Acute otitis media (AOM)

Question 1

What is acute otitis media (AOM)?

Answer 1

AOM refers to an infection of the middle ear, commonly seen in young children.

Question 2

Why is AOM clinically significant?

Answer 2

It can lead to complications such as hearing loss and may indicate underlying health issues.

Question 3

What often precedes acute otitis media?

Answer 3

AOM often follows a viral upper respiratory tract infection (URTI).

Question 4

What bacteria are commonly associated with AOM?

Answer 4

• Streptococcus pneumoniae
• Haemophilus influenzae
• Moraxella catarrhalis.

Question 5

What are common symptoms of AOM?

Answer 5

• Otalgia (ear pain)
• Fever
• Hearing loss
• Recent URTI symptoms

Question 6

Otoscopy findings in AOM:

Answer 6

• bulging tympanic membrane → loss of light reflex
• opacification or erythema of the tympanic membrane
• perforation with purulent otorrhoea
• decreased mobility if using a pneumatic otoscope

Question 7

How can fluid accumulation in AOM affect hearing?

Answer 7

Fluid accumulation can impair sound transmission, leading to temporary hearing difficulties.

Question 8

What clinical criteria are used for diagnosing AOM?

Answer 8

• acute onset of symptoms
• evident middle ear effusion
• signs of tympanic membrane inflammation

Question 9

Do most cases of AOM require antibiotics?

Answer 9

Most cases are self-limiting and do not require antibiotics.

Question 10

What should be administered for pain relief in AOM?

Answer 10

Analgesia should be administered to alleviate ear pain.

Question 11

What should parents do if AOM symptoms worsen?

Answer 11

Advise parents to seek medical attention if symptoms worsen or do not improve within three days.

Question 12

When are antibiotics warranted in AOM?

Answer 12

Antibiotics may be warranted in cases of prolonged symptoms or systemic illness.

Question 13

What is the recommended antibiotic for AOM?

Answer 13

A 5-7 day course of amoxicillin is recommended unless there is a penicillin allergy.

Question 14

common outcomes from having AOM:

Answer 14

• perforation of the tympanic membrane → otorrhoea. Can lead to → chronic suppurative otitis media (CSOM). CSOM is defined as perforation of the tympanic membrane with otorrhoea for > 6 weeks
• hearing loss
• labyrinthitis

Question 15

What are potential complications of untreated AOM?

Answer 15

• mastoiditis
• meningitis
• brain abscess
• facial nerve paralysis