Ear pain resident survival guide (pediatrics): Difference between revisions

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==Causes==
==Causes==
===Life Threatening Causes<ref name="pmid29365233">{{cite journal| author=Earwood JS, Rogers TS, Rathjen NA| title=Ear Pain: Diagnosing Common and Uncommon Causes. | journal=Am Fam Physician | year= 2018 | volume= 97 | issue= 1 | pages= 20-27 | pmid=29365233 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29365233  }}</ref>===
===Life Threatening Causes===
Ear pain is not life threatening
Ear pain is not life threatening


Common Causes
== Common Causes ==
primary otalgia  
primary otalgia <ref name="pmid20736106">{{cite journal| author=Neilan RE, Roland PS| title=Otalgia. | journal=Med Clin North Am | year= 2010 | volume= 94 | issue= 5 | pages= 961-71 | pmid=20736106 | doi=10.1016/j.mcna.2010.05.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20736106  }}</ref>


====== Otitis externa <ref name="pmid16138712">{{cite journal| author=Wang MC, Liu CY, Shiao AS, Wang T| title=Ear problems in swimmers. | journal=J Chin Med Assoc | year= 2005 | volume= 68 | issue= 8 | pages= 347-52 | pmid=16138712 | doi=10.1016/S1726-4901(09)70174-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16138712 }}</ref> (swimmer's ear)<ref name="pmid231986732">{{cite journal| author=Schaefer P, Baugh RF| title=Acute otitis externa: an update. | journal=Am Fam Physician | year= 2012 | volume= 86 | issue= 11 | pages= 1055-61 | pmid=23198673 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23198673  }}</ref>======
====== Otitis externa  (swimmer's ear)======


*Pseudomonas.<ref name="pmid10809975">{{cite journal| author=Zichichi L, Asta G, Noto G| title=Pseudomonas aeruginosa folliculitis after shower/bath exposure. | journal=Int J Dermatol | year= 2000 | volume= 39 | issue= 4 | pages= 270-3 | pmid=10809975 | doi=10.1046/j.1365-4362.2000.00931.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10809975  }}</ref>
*Pseudomonas.
*Staph aureus.
*Staph aureus.


==== Mechanical obstruction ====
==== Mechanical obstruction ====
*Earwax<ref name="pmid28045632">{{cite journal| author=Schwartz SR, Magit AE, Rosenfeld RM, Ballachanda BB, Hackell JM, Krouse HJ | display-authors=etal| title=Clinical Practice Guideline (Update): Earwax (Cerumen Impaction) Executive Summary | journal=Otolaryngol Head Neck Surg | year= 2017 | volume= 156 | issue= 1 | pages= 14-29 | pmid=28045632 | doi=10.1177/0194599816678832 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28045632  }} </ref>
*Earwax
*Foreign body<ref name="pmid23601480">{{cite journal| author=Conover K| title=Earache. | journal=Emerg Med Clin North Am | year= 2013 | volume= 31 | issue= 2 | pages= 413-42 | pmid=23601480 | doi=10.1016/j.emc.2013.02.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23601480  }} </ref>
*Foreign body


Otitis media<ref name="pmid2732519">{{cite journal| author=Teele DW, Klein JO, Rosner B| title=Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study. | journal=J Infect Dis | year= 1989 | volume= 160 | issue= 1 | pages= 83-94 | pmid=2732519 | doi=10.1093/infdis/160.1.83 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2732519  }} </ref><ref name="pmid28707578">{{cite journal| author=Leung AKC, Wong AHC| title=Acute Otitis Media in Children. | journal=Recent Pat Inflamm Allergy Drug Discov | year= 2017 | volume= 11 | issue= 1 | pages= 32-40 | pmid=28707578 | doi=10.2174/1874609810666170712145332 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28707578  }} </ref><ref name="pmid24453496" />
Otitis media<ref name="pmid24453496" />
*common cold or upper respiratory tract infection <ref name="pmid21918146">{{cite journal| author=Worrall G| title=Acute earache. | journal=Can Fam Physician | year= 2011 | volume= 57 | issue= 9 | pages= 1019-21, e320-2 | pmid=21918146 | doi= | pmc=3173423 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21918146  }} </ref>
*common cold or upper respiratory tract infection  


*Streptococcus pneumoniae
*Streptococcus pneumoniae
*nontypable Haemophilus influenzae
*nontypable Haemophilus influenzae
*Moraxella catarrhalis
*Moraxella catarrhalis
Otitis media with effusion<ref name="pmid10944048">{{cite journal| author=Kubba H, Pearson JP, Birchall JP| title=The aetiology of otitis media with effusion: a review. | journal=Clin Otolaryngol Allied Sci | year= 2000 | volume= 25 | issue= 3 | pages= 181-94 | pmid=10944048 | doi=10.1046/j.1365-2273.2000.00350.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10944048  }} </ref><ref name="pmid24453496">{{cite journal| author=Qureishi A, Lee Y, Belfield K, Birchall JP, Daniel M| title=Update on otitis media - prevention and treatment. | journal=Infect Drug Resist | year= 2014 | volume= 7 | issue=  | pages= 15-24 | pmid=24453496 | doi=10.2147/IDR.S39637 | pmc=3894142 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24453496  }}</ref><ref name="pmid8229477">{{cite journal| author=Owen MJ, Baldwin CD, Swank PR, Pannu AK, Johnson DL, Howie VM| title=Relation of infant feeding practices, cigarette smoke exposure, and group child care to the onset and duration of otitis media with effusion in the first two years of life. | journal=J Pediatr | year= 1993 | volume= 123 | issue= 5 | pages= 702-11 | pmid=8229477 | doi=10.1016/s0022-3476(05)80843-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8229477  }}</ref>
Otitis media with effusion


