Otitis Media with Effusion |
- Clear or serous ear discharge
- Hearing loss, ear fullness
- No significant ear pain
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- Otoscopy shows fluid behind the tympanic membrane
- Tympanometry to assess middle ear pressure
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- Observation (self-limiting in many cases)
- Myringotomy with tube placement for chronic cases
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Acute Otitis Media with Tympanic Membrane Rupture |
- Purulent ear discharge following ear pain
- Reduced pain after rupture
- Fever, irritability (especially in children)
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- Otoscopy reveals perforation of the tympanic membrane with purulent discharge
- Culture of ear discharge if necessary
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- Oral antibiotics (e.g., amoxicillin) for bacterial infection
- Topical antibiotic ear drops if needed
- Monitor for tympanic membrane healing
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Chronic Suppurative Otitis Media |
- Persistent, foul-smelling ear discharge
- Hearing loss
- Perforated tympanic membrane
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- Otoscopy shows perforation with ongoing discharge
- CT scan of the temporal bone if cholesteatoma is suspected
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- Topical antibiotics (e.g., ciprofloxacin drops)
- Surgical repair (tympanoplasty) if necessary
- Regular cleaning of the ear canal (aural toilet)
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Otitis Externa (Swimmer's Ear) |
- Ear pain, discharge, itching
- External ear canal is inflamed and swollen
- Watery, sometimes purulent discharge
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- Otoscopy reveals inflammation and debris in the ear canal
- Swab for culture if discharge is present
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- Topical antibiotic ear drops (e.g., ciprofloxacin)
- Topical corticosteroids to reduce inflammation
- Aural toilet (cleaning of the ear canal by a healthcare provider)
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Acute or Chronic Sinusitis |
- Thick, purulent nasal discharge
- Facial pain/pressure, nasal congestion
- Postnasal drip, cough
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- Clinical examination (nasal endoscopy if needed)
- CT scan of the sinuses in chronic cases
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- Decongestants, nasal saline irrigation
- Antibiotics for bacterial sinusitis (e.g., amoxicillin)
- Nasal corticosteroids in chronic sinusitis
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CSF Rhinorrhea (Cerebrospinal Fluid Leak) |
- Clear, watery nasal discharge (often unilateral)
- Worsens with bending forward or straining
- History of head trauma or surgery
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- Glucose test of nasal discharge (high glucose content indicates CSF)
- Beta-2 transferrin test (specific for CSF)
- CT or MRI to locate the source of the leak
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- Referral to neurosurgery for repair
- Bed rest, avoidance of straining
- Prophylactic antibiotics to prevent meningitis
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Allergic Rhinitis |
- Clear, watery nasal discharge
- Itchy eyes, sneezing, nasal congestion
- Symptoms triggered by allergens (e.g., pollen, dust)
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- Clinical diagnosis based on history and physical exam
- Skin prick testing or serum IgE testing for allergens
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- Antihistamines (oral or nasal spray)
- Nasal corticosteroids
- Avoidance of triggers
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Nasal Polyps |
- Persistent nasal discharge (often clear or mucoid)
- Nasal obstruction, reduced sense of smell
- May be associated with chronic sinusitis or asthma
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- Nasal endoscopy to visualize polyps
- CT scan of the sinuses if polyps are large or recurrent
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- Intranasal corticosteroids
- Surgical removal if obstructive or causing frequent infections
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