Otitis externa --> bacterial conjunctivitis?

[chameleonknight]

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Question for the demi-gods of the ocular region:

Is it possible for a patient with a mild case of bac. conjuctivitis to have developed that from a case of otitis externa?

Hope this isn't a completely stupid question......

Thanks.

 

[Andrew_Doan]

Question for the demi-gods of the ocular region:

Is it possible for a patient with a mild case of bac. conjuctivitis to have developed that from a case of otitis externa?

Hope this isn't a completely stupid question......

Thanks.

Sure.

The same common bugs that infect the ears also infect the eyes: H. flu, strep. pneumo., moraxella, and adenovirus.

Also, for otitis externa, I think pseudomonas is the common bug, which can also infect the eyes.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9041623

Conjunctivitis in infants and children.

Wald ER.

Pediatr Infect Dis J. 1997 Feb;16(2 Suppl):S17-20.

BACKGROUND: Acute bacterial conjunctivitis, chiefly affecting young children, is generally caused by one of three common pathogens, Haemophilus influenzae, Streptococcus pneumoniae and adenovirus. H. influenzae is the most prevalent causative organism. Some patients presenting initially with conjunctivitis subsequently develop acute otitis media, with H. influenzae the most common etiologic agent of what has been termed the "conjunctivitis-otitis" syndrome. Optimal treatment of acute conjunctivitis would result in a clinical and bacteriologic cure of the conjunctivitis and the prevention of the development of otitis media. Application of topical antimicrobials at 4- to 6-h intervals a day for 1 week to 10 days results in the resolution of the conjunctivitis. However, topical treatment is difficult to administer to toddlers and does not effectively reduce the potential for the development of otitis media. Compared with topical and placebo treatment, oral antibiotics effective against H. influenzae have proved to be most effective in preventing the otitis media associated with conjunctivitis. CONCLUSION: Acute bacterial conjunctivitis is a common disorder in children < 6 years of age. H. influenzae is the most common etiology of the "conjunctivitis-otitis syndrome." The optimal treatment for this condition is still being studied.

 

[chameleonknight]

Thanks. 😀

So depsite the vagueness of this study, would you go ahead and prescribe an oral antibiotic as well as the drops?

 

[Andrew_Doan]

If they only have conjunctivitis, then I only treat the eye manifestations. If they have both, then I will prescribe drops and oral antibiotics.