acute otitis media Flashcards
what is AOM?
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
how is AOM different from otitis media with effusion?
OME is characterised by fluid in the middle ear, but is not associated with symptoms and signs of an acute ear infection
AOM is associated with fluid in the middle ear and rapid onset of symptoms and signs of an ear infection
when is AOM considered recurrent?
3 or more well documented and separate episodes in 6 months
what are the causes of AOM?
- bacteria e.g Haemophilus influenzae, strep pneumoniae
- viral pathogens e.g influenza virus, parainfluenza, adenovirus
what are the risk factors for AOM?
- young age
- male
- smoking
- contact with children
- formula feed
- use of dummy
- FH
- GORD
what are the complications of AOM?
- persistent otitis media with effusion
- recurrent infection
- hearing loss (usually conductive and temporary)
- tympanic membrane perforation
- labyrinthitis
what will be observed on otoscopic examination in AOM?
- red, yellow or cloudy tympanic membrane
- moderate/ severe bulging of TM
- perforation of TM +/- discharge in ear canal
what are the symptoms of AOM?
acute onset of
- earache
younger kids may
- hold/tug/ rub ear
- cry
- fever
- restlessness
- rhinorrhoea
- behaviour changes
- cough
how should AOM be managed initially at presentation?
- Admit if complications, severe systemic infections or in children <3 months with temp 38 or more
- advise paracetamol or iboprofen for pain
- if high risk of complications or symptoms/signs of more serious disease, offer antibiotics. 5-7 day course of amoxicillin.
what should be done in persistent acute otitis media treatment failure?
refer
if have not taken antibiotics, 5-7 day course of amoxicillin. If this doesn’t show improvement after 2-3 days and patient is deteriorating, offer second line antibiotic. 5-7 day of co amoxiclav.
