Otitis media refers to middle ear inflammation or infection that is common in young children. It includes acute otitis media, caused by bacterial infection, and otitis media with effusion, which features non-infected fluid in the middle ear. Risk factors include young age, exposure to cigarette smoke, and viral upper respiratory infections. Common pathogens are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Symptoms include fever, ear pain, and irritability. Diagnosis involves examining the eardrum via otoscopy. Treatment is with antibiotics such as amoxicillin or azithromycin. Complications can include hearing loss, mastoiditis,
Otitis media refers to middle ear inflammation or infection that is common in young children. It includes acute otitis media, caused by bacterial infection, and otitis media with effusion, which features non-infected fluid in the middle ear. Risk factors include young age, exposure to cigarette smoke, and viral upper respiratory infections. Common pathogens are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Symptoms include fever, ear pain, and irritability. Diagnosis involves examining the eardrum via otoscopy. Treatment is with antibiotics such as amoxicillin or azithromycin. Complications can include hearing loss, mastoiditis,
Otitis media refers to middle ear inflammation or infection that is common in young children. It includes acute otitis media, caused by bacterial infection, and otitis media with effusion, which features non-infected fluid in the middle ear. Risk factors include young age, exposure to cigarette smoke, and viral upper respiratory infections. Common pathogens are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Symptoms include fever, ear pain, and irritability. Diagnosis involves examining the eardrum via otoscopy. Treatment is with antibiotics such as amoxicillin or azithromycin. Complications can include hearing loss, mastoiditis,
Otitis media refers to middle ear inflammation or infection that is common in young children. It includes acute otitis media, caused by bacterial infection, and otitis media with effusion, which features non-infected fluid in the middle ear. Risk factors include young age, exposure to cigarette smoke, and viral upper respiratory infections. Common pathogens are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Symptoms include fever, ear pain, and irritability. Diagnosis involves examining the eardrum via otoscopy. Treatment is with antibiotics such as amoxicillin or azithromycin. Complications can include hearing loss, mastoiditis,
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OTITIS MEDIA
Teshome Getahun (MD)
TERMINOLOGY Middle ear effusion — Middle ear effusion (MEE) refers to fluid in the middle ear cavity. MEE occurs in both OME (otitis media with effusion) and AOM. Acute otitis media — AOM refers to acute bacterial infection of middle ear fluid. Otitis media with effusion — Otitis media with effusion (OME) refers to middle ear fluid that is not infected. OME is also called serous, secretory, or nonsuppurative otitis media. OME frequently precedes the development of AOM or follows its resolution. EPIDEMIOLOGY Commonest childhood infection second only to common cold Over 80% of children will have experienced at least one episode of otitis media (OM) by the age of 3 yr. Peak prevalence and incidence in 6-20 months
boys > girls
DEFINITIONS Acuteotitis media- inflammation of the middle ear presenting with rapid onset of symptoms (Lasting <2weeks)
Chronicotitis media- persistent discharge
from the middle ear for 2 weeks or longer PREDISPOSING FACTORS
Young age Low socioeconomic status Immunodeficiency Passive smoking Otitis media occurring in the 1st 12months of life Sibling with recurrent otitis media Down syndrome (craniofacial dysmorphism) Structural defects that impair Eustachian tube function (e.g. cleft palate) URTI (viral, bacteria) Breast feeding reduces incidence of otitis media ETIOLOGY Common pathogens: Streptococcus pneumoniae (40%) Haemophilus influenzae (25-30%) Moraxella catarrhalis (10-15%) Less common causes Staph. aureus (acute, chronic) Pseu. aeruginosa (chronic) Anaerobic organisms Group A streptococcus Virus RSV, rhinovirus, adenovirus, influenza virus PATHOGENESIS • Bacteria gain access to the middle ear when the normal patency of eustachian tube is blocked by: Local infection Pharyngitis Enlarged adenoids Obstruction of secretions from the middle ear to the pharynx, result in middle ear infection PATHOGENESIS Antecedent infection
Congestion of the resp. mucosa of the nose, nasopharynx ,
eustachian tube
Obstruction of the narrowest part of the tube
Negative pressure and accumulation of secretions produced by the
mucosa of the middle ear
Virus and bacteria colonize the URT and reach the middle ear via aspiration , reflux and insufflation 8
Suppuration w clinical signs of AOM
CLINICAL FEATURE Neonates& infants may be asymptomatic or may present with non-specific manifestations: Fever Irritability Changing in sleeping or sucking habit Vomiting Diarrhea Ear pulling CONTI … Older children present with Fever Irritability Vomiting/Diarrhea URTI Pain (one, both ears) Ear discharge CHRONIC OTITIS MEDIA Foul-smelling ear discharge Perforation of tympanic membrane Impaired hearing DIAGNOSIS Otoscopy and tympanometry: A certain diagnosis of OM should contain all of the following elements: 1. Recent and usually acute onset of illness, 2. Presence of MEE, and 3. Signs and symptoms of middle-ear inflammation including erythema of the tympanic membrane or otalgia Culture of ear discharge OME TM Normal tympanitic membrane AOM MANAGEMENT Antibiotics Antipain/Antipyretic Ear Wicking
First line antibiotics
Amoxicillin/Cotrimoxazole=10 days Azithromycin (for penicillin allergy) COMPLICATIONS Chronic suppurative otitis media Infectious eczematous dermatitis
