Diseases of the Middle Ear Flashcards
Typically precipitated by URI causing eustachian tube obstruction
Allergic rhinitis, environment (passive smoke) other reasons
Bacterial infection of the mucosally lined air-containing spaces of the temporal bone
Most common in childhood with peak incidence first two years of life
Acute Otitis Media
AOM is the most common in childhood with peak incidence at what age?
first two years of life
What is the most common pathogen in acute otitis media?
S. pneumonia
The majority of acute otitis media cases are viral or bacterial?
viral
List some common pathogens in acute otitis media
S. pneumonia (up to 40%) – most common pathogen
H. influenza (25-30%)
Moraxella catarrhalis (10-20%)
Group A strep (2%)
S. Aureus (1%)
A workup for what is required on any neonate (< 1 month) with an acute otitis media?
sepsis
List some differential diagnoses to consider with a bulging red TM
Acute otitis media
Otitis externa
Referred otalgia
Serous otitis media
Aerotitis (barotrauma)
Bullous myringitis
What is the DOC in acute otitis media?
Amoxicillin/Augmentin
List some complications of AOM
Chronic/recurrent OM
Mastoiditis
Petrositis/petrous apicitis
Otogenic skull base osteomyelitis
Facial nerve paralysis
Sigmoid sinus thrombosis
CNS infections
Speech issues
What is the management of recurrent otitis media?
Long term antibiotic prophylaxis (3-6 months Amoxicillin)
ENT referral (Failure of the above may indicate need for ventilation tubes)
What are the common pathogens seen in chronic otitis media?
P. aeruginosa
S. aureus
Mixed anaerobic infections
What is the most frequent serious complication of middle ear infection?
Mastoiditis
Extension of infection into mastoid air cells – the common intratemporal complication of AOM
Presents several weeks of inadequately treated acute otitis media
Typically refers to the coalescent type that is associated with mastoid
bone destruction
Mastoiditis
What are the common pathogens seen in mastoiditis?
Group A strep
Pneumococcus
Staph
H. flu
What are some complications of mastoiditis?
Intracranial extension
Abscess
Sigmoid sinus thrombosis
Facial nerve paralysis