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Ear Pain, Jaw Pain, Headache, Trouble Swallowing. CT Scan Showed Fluid In Air Cells. How Can It Be Treated?
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From your information, it appears to be a right side petrositis (an inflammation / possible infection).
The petrous bone of the skull where the inner ear is housed and the mastoid tip behind your earlobe.
It is often secondary to respiratory/ inner ear infections as the ear tube and throat are connected. The air cells in the bone are usually filled air. The scan shows a fluid, which is infective/ like sinusitis.
Treatment is antibiotics. They may fail due to:
Wrong antibiotics
Wrong route-oral Vs I.V.
Inadequate dosing
Inadequate duration of antibiotic treatment
Undrained abscess (pus)—your scans do not say this.(but I would like a detailed report of the scans posted here).
Resistant/ atypical microbes causing it
Untreated, it has the potential to spread to the bone and rarely brain inside with serious sequelae.
Has an ENT doctor seen and investigated you?
Could you mention all the antibiotic regimens given to you? In addition, upload all reports using the site’s uploader. You have a feature to upload the reports / image by yourself at the right side of the query page, please utilize that so that I can answer your queries better.
Do you have fever, vomiting, neck pain?
Do you have hearing defects, ringing in the ear, visual disturbances?
Cough, expectoration, breathlessness? Throat pain, choked nose?
I would like to have all this info and would also suggest an ENT opinion (2nd, if needed), X-ray chest, an EKG, complete blood panel (routine), sputum exam (if produced).
Throat swabs and cultures
IV antibiotics –appropriate, adequate dose and duration, accordingly.
We should look for any simultaneous lung infection and treat appropriately, as cause is usually common.
Please be guided by your ENT specialist at a good centre.
Take care and please keep me informed of your progress.
Good Luck !
I hope to have answered your query satisfactorily.
May I request for your rating and review of this answer as you press the “Accept the answer” button and close the query (if there are no more follow up questions or after I answer them)?
Thank you !
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Thanks for reverting.
Oh, no fever!
Infections usually have fever, but sometimes without. Augmentin is a good respiratory antibiotic to start with. But if it had not worked; you may have to give others which also tackle resistance. Betalactam, beta-lactamase and a fluoroquinolone or combinations like these depending on culture reports. If MRSA is suspected, different gram positive cover is needed.
Have they obtained any pus, secretions for culturing the microbes?
Ideally it is necessary to treat the troubling infections. In addition there is a need to rule out osteomyelitis, (bone infection) - in that case prolonged IV antibiotics will be needed.
Inner ear should be fully evaluated as well as CT scan brain to look for spread, especially if you have visual and hearing loss - something like a cholesteatoma may pose trouble.
Your pain in the neck and ear is probably due to petrous affection.
Take powerful anti-inflammatory NSAIDs till then under guidance, to help with the pain.
Uncommonly, a badly infected bone may have to be surgically debrided.
Continue the antibiotics under supervision until the expert's evaluation.
Hope this information serves as a guide way towards your recovery. Revert if I can be of any more help. Post all reports as I advised.
Take care and keep me informed.
Please accept the answer and close the query with a review, if you have no more doubts.
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