Otitis Media Flashcards
What is acute otitis media?
Acute otitis media is extremely common in young children, with around half of children having three or more episodes by the age of 3 years.
What typically precedes acute otitis media?
Viral upper respiratory tract infections (URTIs) typically precede otitis media.
What are the common bacteria associated with acute otitis media?
Most infections are secondary to bacteria, particularly Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
How do viral URTIs contribute to acute otitis media?
Viral URTIs are thought to disturb the normal nasopharyngeal microbiome, allowing bacteria to infect the middle ear via the Eustachian tube.
What are the clinical features of acute otitis media?
Features include otalgia, ear tugging or rubbing, fever in around 50% of cases, hearing loss, recent viral URTI symptoms, and possible ear discharge.
What are possible otoscopy findings in acute otitis media?
Findings may include bulging tympanic membrane, opacification or erythema of the tympanic membrane, perforation with purulent otorrhoea, and decreased mobility on pneumatic otoscopy.
What criteria are used to diagnose otitis media?
Diagnosis criteria include acute onset of symptoms, otalgia or ear tugging, presence of middle ear effusion, bulging of the tympanic membrane, otorrhoea, decreased mobility on pneumatic otoscopy, and inflammation of the tympanic membrane (erythema).
What is the management for acute otitis media?
Acute otitis media is generally self-limiting and does not require antibiotics. Analgesia should be given for otalgia, and parents should seek medical help if symptoms worsen or do not improve after 3 days.
When should antibiotics be prescribed for acute otitis media?
Antibiotics should be prescribed if symptoms last more than 4 days, the patient is systemically unwell, immunocompromised, younger than 2 years with bilateral otitis media, or if there is perforation/discharge.
What is the first-line antibiotic for acute otitis media?
A 5-7 day course of amoxicillin is first-line. For penicillin allergy, erythromycin or clarithromycin should be given.
What are common sequelae of acute otitis media?
Common sequelae include perforation of the tympanic membrane, chronic suppurative otitis media (CSOM), hearing loss, and labyrinthitis.
What complications can arise from acute otitis media?
Complications include mastoiditis, meningitis, brain abscess, and facial nerve paralysis.
What is glue ear?
Glue ear describes otitis media with an effusion, also known as serous otitis media. It is common, with the majority of children having at least one episode during childhood.
What are the risk factors for glue ear?
Risk factors include male sex, siblings with glue ear, higher incidence in Winter and Spring, bottle feeding, day care attendance, and parental smoking.
At what age does glue ear peak?
Glue ear peaks at 2 years of age.
