Otitis Media Flashcards
ESSENCE
Infection of the middle ear, which is space between tympanic membrane and the inner ear - where cochlea, vestibular apparatus and nerves are found
Bacteria enters from back of through through eustachian tube
AETIOLOGY
Most common and other common
- Streptococcus pneumoniae - most common
- Haemophilus influenzae
- Moraxella catarrhalis
- Staphylococcus aureus
CLINICAL FEATURES
Presentation
- Ear pain
- Reduced hearing affected ear
- Feeling generally unwell, maybe fever
- Symptoms of upper airway infection - cough, runny nose, sore throat
- If affects vestibular system
- Balance issues and vertigo
- If tampanic membrane perforated
- Discharge
CLINICAL FEATURES
Describe normal appearance tympanic membrane
- Pearly grey, translucent and slightly shiny
CLINICAL FEATURES
Tympanic membrane on otoscope
- Bulging, red, inflamed looking membrane
- Discharge and hole if perforation
AETIOLOGY
Risk factors
- External auditory canal obstruction
- High humidity
- Swimming
- Warmer temperatures
- Local trauma
- Allergy
- Immunocompromised
- Prolonged use antibiotics
INVESTIGATIONS
First line
- Pneumatic otoscopy
- Tympanometry
MANAGEMENT
General
- Most resolve without antibiotics within 3 days
- Analgesia
MANAGEMENT
When use antibiotics
Immediate antibiotics - at initial presentation in patients with significant co-morbidity, systemically unwell or immunocompromised
Delayed prescription - can be collected and used after 3 days if symptoms have not improved
MANAGEMENT
Antibiotic choice
- 1) Amoxicillin for 5-7 days first line
- Clarithromycin if penicillin allergy
- Erthromycin in pregnant woman allergic to penicillin
COMPLICATIONS
- Ottis media with effusion
- Hearing loss
- Perforated tympanic membrane
- Labyrinthtitis
- Facial nerve palsy (rare)
- Meningitis (rare)
- Abscess (rare)
- Mastoiditis (rare)
EPIDEMIOLOGY
Lifetime incidence
10%
EPIDEMIOLOGY
Age group
Peak 7-12 years
