Otitis media

Question 1

Otitis media presentation

Answer 1

• rapid onset ear pain
• bulging red, yellow or cloudy tympanic membrane
• pyrexia and malaise
• vomiting
• coryza following URTI

Question 2

Otitis media causes

Answer 2

• Haemophilus influenzae
• Strep pneumoniae
• Moxarella

Question 3

Otitis media risk factors

Answer 3

• recent URTI
• young age
• craniofacial abnormalities
• smoking

Question 4

Otitis media management

Answer 4

• usually resolves with analgesia
• co-amoxiclav 5-7 days if persistent after 48 hours
• amoxicillin if high risk group, systemically unwell or serious symptoms
• erythromycin or clarithromycin 2nd line
• refer to hospital if complications (mastoiditis) or systemic infection

Question 5

Otitis media complications

Answer 5

• mastoiditis
• hearing loss
• perforation

Question 6

Otitis media with effusion otoscopy findings

Answer 6

• retraction of membrane
• dull, grey appearance of membrane
• loss of light reflex
• bubbles on fluid level

Question 7

Otitis media with effusion management

Answer 7

• grommets for adults
• children: active monitoring for 3 months and then repeat hearing test
• if test shows bilateral OME or severe hearing loss, use grommets
• follow up until grommets excluded and eardrum healed
• refer if abnormal tympanic membrane

Question 8

Complications of otitis media with effusion

Answer 8

• otorrhoea
• infection
• tympanosclerosis