ACUTE OTITIS MEDIA

Question 1

What are the otoscopic findings in otitis media? Which patient group is most at risk of this condition?

Answer 1

• Bulging tympanic membrane
• Erythema

Infants aged between 6 and 18 months

Question 2

List 5 risk factors of otitis media in children

Answer 2

• Lack of breastfeeding
• Attending nursery
• Positive family history
• Aged between 6 and 18 months
• Exposure to smoking

Question 3

What accounts for around 2/3 of causes of acute otitis media?

Answer 3

Viral upper respiratory tract infections

Question 4

List some viral and some bacterial causes of acute otitis media

Answer 4

• Bacterial: streptococcus pneumonia, haemophilus influenza, moraxella catarrhalis
• Viral: syncytial virus, rhinovirus, enterovirus

Question 5

What are some intratemporal and intracranial complications of AOM?

Answer 5

• Intratemporal: tympanosclerosis, tympanic membrane perforation, hearing loss, mastoiditis, labyrinthitis, facial nerve palsy
• Intracranial: meningitis, intracranial abscess, cavernous sinus syndrome, subdural empyema

Question 6

What are the two main investigations that you can do in AOM? When would you do them?

Answer 6

• Consider swab for MC&S if ear discharging
• Imaging (CT and/or MRI) if complications are suspected

Question 7

How would you treat AOM?

Answer 7

1. Analgesia + antipyretics
2. Failure to improve within 2 days → consider prescribing oral antibiotics: 10 days amoxicillin, or co-amoxiclav if no improvement