*Enter into group child care(Amounts of time spent)
*Enter into group child care(Amounts of time spent)
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=== Truma ===
=== Truma ===


* Air travel<ref name="pmid25599243">{{cite journal| author=Wright T| title=Middle-ear pain and trauma during air travel. | journal=BMJ Clin Evid | year= 2015 | volume= 2015 | issue=  | pages=  | pmid=25599243 | doi= | pmc=4298289 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25599243  }} </ref>
* Air travel
=== secondary otalgia<ref name="pmid20736106" /><ref name="pmid29365233" />===
=== secondary otalgia<ref name="pmid20736106" /><ref name="pmid29365233" />===


==== Refered ear pain====
==== Refered ear pain====


* Tonsillitis and Tonsillectomy<ref name="pmid30798778">{{cite journal| author=Mitchell RB, Archer SM, Ishman SL, Rosenfeld RM, Coles S, Finestone SA | display-authors=etal| title=Clinical Practice Guideline: Tonsillectomy in Children (Update). | journal=Otolaryngol Head Neck Surg | year= 2019 | volume= 160 | issue= 1_suppl | pages= S1-S42 | pmid=30798778 | doi=10.1177/0194599818801757 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30798778  }}</ref>
* Tonsillitis and Tonsillectomy


* Toothaches.  
* Toothaches.  
Line 68: Line 67:
* Mumps  
* Mumps  
* dental infections  
* dental infections  
* Temporomandibular joint disorder (TMJ) <ref name="pmid25822556">{{cite journal| author=Gauer RL, Semidey MJ| title=Diagnosis and treatment of temporomandibular disorders. | journal=Am Fam Physician | year= 2015 | volume= 91 | issue= 6 | pages= 378-86 | pmid=25822556 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25822556  }} </ref>
* Temporomandibular joint disorder (TMJ)  


==FIRE: Focused Initial Rapid Evaluation==  
==FIRE: Focused Initial Rapid Evaluation==  
The first step when the child come at hospital with ear pain for examination by otoscopy.  
The first step when the child come at hospital with ear pain for examination by otoscopy.  
'''Ear pain'''<ref name="pmid18350760">{{cite journal| author=Ely JW, Hansen MR, Clark EC| title=Diagnosis of ear pain. | journal=Am Fam Physician | year= 2008 | volume= 77 | issue= 5 | pages= 621-8 | pmid=18350760 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18350760  }} </ref>
'''Ear pain'''
* Abnormal ear examination(otoscopy).
* Abnormal ear examination(otoscopy).
** primary otalgia.
** primary otalgia.

Revision as of 15:33, 20 August 2020


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Ear pain resident survival guide (pediatrics) Microchapters
Overview
Causes
FIRE
Diagnosis
Treatment
Do's
Don'ts

Overview

This section provides a short and straight to the point overview of the disease or symptom. The first sentence of the overview must contain the name of the disease.

Causes

Life Threatening Causes

Ear pain is not life threatening

Common Causes

primary otalgia

Otitis externa (swimmer's ear)
  • Pseudomonas.
  • Staph aureus.

Mechanical obstruction

  • Earwax
  • Foreign body

Otitis media[1]

  • common cold or upper respiratory tract infection
  • Streptococcus pneumoniae
  • nontypable Haemophilus influenzae
  • Moraxella catarrhalis

Otitis media with effusion

  • Enter into group child care(Amounts of time spent)
  • Exposure of smoking
  • Peroid of breastfeeding

Truma

  • Air travel

secondary otalgia[2][3]

Refered ear pain

  • Tonsillitis and Tonsillectomy
  • Toothaches.
  • Sorethroat.
  • Mumps
  • dental infections
  • Temporomandibular joint disorder (TMJ)

FIRE: Focused Initial Rapid Evaluation

The first step when the child come at hospital with ear pain for examination by otoscopy. Ear pain

  • Abnormal ear examination(otoscopy).
    • primary otalgia.
  • Normal ear examination(otoscopy).
    • secondary otalgia.
  • imaging studies.

IF Diagnosis is not clear from the history and physical examination.

Complete Diagnostic Approach

Shown below is an algorithm summarizing the diagnosis of [[disease name]] according the the [...] guidelines.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Treatment

Shown below is an algorithm summarizing the treatment of [[disease name]] according the the [...] guidelines.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Do's

  • The content in this section is in bullet points.

Don'ts

  • The content in this section is in bullet points.

DO NOT block any drainage coming from the ear. DO NOT try to clean or wash the inside of the ear canal. DO NOT put any liquid into the ear. DO NOT attempt to remove the object by probing with a cotton swab, a pin, or any other tool. To do so will risk pushing the object farther into the ear and damaging the middle ear. DO NOT reach inside the ear canal with tweezers.

References

  1. ↑
  2. ↑
  3. ↑


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