Otitis media

Question 1

What?

Answer 1

Infection of middle ear from URT through Eustachian tube

Question 2

Pathogens most commonly associated with URT infections?

Answer 2

Respiratory synctial virus
Strep. pneumoniae
H. influenza
Moraxella Catarrhalis

Question 3

Who?

Answer 3

Children under 10

Question 4

Acute or chronic?

Answer 4

Can be acute or chronic

Question 5

What does infection cause?

Answer 5

Inflammation of middle ear mucosa & inflammatory exudate in middle ear space

Question 6

Clinical features?

Answer 6

Otalgia

Hearing disturbances

Question 7

Typical presentation?

Answer 7

Otalgia followed by discharge

Question 8

If it doesn’t resolve what can happen?

Answer 8

Tympanic membrane perforation & discharge

Question 9

Treatment?

Answer 9

NSAIDs
Often viral & will settle in 72 hrs without antibiotics
If systemic features to after 72 hours - systemic antibiotic

Question 10

Which systemic antibiotic is used ?

Answer 10

Amoxicillin

Question 11

In what age group is systemic antibiotic especially important in?

Answer 11

Children < 2 years

Question 12

If tenderness over mastoid?

Answer 12

Urgent ENT referral