otitis media

[wrybosome]

My doc retired recently, and I haven't yet found another that I like nearly as much so I'm without at the moment. I have a quick question for any MDs with some time on their hands.

Friday morning (2 days ago) I woke up with a feeling of fullness in my right ear and pain in my jaw. I waited through the day to see if it would go away but it slowly got worse. It was signicantly worse yesterday moning so I sought treatment.

Not having a doc right now and not wanting to sit in an ER, I went to a 'minute clinic' at a local CVS, staffed by a CRNP who diagnosed a middle ear infection and prescribed oral Amoxicillin and otic Floxacin. Symptoms I have:

*hearing loss that ear
*sense of pressure and constant dull ache in ear
*swollen shut tube, makes funny squeak on valsalva
*low grade fever
*swollen jaw (can not fully close bite w/o serious pain)
*pain when ears manipulated
*tenderness in the area of cheek/jaw just forward of the ear

I know that you can't diagnose over teh internet without an IP-otoscope, but is this all consistent with middle ear infection? 24 hours on antibiotics has produced no change for better or worse. The jaw swelling is the most painful/irritating aspect.

Would you personally wait further for improvement or would you take a trip to the ER?

I appreciate any thoughts you might have,

Tim

 

[DocVikingo]

Hi Tim,

Bummer.

What you describe is not "all consistent with middle ear infection" (otitis media). Hearing loss in the affected ear, feelings of pressure/fullness and constant dull ache in that ear, a "funny squeak" on Valsalva and low grade fever are. Swollen jaw, pain upon manipulation of the ear and tenderness in the area of cheek/jaw just forward of the ear are more consistent with infection of the external auditory canal (otitis externa).

Interestingly, Floxin Otic solution primarily is used to treat infections of the external ear canal. It can be used to treat infections of the middle ear in persons with perforated ear drums, but you make no mention of a rupture.

Amoxicillin may be used to treat either form of infection. Sometimes it is ineffective and Augmentin or another more powerful antibiotic is tried as a second course.

Twenty-four hours may be insufficient time to assess the ultimate effectiveness of what already has been prescribed.

Helpful?

Regards,

DocVikingo

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

 

[wrybosome]

Interestingly, Floxin Otic solution primarily is used to treat infections of the external ear canal. It can be used to treat infections of the middle ear in persons with perforated ear drums, but you make no mention of a rupture..

Forgot to mention that there was no sign of a rupture. I thought it was interesting too that the treatment seemed to be for both outer and inner ear.

Twenty-four hours may be insufficient time to assess the ultimate effectiveness of what already has been prescribed.

Helpful? .

Yes, thanks. Out at 72 hours on the antibiotics now and the pain/swelling are decreasing quite a bit. At work + in pain = internet whinging.

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

Damn! Thought I had you there.
Thanks for your time & happy diving.