Flashcards in ENT - Otitis media Deck (18):
what are the two different diagnoses for acute otitis media?
- AOM: acute inflammatory disease of middle ear and tympanic membrane with or without purulent middle ear fluid
- OME: presence of middle ear effusion without any local or systemic signs of inflammation
what are the signs and symptoms of AOM?
- rapid onset
- bulging / fullness of TM
- redness of TM
- perforation of membranes with drainage
- ear pain, irritability, fever
"middle ear effusion without signs or symptoms of inflammation"
otitis media with effusion
what is the key factor regarding long term consequences of middle ear infections, including hearing loss?
duration of disease
what is the pathophysiology of otitis media?
- preceding viral illness
- immature immune system
- auditory tube dysfunction
what variable are responsible for declining expression of otitis media in the developing world?
immunization is changing:
- complexity or virulence at presentation
what are the absolute contraindications to observing otitis media vs treating it?
- age under 6 months
- immune deficiency disorder
- severe illness or previous treatment failure
- inability to ensure follow up
what are the relative contraindications to observing otitis media vs treating it?
- relapse within 30 days
- bilateral otitis media if less than 2 years of age
- syndrome such as craniofacial malformation
what is the first line abx for otitis media? severe otitis media?
- amoxicillin plus clavulanate
what is the first line abx for otitis media with PCN allergy?
what is the first line abx for otitis media with PCN AND ceph allergy?
when should children be reevaluated for failure of otitis media abx?
can steroids be used for otitis media?
what are the complications of otitis media?
- TM perforation
- chronic otorrhea
- chronic otomastoiditis
- hearing loss
what are signs that otitis media is no longer simply a difficult ear infection?
one or more of:
- persistent low intensity pain greater than 1 wk duration
- foul smelling persistent otorrhea
- retroorbital pain
- facial nerve paralysis
what type of organisms are associated with mastoiditis with abscess?
what is the most common organism associated with meningitis?
strep pneumo in acute otitis media