Tintinalli 9th. p1560~1566 & Schwartz 3rd, p2177~2183
D1. Bullous Myringitis
(1) Otitis media와 동일한 typical organism이 원인
① S. pneumoniae, H. influenzae, M. catarrhalis
② Not Mycoplasma pneumonia
(2) Severe otalgia, deep EAC나 TM에 bulla formation
(3) Treatment
① Amoxicillin (2nd line augmentin, cefdinir, cefpodoxime)
② 72시간 동안 반응 없을 시 augmentin, levofloxacin, moxifloxacin
D2. Supprative Otitis Media
(1) 원인균 : S. pneumonia, H. influenza
(2) Treatment : Amoxicillin, or bactrim, azithromycin, cefuroxime (2nd generation)
D3. Furunculosis of EEC
(1) 원인균 : Staphylococci
(2) Treatment : Dicloxacillin, clindamycin, first or 2nd generation cephalosporin
D4. Otitis Externa
(1) 원인균 : Pseudomonas aeruginosa, Stap. aureus, Enterobacteriaceae, Proteus species
(2) 면역저하 환자에서는 fungus (Aspergillus or Candida)
(3) Treatment
① Cleansing of the external auditory canal
② Acidifying agents, topical antimicrobials (acidifying agent는 TM 손상 시 금기)
: Topical agents - ofloxacin, ciprofloxacin, acetic acid
③ Steroid 는 optional
④ Oral antibiotics는 fever 동반되거나 malignant Otitis externa로 진행 시 사용
D5. Post-Traumatic Perichondritis
(1) 원인균 : Pseudomonas, S. aureus
(2) Treatment : Antipseudomonal penicillin & aminoglycoside
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Some of Common topical otic preparations
