Description: jurnal mengenai akut otitis eksterna dari Candian Pediatric Society Acute otitis externa, also known as ‘swimmer’s ear’, is a common disease of. torhinolary. fO. OPUS JOURNALS. ng o. Clinics Clinics of Otorhinolaryngology. ology. Clin of Otorhinolaryngology() Research Article. Malignant. Paediatr Child Health Vol 18 No 2 February Acute otitis externa (AOE), also known as âswimmerâs earâ, is a common disease of.
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Published on Feb View 21 Download 0. It is defined by diffuse inflammation of the external ear canal. Primarily a disease of children over two years of age, it is commonly associ-ated with swimming.
Local defence mechanisms become impaired by prolonged ear canal wetness. Skin desquamation leads to micro-scopic fissures that provide a portal of entry for infecting organ-isms.
Ear piercing may lead to infection of the pinna. Several evidence-based clinical practice guidelines and reviews have been published. Jurnql patients with AOE have discharge from their ear canal.
A distinguishing sign of AOE from acute otitis media with otorrhea is the finding of tenderness of jjurnal tragus when pushed and of the pinna when pulled in AOE. These signs are clas-sically described as out of proportion to the degree of inflammation observed.
On direct otoscopy, the jurnap is edematous and ery-thematous and may be associated with surrounding cellulitis. Elements to consider in the diagnosis of diffuse eksternna otitis externa: Rapid onset generally within 48 h in the past three weeksAND2. The twomostcommonly isolated organisms are Pseudomonas aeruginosa and Staphylococcus aureus. Other Gram-negative bacteria are less common. Rare fungal infections have been described with Aspergillus species and Candida species.
Swabs should be taken only in unresponsive or severe cases. TheCochrane publication reviewed 19 studies that included participants. Overall, only three of the 19 studies were con-sidered to be of high quality and only two were performed in a pri-marycaresetting.
AllrightsreservedCps Hui; Canadian paediatric society, infectious Diseases and immunization Committee. Acute otitis externa, also known as swimmers ear, is a common dis-ease of children, adolescents and adults. While chronic eksherna otitis media or acute otitis media with tympanostomy tubes or a perfo-ration can cause acute otitis externa, both the infecting organisms and management protocol are different.
Acute otitis externa
This practice point focuses solely on managing acute otitis externa, without otitiss otitis media, tym-panostomy tubes or a perforation being present. Acute otitis externa; Swimmers earlotite externe aiguLotite externe aigu, ou otite du baigneur, est une maladie courante chez les enfants, les adolescents et les adultes.
Lotite moyenne suppurative chronique et lotite moyenne aigu corrige par des tubes de tympanostomie ou accompagne dune perforation peuvent tre responsables dune otite externe aigu, mais tant les organismes infectieux que le protocole de prise en charge diffrent. Le prsent point de pratique porte exclusivement sur la prise en charge de lotite externe aigu sans prsence concomitante dotite moyenne aigu, de tubes de tympanostomie ou eksteerna perforation.
No randomized control trials have been published comparing topical to systemic antimicrobials. Topical acidifying solutions eg, Buro-Sol have also been shown to be equally effective as topical antimicrobials in clinical cure rates at one week, but inferior in clinical and microbiological cure at two to three weeks. Topical antisepticssuchasalcohol,gentianviolet,m-Cresylacetate,thi-merosal and thymol have been shown in small studies to be equally effective as topical antimicrobials but are not specifically marketed inCanadafortreatmentofAOE.
For treating mild-to-moderate acute otitis externa, the follow-ing steps are recommended: First line therapy for mild-to-moderate AOE should be a topical antibiotic with or without topical steroids for seven to 10 days.
Adequate pain control for mild-to-moderate AOE can be achieved with systemic acetaminophen, nonsteroidal anti-inflammatory medications or oral opioid preparations. Topical steroid preparations have had mixed effects on hastening pain relief in clinical trials and cannot be recommended as monotherapy. If the clinician cannot see the ear canal, an expandable wick can be placed to decrease canal edema and facilitate topical medication delivery.
Ear candling has been shown to have no efficacy and can be harmful. This invasive infection of the cartilage and bone jurnao the canal and external ear may present with facial nerve palsy and eksrerna as a prominent symptom.
Imaging with a computed tomog-raphy or magnetic resonance imaging scan may be needed to con-firm the clinical diagnosis.
Some experts recommend simple tech-niques for keeping water out of the ears eg, inserting a soft, mal-leable plug into the auricle to block entry to the ear canal or removing water from the ears ekstegna swimming by positioning or shaking the head, or by using a hair dryer on a low setting. Others advise avoiding cotton swabs because they might impact cerumen.
Daily prophylaxis with alcohol or acidic drops during at-riskactivitieshasalsobeensuggestedbutnotstudied. Usinghard earplugs should be avoided because they can cause trauma, and the use of custom ear canal molds and tight swim caps remains controversial.
Solution may be applied by saturating a gauze or cotton wick which may be left in the canal for 24 h to 48 h, keeping the wick otitjs by adding a few drops of solution as required. Charles PS Hui MDThe recommendations in this document do not indicate an exclusive course of treatment or procedure to be followed.
Variations, taking into account indi-vidualcircumstances,maybeappropriate. Arch Otolaryngol ;99 1: Pseudomonas aeruginosa infection of the auricular cartilage caused by high ear piercing: OutbreakofPseudomonas aeruginosa infections caused by commercial piercing of upper ear cartilage.
Am Fam Physician ;74 9: Microbiology of acute otitis externa. Systematicreview of topical antimicrobial therapy for acute otitis externa. Clinicalcomparisonofanantibioticsointmentaloneorincombination with hydrocortisone acetate. Eur Arch Otorhinolaryngol ; 9: Clinicalefficacyof three common treatments in acute otitis externa in primary care: Lancet Infect Dis ;4 1: Rekomendasi antibiotik lini pertama adalah clavulanateamoxicillin- Documents.
Acute otitis externa
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