The dermatologic management of otitis externa.
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Disease Management↗
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Results for “Otitis Externa”
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Use of EMLA cream as an analgesic in the management of painful otitis externa.
A new application of EMLA cream is described. Relief of pain in otitis externa is difficult and systemic analgesics for this localized condition are often ineffective. Meticulous cleaning of the external auditory meatus is an essential step in the treatment. EMLA cream is an effective analgesic which can be used to relieve pain and anaesthetize the external auditory meatus to allow cleaning in patients with intact tympanic membranes.
Anesthetics, Local↗
Current medication in otitis externa.
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Humans↗
A modern therapeutic regimen for otitis externa.
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Humans↗
Effects of fatty acids on the growth and composition of Malassezia pachydermatis and their relevance to canine otitis externa.
Malassezia pachydermatis is one of the many infective agents involved in canine otitis externa. Two major phenotypes (large and small colony types), which had different fatty acid compositions, were found among strains of M pachydermatis isolated from canine ears or skin. The large-colony type contained palmitic, stearic, oleic and linoleic acids, whereas the small-colony type contained myristic, palmitic, stearic, linoleic acids and five other unidentified fatty acids. Exogenous saturated fatty acids in the medium had no effect on the growth of a large colony strain but oleic and linoleic acids were mycostatic. Adding fatty acids to the medium changed the fatty acid composition of the strain. Saturated fatty acids were incorporated as such into the cell, but the unsaturated fatty acids caused complex changes in composition, including the appearance of a new fatty acid. It is suggested that these changes in the fatty acid composition of M pachydermatis could explain the mycostatic effect of unsaturated fatty acids like oleic and linoleic acids at least in vitro.
Animals↗
Use of ticarcillin in the management of canine otitis externa complicated by Pseudomonas aeruginosa.
Twelve dogs were referred with purulent and proliferative otitis externa. Prior treatment included fluoroquinolones, glucocorticoids and polyvalent ear drops over seven days to five months. In all cases the vertical and horizontal ear canals were inflamed and thickened, with ruptured tympanic membranes in four cases. No abnormalities were seen on radiography of the osseous bullae. Numerous rod bacilli and degenerate neutrophils were seen on cytology. Pseudomonas aeruginosa resistant to fluoroquinolones and gentamicin was cultured in all cases. Treatment was initiated with 1 to 2 mg/kg prednisolone per os once daily, and a cleansing and drying ear cleaner followed by topical administration of injectable ticarcillin solution four times daily. Cases with ruptured tympanae also received 15 to 25 mg/kg ticarcillin three times daily intravenously until the membranes had healed. All cases were anaesthetised for repeated saline ear flushes until no further discharge was evident and no rods were seen on cytology. Topical ticarcillin and the ear cleaner were continued twice daily for 14 days after clinical resolution. The duration of treatment ranged from 14 to 36 days. Treatment was withdrawn in one case which developed a drug reaction. All other cases responded well with no adverse effects.
Animals↗
Otitis externa in the dog -- a clinical and microbiological study.
The effect on canine otitis externa of a topical preparation composed of Fucidin, Framycetin, Nystatin, and Prednisolone was evaluated in a clinical trial comprising 235 dog ears. Cases caused by parasites or foreign bodies and cases requiring systemic therapy were excluded. Swabs from these and an additional 434 affected ears were examined bacteriologically and the sensitivity to antibiotics of the bacteria isolated determined. The infection most frequently diagnosed was staphylococci plus yeasts (29 % of total material) followed by pure yeast-infections (19 %) and pure staphylococcus infections (16 %). Pseudomonas aeruginosa and/or Proteus mirabilis were found in 7 % of the ears, while no organisms could be isolated from 22 %. Sensitivity tests showed a satisfactory in vitro effect of Neomycin (Framycetin) on most of the bacteria commonly isolated, and a very good effect of Fucidin on the staphylococci. Approximately 91 % of the ears treated were clinically cured or improved very considerably; the relation between clinical response and type of infection is shown diagrammatically in Fig. 1. It was confirmed that infections with Ps. aeruginosa represent a special problem; the results of post-treatment sensitivity tests seem to suggest, however, that a longer or more intense course of treatment than the one used in the trial (two weeks) would provide the answer to this.
Animals↗
Otitis externa by Pseudomonas aeruginosa associated with whirlpools.
Over a period of about 1 year, otitis externa occurred in at least 300 visitors to a recreational park. The infections were associated with the presence of Pseudomonas aeruginosa in insufficiently chlorinated whirlpools.
Chlorine↗
[Malignant otitis externa (2 cases)].
Malignant external otitis is a progressive necrotizing otitis. It's a rare severe and evolutive clinical entities, old diabetics are the most victim. Pseudomonas aeruginosa is the bacteria responsible in the most cases. Prognostic vital can be affected, treatment must be energic, rapid and well adapted. The authors report two old diabetic women presenting a malignant external otitis and discuss etiopathogenic, physiopathologic, diagnosis and treatment of this illness.
