| ID | 282 |
|---|---|
| Name | ACUTE SUPPURATIVE OTITIS MEDIA |
| Cause | Usual pathogens causing ASOM include Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Acute suppurative otitis media usually causes severe deep ear pain, fever, and a conductive hearing loss in the affected ear. |
| Signs Symptoms | Unusual irritability. Difficulty sleeping or staying asleep. Tugging or pulling at one or both ears. Fever, especially in infants and younger children. Fluid draining from ear(s) Loss of balance. Hearing difficulties. Ear pain. |
| Diagnosis | Otitis media is diagnosed clinically via objective findings on physical exam (otoscopy) combined with the patient's history and presenting signs and symptoms. Several diagnostic tools are available such as a pneumatic otoscope, tympanometry, and acoustic reflectometry, to aid in the diagnosis of otitis media |
| Investigations | Otitis media is diagnosed clinically via objective findings on physical exam (otoscopy) combined with the patient's history and presenting signs and symptoms. Several diagnostic tools are available such as a pneumatic otoscope, tympanometry, and acoustic reflectometry, to aid in the diagnosis of otitis media |
| Management | Management: 1. To control infection- The first-choice oral antibiotic treatment is amoxicillin 500mg 8 hourly daily (or 20-40mg/kg/day) or erythromycin 500mg 6 hourly daily (or 50mg/kg/day) plus sulfonamide 150mg/kg/day for 10 days. In resistant cases, alternatives useful are cefaclor 20-40mg/kg/day or amoxiclav 20-40mg/kg/day combinations. 2. For symptomatic relief- Aspirin (300-600mg t. d. p. c) or paracetamol 500mg is given for pain & temperature. Application of dry heat help to relieve pain. 3. Nasal decongestant- Xylometazoline or oxymetazoline nasal decongestant drop & antihistamine preparation is used for patency of the tube. 4. Local treatment- Pus is cleaned aseptically daily until the ear is dry. 5. If the above treatment fails, myringotomy to be needed for evacuation of pus and helping resolution. Indication of myringotomy: 1. Acute pain persisting inspite of conservative treatment, child restless, sleep disturbed. 2. Bulged drum- not responding to conservative treatment. 3. Inadequate drainage of pus. 4. Delayed resolution inspite of adequate treatment. 5. Early feature of complication. Inspite of myringotomy if there is delayed resolution or masked mastoidtis- cortical mastoidectomy to be done. |
| Introduction | It is the acrue inflammation of the lining membrane of the whole middle ear cleft. |
| History | |
| Etiology | see under cause |
| Clinical Features | Clinical features: 5 stages: 1. Stage of tubal occlusion or acute salphingitis. 2. Stage of exudation or pre-suppuration. 3. Stage of suppuration. 4. Stage of resolution. 5. Stage of complication. Sign/Symptoms: 1. Severe earache which makes the child wake up from sleep & scream with agony. 2. Deafness. 3. Temp. & bubbling sound is heard in the ear. 4. The tymp. membrane is bulged, congested & ultimately burst with pulsating discharge. 5. Persistence of otorrhoea, temporal headache, hectic rise of temp., vertigo, facial paralysis etc. indicates complication. |
| Preventions | |
| Treatment | Most patients can be treated effectively with an analgesic such as a nonsteroidal antiinflammatory medication or acetaminophen. Choice of initial antibiotic — Our choice for first-line therapy is amoxicillin-clavulanate. In most adults, the dose is amoxicillin 875 mg with clavulanate 125 mg orally twice daily Topical quinolones are the treatment of choice for chronic suppurative otitis media; they are equally or more effective as aminoglycosides and lack the risk of ototoxicity. Quinolones are effective in resolving otorrhoea and eliminating the microorganism |
| Complications | |
| Prognosis | |
| Types | |
| Classification | |
| Observation | |
| Pathology |
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