Term
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Definition
pruritis;
otalgia;
fullness;
throbbing pain;
hearing loss |
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Term
| Symptoms of Otitis Externa |
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Definition
edema;
erythema;
foul-smelling secretions;
cellulitis |
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Term
| Common Causative Organisms of Otitis Externa |
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Definition
Pseudomonas aeruginosa;
Staph. aureus |
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Term
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Definition
antibiotic & corticosteroid combination otic drops;
- corticosteroid decreases inflammation, allows Abx to access infection site;
- anti-inflammatory, antipruritic, vasoconstrictive activity;
- suspension is PREFERRED, but solution can be used; |
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Term
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Definition
neomycin SO4 3.3%, Colistin SO4 3 mg/ml, hydrocortisone 1%;
- used in tx of otitis externa |
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Term
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Definition
| Neomycin SO4 5 mg/mL, Polymixin-B SO4 100K U/mL, Hydrocortisone 1% |
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Term
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Definition
DO NOT INSERT ANYTHING INTO EAR - EVEN Q-TIPS!!!
If excessive ear wax:
- flush w/ warm water w/ ear bulb;
- if fails, use carbamide peroxide (DEBROX) - 5-10 gtts AU for 15 min BID to QID;
- if DEBROX fails, see MD; |
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Term
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Definition
| Similasan Ear Ache Relief (chamomila, mercurius solubiler, sulphur), Sweet Oil |
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