Eye and Ear infections

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Eye and Ear infections
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Ear infections
tympanic membrane
Otitis externa
Otitis media
Exogenous organisms via external auditory canal
Endogenous organisms via eustachian tube
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Otitis media - Infection of inner and middle ear

• Primarily a disease of children (1-3)
• Nasopharyngeal organisms via eustachian tube and
  possibly blood borne. (H. influenzae, Strep
  pneumoniae)
• Risk factors - LOSS of middle ear ventilation
• - anatomic
• - recent / concurrent viral URTI
• Symptoms - earache, irritability, hearing loss
• - fever, purulent ear discharge.

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Otitis media

• Complications - perforation and discharge
• - recurrence (hearing loss, learning deficit)
• Management - antibiotic therapy
• Prevention - social / hygiene
• - vaccination (indirect benefit)
• - Grommets

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Otitis externa - infection of outer ear

• Usually exogenous organisms
• Symptoms ear ache, hearing loss, itch
• Predisposing factors
• moisture - source of organism
• - rate of growth
• - swimmers / tropical ear
• trauma - break surface defences
• - reservoir / vehicle

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Otitis externa

• Organisms - Pseudomonas aeruginosa
• - Staphylococcus aureus
• - Aspergillus spp.
• Treatment - oral antibiotics NO!
• - topical broad spectrum
• (thick drops or wicks)
• - cotricosteroids
• Prevention - avoid predisposing events.
• ( post swim drops, blue tack, ear NO GO zone)

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Eye infections

• Conjunctivitis - mucous membrane lining.
• Keratitis - cornea.
• Minimal / no normal flora
• Host defenses - chemical (tears, lysozyme)
• - blinking, keratin
• Risk factors - large inoculum
• - blocked tear duct
• - trauma

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Conjunctivitis

• Sticky eye, itch, redness, irritation.
• Primary bacterial
• Common organisms - nasopharyngeal bacteria
• - auto-inoculation
• Viral conjunctivitis
• Usually adenovirus (Exogenous)
• Highly contagious (person to person, pools)
• Usually self limiting, occ haemorrhagic

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Chlamydial conjunctivitis

• One organism, two types and two diseases
• Inclusion disease
• Acute disease
• Organisms of genital type / reservoir
• Self inoculation in adults
• Maternal source in neonates

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Trachoma

• A chronic disease (10 15 yrs) , with non
  genital organisms.
• Person to person transmission (flies!)
• Recurrent infection and hypersensitivity,
  secondary bacterial infection, inflammation,
  scarring, abraded cornea, opacity and blindness.
• Leading cause of blindness worlwide.
• Prevention is social clean water, less crowding.

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Neonatal conjunctivitis

• NOT the usual suspects
• Blocked tear ducts.
• Blocked tear ducts S. aureus.
• OR possibly, maternal genital infection.
• Gonorrhoea, Chlamydia or herpes.

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Miscellaneous

• Stye - S. aureus folliculitis of eyelash
• Fungal keratitis - high exposure, low infection
• - trauma (splinter, contact lens)
• - slow disease
• - difficult to diagnose and treat.
• Amoebic keratitis - remarkable symbiotic
  infection
• - amoebae bacteria trauma.
• - RARE infection good story.
• LOA LOA - nightmare material