Acute Otitis Media Flashcards
1
Q
What is the course of presentation for AOM?
A
- days to weeks
2
Q
What age group are commonly affected by AOM?
A
- 2/3 will have AOM by age 3
- school age children
3
Q
What is the Px of AOM?
A
- anatomy of the eustachian tube in younger children is short, straight, wide
- Easier for nasopharyngeal organisms to migrate via the eustachian tube to middle ear
4
Q
What are the common CO for AOM?
A
- S. Pneumonia
- H. Influenza
- M. Catarrhalis
- S. Pyogenes
- Respiratory Synyctial virus
- Rhinovirus
5
Q
What are the RF for AOM?
A
- age (peak age 6-15 months)
- boy
- passive smoking
- bottle feeding
- passifier use
- winter months
6
Q
What are the sx of AOM?
A
- severe ear pain
- malaise
- fever
- coryzal sx
7
Q
What will you find on examination of AOM?
A
- otoscopy
- erythematous tmpanic membrane
- small tear + purulent discharge - if perforated
- conductive hearing loss
- cervical lymphadenoapthy
- check for facial nerve function too
8
Q
A
9
Q
What are the differential diagnosis for AOM?
A
- Chronic Suppurative Otitis Media (CSOM)
- Otitis Media with Effusion (OME)
- Otitis Externa (OE)
10
Q
What Ix would you order for AOM?
A
- clinically diagnosed
- FBC and CRP
- fluid MC&S - ear discharge
- blood culture if sepsis
11
Q
How would you mx AOM?
A
- resolve spontaneously within 24 hours, nearly all within 3 days
- simple analgesics
- ‘watch and wait’ approach
- consider oral abx
12
Q
When would you consider oral abx?
A
- Systemically unwell children not requiring admission
- Known risk factors for complications, such as congenital heart disease or immunosuppression
- Unwell for 4 days or more without improvement, with clinical features consistent with acute otitis media
- Discharge from the ear (ensure swabs are taken prior to commencing antibiotic therapy)
- Children younger than 2 years with bilateral infections
13
Q
What are the cx of AOM?
A
- Mastoiditis
- meningitis
- facial nerve paresis
- intracranial abscess
- sigmoid sinus thrombosis
- chronic otitis media