Anti-Bacterial Agents↗
Antimicrobial susceptibility of staphylococci isolated from otitis externa in dogs.
Samples were obtained from 65 unmedicated adult dogs, processed for isolation of Staphylococcus species and tested for susceptibility to penicillin G, gentamicin, oxacillin, tetracycline, trimethoprim-sulphamethoxazole, streptomycin, ampicillin and rifampin. Forty-four isolates were obtained, which represents 67.7% of samples. Coagulase-negative species were most commonly found, and the most frequently isolated staphylococcus species were Staph. epidermidis and Staph. aureus. Other species, such as Staph. simulans, Staph. haemolyticus, Staph. saprophyticus and Staph. intermedius were also isolated. Resistance to antibiotics was frequently observed, with 90.9% of the isolates showing resistance to at least one drug. The most active antimicrobial agents against staphylococci isolated from otitis externa of dogs were rifampin and oxacillin. Multidrug resistance was a common finding, and one strain of Staph. haemolyticus species, was resistant to all tested antimicrobial agents. Resistance to three or more different drugs was a common finding, observed in 16 strains (36.4%) of both coagulase-positive and coagulase-negative staphylococci. This study highlights the emergence of cases of otitis externa determined by coagulase-negative staphylococcus strains and once more emphasizes the need for bacterial culture with species identification and susceptibility testing of swab specimens from the ear canal in order to choose appropriate antimicrobial agents.
Animals↗
[Bacterial and mycotic flora in otitis externa].
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Humans↗
Otitis externa: are we giving adequate care?
A series of 26 patients with diagnosis of otitis externa were given treatment consisting of either drops only or manual aural toilet followed by aural drops. The efficacy in terms of resolution of symptoms and clinical signs were compared. In all but the most minor of cases, adequate curative treatment had to consist of complete aural toilet as well as aural drops. It was also shown that without aural toilet and visualization of the tympanum, more serious middle ear pathology could be missed.This study indicates that unless the patient is given the opportunity to have his ears properly cleaned, the general practitioner may not only be giving inadequate and ineffective treatment, but he may also be missing serious ear disease.
Combined Modality Therapy↗
Two ear problems you may not need to refer. Otitis externa and bullous myringitis.
Primary care physicians are being forced to broaden the scope of their practice because of the financial restraints placed on them by managed care. Common otologic conditions such as otitis externa and bullous myringitis, which are often referred to otolaryngologists, can be promptly diagnosed and treated by primary care physicians. Referral to a subspecialist is indicated when symptoms persist despite treatment and when the cause of ear pain remains unexplained after thorough evaluation.
Acute Disease↗
An outbreak of Pseudomonas aeruginosa pneumonia and bloodstream infection associated with intermittent otitis externa in a healthcare worker.
OBJECTIVES: To investigate an outbreak of Pseudomonas aeruginosa pneumonia and bloodstream infection among four neonates, determine risk factors for infection, and implement preventive strategies. DESIGN: Retrospective case finding; prospective surveillance cultures of patients, personnel, and environmental sites; molecular typing by pulsed-field gel electrophoresis; and a matched case-control study. PATIENTS AND SETTING: Neonates in the level-III neonatal intensive care unit of a tertiary-care pediatric institution. INTERVENTIONS: Cohorting of patients with positive results for P. aeruginosa, work restrictions for staff with positive results, implementation of an alcohol-based hand product, review of infection control policies and procedures, and closure of the unit until completion of the investigation. RESULTS: Seven (4%) of 190 environmental cultures and 5 (3%) of 178 cultures of individual healthcare workers' hands grew P. aeruginosa. All four outbreak isolates and one previous bloodstream isolate were genotypically identical, as were the P. aeruginosa isolates from the hands and external auditory canal of a healthcare worker with intermittent otitis externa. Four of 5 case-patients versus 5 of 15 matched control-patients had been cared for by this healthcare worker (P = .05). The healthcare worker was treated and no further cases occurred. CONCLUSIONS: These findings suggest that a healthcare worker with intermittent otitis externa may have caused this cluster of fatal P. aeruginosa infections, adding the external ear to the list of colonized body sites that may serve as a source of potentially pathogenic organisms.
Bacteremia↗
Septic arthritis of the temporomandibular joint complicating otitis externa.
Septic arthritis of the temporomandibular joint is an uncommon condition. As a complication of otitis externa it is extremely rare. Two cases are reported and the aetiology, diagnosis and management discussed.
Aged↗
Malignant otitis externa in an infant with selective IgA deficiency: a case report.
The occurrence of malignant otitis externa (MOE) in infancy is rare. We report a case of MOE in a neonate who was later identified to have selective IgA deficiency. She was successfully treated with oral ciprofloxacin, but developed external auditory canal stenosis, a deformed pinna, persistent facial nerve palsy, temporal bone erosion and hearing loss. No cases of MOE in selective IgA deficiency have been reported in literature. This is also the first report on the use of ciprofloxacin in infants with MOE.
Child, Preschool↗