20 month old with cultured and identified pseudomonas bacterial infection in her ears. tx. option given was i.v. antibiotics. I am a dentist . My sister asks me to explain heath related concerns or search the net for information. any information you can pass on will be greatly appreciated.
Reply: -----------------
The recommended treatment for a pseudomonas infection of the ear depends on the type of ear infection (middle or outer), the severity of the infection, the overall health and immune status of the child, the initial manifestations of the infection, etc.
Pseudomonas can be a serious problem particularly in an immuno-compromised individual who has weakened natural defenses against infection. On the other hand, in an otherwise healthy patient, it can represent more or less a nuisance infection such as that seen in a child with tubes placed in the past for middle ear problems who develops liquid drainage through the tubes.
The pseudomonas organism tends to be found where there is a moist environment (eg where there is liquid drainage). It may also develop as a contaminant or re-infection in an infection initially caused by another organism. An example of this would be in the previous example of a child who developed drainage from the ears after tubes were placed. In this situation topical therapy of the ear infection may be all that is necessary ie periodic cleansing of the ear canal with a dilute acetic acid solution (vinegar and water) combined with topical antibiotic drops active against pseudomonas like Tobradex or Garamycin ophthalmic drops. It is not uncommon for outer ear infections to be associated with pseudomonas such as the common "swimmer's ear". This type of infection is usually associated with some minor trauma to the skin of the ear canal combined with prolonged exposure to water in the ear canals. Outer ear infections tend to be quite painful and associated with swelling and redness. Occasionally the swelling is such that drops will not penetrate into the ear canal unless a small wick is placed into the opening of the ear canal. More severe infections, whether middle or outer ear, especially in an individual with a weakened immune system warrants intravenous therapy. In adults there is an oral antibiotic availabe that may be effective in certain pseudomonas infections and is called Ciprofloxacin (Cipro). The use of Cipro however is contraindicated for oral use in children under 14 or so years of age because of risks of abnormal growth of certain bones.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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