Acute Otitis Media

Question 1

Definition

Answer 1

defined as the presence of inflammation in the middle ear, associated with an effusion and accompanied by the rapid onset of symptoms and signs of an ear infection

Question 2

What is the difference between otitis media and otitis media with effusion

Answer 2

OM is almost always due to an infective cause and TM will bulge out

OM with effusion is due to eustachian tube dysfunction

Question 3

Risk factors - 5

Answer 3

young age
Smoking
Frequent contact with other children
Use of a dummy
Formula feeding - breastfeeding has more protective effects

Question 4

Presentation - 7

Answer 4

rapid onset of ear pain
Fever
anorexia
vomiting
hearing loss
aural fullness
discharge

Question 5

Causes - 1

Answer 5

Most common cause is bacterial infection, most commonly Pseudomonas Aeruginosa

Question 6

Investigations

Answer 6

Diagnosis is done from history and examination of tympanic membrane - will be dry and bulging out

Question 7

Management - 3

Answer 7

Consider admitting:
- kids under 3 months or with a temperature over 39

• Presribe antibiotics if systemically unwell
• regular paracetamol or ibruprofen for pain

Question 8

Complications - 2

Answer 8

Intracranial - meningitis, brain abscess

Extra-cranial - facial nerve palsy, mastoiditis, labrynthtitis.

Question 9

Differentials - 3

Answer 9

otitis externa

TMJ disorder

Mastoiditis