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n CME : Your SA Journal of CPD - Common infections of the ear : main topic

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Abstract

The tragus, the tortuous S-shape course of the ear canal and the obliquity of the tympanic membrane offer protection to the delicate middle ear structures. &lt;br&gt; The underlying pathophysiology of otitis externa is maceration of the skin of the external ear canal. The hair and lipid content of cerumen renders the ear canal impervious to water, thus preventing infection. &lt;br&gt; Wax is protective and should not be removed. It contains lysozyme and immunoglobulins that inhibit the growth of bacteria and fungi. &lt;br&gt; Four types of otitis externa are recognised, non-infective, fungal, bacterial and diabetic. &lt;br&gt; Diabetic otitis externa is a life-threatening condition and in order to prevent mortality early diagnosis and treatment with intravenous triple antibiotics is mandatory. &lt;br&gt; The causative organisms in acute otitis media are <I>Haemophilus influenzae&lt;/I&gt; and streptococcus and the treatment of choice for children living in rural areas is procaine penicillin and amoxicillin and for those living in urban areas either Augmentin or cefuroxime. &lt;br&gt; Two types of chronic otitis media are recognised - cholesteatomatous and non-cholesteatomatous chronic otitis media. &lt;br&gt; Cholesteatomatous chronic otitis media is regarded a serious condition because cholesteatoma releases proteolytic enzymes that cause bone resorption with extension of infection into the bony labyrinth, facial canal and intracranially. &lt;br&gt; Chronic otitis is regarded as a lifethreatening condition because of its association with intracranial complications, which carries a mortality of 10 - 30%. &lt;br&gt; Tuberculous otitis media is common in children. The golden rule is that any child who presents with ipisilateral otorrhoea and lower motor neuron VII cranial nerve palsy has tuberculous otitis media until proven otherwise.

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/content/m_cme/22/4/EJC62755
2004-04-01
2016-12-08
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