Acute otitis media: Difference between revisions
(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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**** Amoxicillin | **** Amoxicillin | ||
**** Clavulanic acid added if treatment failure | **** Clavulanic acid added if treatment failure | ||
**Complications | |||
*** Intratemporal complications | |||
**** Mastoiditis | |||
***** Children | |||
***** Infection spread to mastoid -> collection of pus -> destruction of air cells -> empyema | |||
***** Antibiotics | |||
****** Always! | |||
****** Vancomycin | |||
***** Mastoidectomy in severe cases | |||
**** Peripheral facial nerve palsy | |||
**** Labyrinthitis | |||
***** Inflammation of inner ear | |||
***** Vertigo | |||
***** Nystagmus | |||
***** Sensorineural hearing loss | |||
*** Intracranial complications | |||
**** Meningitis | |||
**** Otogenic abscess | |||
***** Epidural, subdural or cerebral | |||
***** Headache | |||
**** Sinus thrombosis | |||
*** Extracranial complications | |||
**** Bezold abscess | |||
***** Deep to sternocleidomastoid, pus from mastoiditis erodes through the mastoid part of the temporal bone | |||
<noinclude>[[Category:Ear, nose, throat (ENT)]]</noinclude> | <noinclude>[[Category:Ear, nose, throat (ENT)]] | ||
</noinclude> | |||
Latest revision as of 14:29, 23 November 2023
- 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
- Ear pain
- 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
- Complications
- Intratemporal complications
- Mastoiditis
- Children
- Infection spread to mastoid -> collection of pus -> destruction of air cells -> empyema
- Antibiotics
- Always!
- Vancomycin
- Mastoidectomy in severe cases
- Peripheral facial nerve palsy
- Labyrinthitis
- Inflammation of inner ear
- Vertigo
- Nystagmus
- Sensorineural hearing loss
- Mastoiditis
- Intracranial complications
- Meningitis
- Otogenic abscess
- Epidural, subdural or cerebral
- Headache
- Sinus thrombosis
- Extracranial complications
- Bezold abscess
- Deep to sternocleidomastoid, pus from mastoiditis erodes through the mastoid part of the temporal bone
- Bezold abscess
- Intratemporal complications
- Epidemiology