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Cesar M. Mendoza, Jr., RMT, M. Bio. Ed.
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General Information:
There are three pathways for pathogens to enter
the ear
Through the eustachian (auditory)tube, from
the throat and nasopharynx
From the external ear
By the blood or lymph
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Usually bacteria are trapped in the middle ear when a
bacterial infection in the throat and nasopharynx causes
the euctachian tube to closeAnaerobic condition in the middle ear, allowing
obligate and facultative anaerobes to grow and cause
pressure on the tympanic membrane (eardrum)
Viral infections and allergies may also close to
eustachian tube
OTITIS MEDIA infection of the middle ear
OTITIS EXTERNA- infection of the outer ear canal
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ANATOMY OF THE EAR
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Viral and Bacterial Ear InfectionDisease
Otitis Externa, External Otitis, Ear Canal Infection,Swimmers Canal.
Infection of the ear canal with itching Pain
A maldorous discharge
Tenderness, redness, swelling, and impaired hearing
Most common during the summer swimming season Swimmers ear because it often results from swimming in
water contaminated with Pseudomas aeruginosa
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EAR CANAL INFECTION
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Otitis Media, Middle ear InfectionComplication of the common cold.
Persistent and severe earache
Temporary hearing loss
Bulging of the eardrum (tympanic membrane)
Nausea, vomiting diarrhea, and fever in young children; may
rupture of the ear drum, bloody discharge and then pus from the air.
SEVERE COMPLICATIONS
Including bone infection,
permanent hearing loss and meningitis mat occur
Most common in young children (between 3 mons and 3 years of
age)
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Normal Membrane
Opaque withInflammation
Bulging Membrane
Chronic Inflammation Late, Severe OMResolving Infection
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Additional Information
Etiologic Agent:
Escherichia coli
pseudomonas aeruginosa
proteus vulgaris
Staphylococcus
rarely by a fungus, such as aspergillus
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Mode of Transmission:Contaminated swimming pool
Indigenous microflora; articles inserted in ear canal for
cleaning out debris and wax
Diagnosis:
Material from the infected ear canal should be sent to the
microbiology laboratory for culture and susceptability
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Etiologic Agent:Otitis media may be caused by bacteria or viruses
3 most common causes are
Streptococcus pneumoniae (a gram positive diplococcus )
Haemophilus influenzae (a gram positive diplococcus)
Less common bacterial causes include streptococcus
pyogens and staphylococcus aureus
Viral causes include measles virus, Para influenza virus,and respiratory syncytial virus (RSV)
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Mode of Transmission:
Probably not communicable
Diagnosis:If there is a discharge from the ear, a sample should be
sent to microbiology laboratory for C&S
B- lactamase testing should be performed on isolates ofH. influenzae and S. pneumoniae
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Swimmer's Ear Overview Swimmer's ear (also called otitis externa) is a painful condition of
the visible or outer portion of the ear and ear canal (outer ear).The ear canal is a cylinder-shaped structure that extends from the
outer part of the ear, above the ear lobe, all the way to the
eardrum (tympanic membrane). The typical size of the canal is
about 2.5 centimeters in length and 7-9 millimeters in width
Swimmer's Ear Causes The skin lining the ear canal and outer ear serves as a barrier
against infection from bacteria and fungi. The ear is protected
against infection because the lining is slightly acidic. The lining isalso a physical barrier that protects against excessive moisture.
Any break in the skin lining can lead to infection, allowing
bacteria or fungi to invade the outer ear.
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The barrier can become broken and lead to aninfection in the following ways
When you attempt to clean your ears with cotton-tipped swabs or otherobjects inserted in the ear, the skin lining of the ear canal may break. Thiscan also remove the protective ear was from the ear canal.
Excessive moisture in the ear canal from showering or swimming alsoalters the acidic environment of the ear canal, and allows for the invasionof bacteria or fungi. This is the reason this condition happens mainly in
the summer months, and hence, is called swimmer's ear. Ear plugs, hearing aids, headphones, and other devices that may be
inserted into the ear canal may increase the risk of swimmer's ear.
Chemicals such as hair dyes, bleaches, and shampoos may irritate the earcanal and alter its protective properties. An infection can result.
Generally, any inflammation of the outer ear canal, such as infections,allergies, or skin conditions, can lead to swimmer's ear.
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Swimmer's Ear Symptoms The most common symptom of swimmer's ear is pain. Pain
gradually begins over a day or two. The pain almost alwaysinvolves only one ear. The pain is especially intense when theear is touched or pulled.
The ear canal may itch.
The outer ear may be red, and in severe cases the ear canal
may be swollen shut. The ear may drain. This drainage may be clear, white,
yellow, or sometimes bloody and foul smelling. Some fluidmay crust at the opening of the ear canal.
With severe swelling or drainage, the person may have
trouble hearing. Ringing in the ear (tinnitis)and dizziness or vertigo may also
be present.
Fever is generally not present. If there is a fever, it is notusually high.
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Swimmer's Ear Treatment
Avoid any further trauma to the ear. Do not attempt to remove visible
debris or drainage from the ear.
Apply heat to the ear to control the pain at home. Warmth from a
heating pad may provide some relief. Fold a towel in half and place it
between the heating pad and the ear. Limit the use of the heating pad
to short periods. The folded towel should help prevent accidental burning
of the ear if the heating pad is too hot.
If the person is not allergic to these, try a variety of over-the-counter pain
medicines such as aspirin, ibuprofen (such as Advil), or acetaminophen
(such as Tylenol).
Nonprescription ear drops are not usually strong enough to cure the
problem. Such drops are useful only for prevention of episodes after
water exposure. Ear drops used for treatment of the condition must be
obtained with a prescription from a doctor.
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Prevention Use of shower caps while bathing and earplugs while swimming will help
keep water out of the ear canal
The best earplugs are often soft balls of special wax. The wax can bepurchased at most pharmacies. Simply roll a small ball of wax in yourhands and press it into the outer ear
Homemade ear drops also help prevent swimmer's ear after waterexposure.
Make a 50:50 mixture of white vinegar and rubbing alcohol for use afterswimming or exposure to water. Apply 3-4 drops in each ear canal afterswimming. This helps dry the canal and maintain the acidic environmentof the ear canal.
Avoid placing objects in the ear that can scrape or scratch the skin of thecanal because this may cause an infection.
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