High environmental temperatures and trauma leads to a breech in the integrity of the ear canal skin (e.g. cotton buds, fingernails, hearing aids, ear plugs, paperclips, match sticks, mechanical removal of cerumen) (12). Host factors comprise anatomical wax and debris which accumulate and lead to moisture retention (e.g. a narrow ear canal, hairy ear canal). Absence or overproduction of cerumen leads to loss of the protective layer and moisture retention respectively. Chronic dermatological disease (e.g. atopic dermatitis, psoriasis, seborrhoeic dermatitis) is among host risk factors which may lead to OE. Atopic …show more content…
Bilateral symptoms (rare) 10. Frequently, a history of exposure to or activities in water (e.g. swimming, surfing, and kayaking) 11. Usually, a history of preceding ear trauma (e.g. forceful ear cleaning, use of cotton swabs, or water in the ear canal) 12. Exposure to local radiotherapy (3,27). Physical examination Findings vary between circumscript, diffuse and necrotizing OE. The key physical finding of OE is tenderness upon palpation of the tragus (anterior to ear canal) or application of traction to the pinna (the hallmark of diffuse AOE) (3). Examination reveals erythema, edema, and narrowing of the external auditory canal (EAC), and a purulent or serous discharge may be noted (see the image below) (21). Figure 2. Acute otitis externa. Ear canal is red and edematous, and discharge is present. Conductive hearing loss may be evident. Cellulitis of the face or neck or lymphadenopathy of the ipsilateral neck occurs in some patients (27). The tympanic membrane may be difficult to visualize and may be mildly inflamed, but it should be normally mobile on insufflations. Eczema of the pinna may be present. By definition, cranial nerve involvement (i.e. of cranial nerve VII and IX - XII) is not associated with simple OE. Fungal OE results in severe itching but typically causes less pain than bacterial OE does. A thick discharge that may be white or gray is often
Normocephalic atraumatic. Pupils equally round and reactive to light, extraocular motions intact. Oral cavity shows oropharynx clear but slightly dried mucosal membranes. TM (tympanic membranes) clear. Neck, supple. There is no thyromegaly, no JVD. No cervical supraclavicular, axillary, or inguinal lymphadenopathy.
Signs and symptoms to evaluate include, itching, burning, and tingling, as well as the tract of pain sensations. A complete physical examination and review of vital signs would be completed. Further diagnostic criteria include review of all underlying health conditions, paying particular attention to any diseases leading to immunosuppression, and all current medications (Cash & Glass, 2014). Diagnosis is typically completed based upon presentation and Laboratory conformation is not required, however viral cultures can confirm the diagnosis in cases of unusual presentation (Ferri,
Bill is a 79 year old patient living in a residential facility. After a recent physical therapy session he began experiencing pain on the left side of his head, as well as complaining of a headache. Although his vital signs showed to be normal, the doctor noticed exudate drainage leaking from his left ear. An ear culture was then taken with a swab and transported to the lab for further testing.
Head: normocephalic and atraumatic. Non-tender frontal and maxillary sinuses. Eyes: TMs slightly opaque with light reflex and landmarks present.
The function of the epidermis to prevent entry of pathogens is disturbed, which leads in dry skin. The dermatopathological signs associated with Atopic dermatitis include spongiosis, hyperkeratosis, exocytosis, parakeratosis, eosinophilis and lymphocytic infiltrates (Williams, 2005). People with the Atopic dermatitis condition produce immunoglobin E even with just trigger from low amounts of allergens. Rhinoconjunctivitis and asthma are some of the symptoms associated with Atopic dermatitis. In infancy, an individual may develop a desquamation that is yellow in color on the scalp (Darsow et al., 2010). The rashes spread to the face of the individual and later to the
Ears: External auditory canals clear, no cerumen. Tympanic membranes were intact no erythema, pearly gray in color, no discharge. Hearing grossly intact
Your health care provider may be able to diagnose an ear foreign body based on the information you provide, your symptoms, and a physical exam. Your health care provider may also perform tests, such as checking your hearing and ear pressure, to check for infection or other problems caused by the foreign body in your ear.
Dermatitis is a general term that describes an inflammation of the skin. There are different types of dermatitis, including seborrheic dermatitis and atopic dermatitis (eczema). Although the disorder can have many causes and occur in many forms, it usually involves swollen, reddened and itchy skin. (www.umm.edu/altmed/articles/dermatitis-000048.htm)
To begin, Tortora and Derrickson (2009) stated that, OM is “an acute infection of the middle ear caused mainly by bacteria and associated with infections of the nose and throat and bacteria passing into the auditory tube from the nasopharynx are the primary cause of middle ear infections” (p. 637). In his article titled, Genetics of
Necrotizing otitis externa is very severe and extensive infection of the ear canal. Almost invariably caused by Pseudomonas aeruginosa bacterium. However, other bacteria and fungi have been isolated. An infection extends into the deeper tissues adjacent to the EAC. It primarily occurs in adult patients who are immunocompromised (e.g. as a result of diabetes mellitus or AIDS) and is rarely described in children; it may result in cases of cellulitis and osteomyelitis (8).
I suggest you revisit your primary care doctor for a referral to an Ear/Nose/throat specialist and suggest the above to them for consideration and evaluation.
Thorax and Lungs: Lungs sound: clear. Symmetric chest expansion. Tactile fremitus: bilaterally equal. Respirations: 16. Breath sounds: clear. No resonance, tympani or consolidation present. 1:2 diameters. No wheezing or stridor. No history of lung disease. No chest pain, No wheezing or shortness of breath.
O. Dorsal right foot: mild erythema, no edema, full ROM, pedal pulse +3 brisk capillary pulses
Pneumocephalus is a rare presentation of pneumococcal meningitis. Very few cases have been reported in the literature. Pneumocephalus can arise from trauma, a congenital skull defect, iatrogenic, barotrauma, neurosurgery, post radiation necrosis and meningitis from gas producing organisms. Markham reported 295 cases of pneumocephalus in 1967, 74% was due to trauma, 13% neoplasm and 9% infection (1, 2). Pneumocephalus is usually asymptomatic but symptoms may vary from headache, vomiting, seizures and altered mental status. A large collection of air can behave like a space-occupying lesion causing intracranial hypertension leading to herniation (3, 4).
O: Right index; minimal bleeding, small laceration present at the dorsal DIP joint, Full ROM, tender with palpation; erythema and edema present, clean, minimal tension, minimal bleeding, NO FB, Surrounding intact skin