Acute otitis media

Revision as of 13:25, 23 November 2023 by Nikolas (talk | contribs) (Created page with "* Acute (suppurative) otitis media ** Epidemiology *** Infants *** Small children *** 80% by 3 years of age ** Etiology *** Bacterial superinfection (on viral <abbr>URTI</abbr>) which ascends through eustachian tube *** S. pneumoniae *** H. influenzae ** Risk factors *** Previous AOM *** Chronic otitis media *** Parental smoking ** Protective factors *** Prolonged breastfeeding *** Pneumococcal vaccine ** Clinical features *** Ear pain **** Infants repeatedly touch the e...")

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Acute (suppurative) otitis media
- Epidemiology
  - Infants
  - Small children
  - 80% by 3 years of age
- Etiology
  - Bacterial superinfection (on viral URTI) which ascends through eustachian tube
  - S. pneumoniae
  - H. influenzae
- Risk factors
  - Previous AOM
  - Chronic otitis media
  - Parental smoking
- Protective factors
  - Prolonged breastfeeding
  - Pneumococcal vaccine
- Clinical features
  - Ear pain
    - Infants repeatedly touch the ear
  - Fever
  - Discharge from ear
    - Only if there is spontaneous tympanic perforation
  - Conductive hearing loss
- Diagnosis
  - Early: Retracted, hypomobile tympanic membrane
  - Then: Bulging tympanic membrane
    - Due to accumulation of pus
  - Loss of light reflex
- Treatment
  - NSAIDs
  - Not decongestants! – prolong course
  - Antibiotics
    - Only in < 2 years, or > 2 years if bilateral, no resolution in 2 days
    - Amoxicillin
    - Clavulanic acid added if treatment failure

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