Acute otitis media

Question 1

What is otitis media

Answer 1

Infection of the middle ear

Question 2

Causes of otitis media

Answer 2

Bacteria (most commonly Strep. pneumoniae - also causes rhino-sinusitis and tonsillitis) enter middle ear from back of throat via eustachian tube. Often follows an upper resp. tract infection

Question 3

Otitis media presentation

Answer 3

3-6yr old presents with irritated, painful ear and may have reduced hearing (conductive) and/or balance issues/vertigo. Symptoms of an upper resp. infection.
If tympanic membrane perforated - discharge from ear

Question 4

Otitis media differentials

Answer 4

Otitis media with effusion, Otitis externa, Ear wax, foreign body

Question 5

Otitis media observations

Answer 5

Bulging, red, inflamed looking tympanic membrane compared to normal pearly-grey.

Question 6

Otitis media management

Answer 6

Most cases self limiting within 3-7 days, recommend paracetamol/ibuprofen for pain and fever.
ABX if persists / does not improve:
Amoxicillin for 5-7 days (Penecillin allergy = Clarithromycin if / Erythromycin if pregnant)