Otitis Media Flashcards
1
Q
Causes of otitis media
A
- Most commonly viral (RSV, rhinovirus, adenovirus, parainfluenza, influenza A)
- Bacterial causes include:
- Streptococcus pneumoniae
- Haemophilus influenzae
- Morazella catarrhalis
- Staphylococcus aureus
2
Q
Management of otitis media
A
- Usually resolves within 3-7 days
- Analgesia if uncomplicated
- Antibiotics PO if less than 2 years
- In the community can use amoxicillin, clarithromycin or erythromycin
- If not responsing to amoxicillin can use co-amoxiclav
- Tympanocentesis can be used if unresponsive to antibiotics or if severe pain
- Do not need ENT referral if drum perforates as will usually heal - review at GP in 6-8 weeks and if no hearing loss and dry no need for repair
- In chronic cases antibiotics, myringoplasty or tympanoplasty can be used
- In OME can use decongestant spray to nasopharynx, valsalva manoeuvre, ventiation tubes (grommet), hearing aids and check the postnasal space if unilateral
3
Q
Otitis media vs otitis media with effusion
A
- Acute otitis media refers to acute infection of middle ear fluid.
- Otitis media with effusion refers to middle ear fluid that is not infected. It is also called serous, secretory, or nonsuppurative otitis media. Frequently precedes the development of AOM or follows its resolution.
4
Q
Presentation of otitis media
A
- Rapid onset otalgia
- Hearing loss
- Fever
- Otorrhoea
- Crying
- Poor feeding
- Ear pulling
- In OME hearing loss is main symptom but is generally very mild - may be noticed due to learning/developmental delay
5
Q
Complications of otitis media
A
- Very unwell
- Intracranial abscess (keep fasted, neurosurgery, need CT brain with contrast)
- Dacial palsy
- Mastoiditis (keep fasted, neuro obs, usually 24hrs of IV antibiotics if well, NBM until ENT review, may need CT head)
- Meningitis
6
Q
Red flags in otitis media with effusion
A
- Young South-East Asian men
- Nasopharyngeal carcinoma
- Middle-aged adults
- Neck nodes
