Otitis media Flashcards
What is otitis media?
inflammation of the middle ear.
What are features of otitis media?
rapid onset of:
pain
fever
irritability
anorexia
vomiting
often after a viral upper respiratory tract infection
What are the otoscopy findings for otitis media?
acute onset of symptoms
otalgia or ear tugging
presence of a middle ear effusion
bulging of the tympanic membrane, or
otorrhoea
decreased mobility on pneumatic otoscopy
inflammation of the tympanic membrane
i.e. erythema
What are the indications for antibiotics in otitis media?
Symptoms lasting more than 4 days or not improving
Systemically unwell but not requiring admission
Immunocompromise or high risk of complications secondary to significant heart, lung, kidney, liver, or neuromuscular disease
Younger than 2 years with bilateral otitis media
Otitis media with perforation and/or discharge in the canal
What is the management of otitis media?
Acute otitis media is generally a self-limiting condition that does not require an antibiotic prescription.
If an antibiotic is given, a 5-7 day course of amoxicillin is first-line. In patients with penicillin allergy, erythromycin or clarithromycin should be given.
What can otitis media lead to?
perforation of the tympanic membrane → otorrhoea
unresolved with acute otitis media with perforation may develop into chronic suppurative otitis media (CSOM)
CSOM is defined as perforation of the tympanic membrane with otorrhoea for > 6 weekS
hearing loss
labyrinthitis
What are the complications of otitis media?
mastoiditis
meningitis
brain abscess
facial nerve paralysis
What is chronic secretary otitis media also known as?
Glue ear
What are features of chronic secretary otitis media?
This presents as persistent pain lasting a couple of weeks after the initial episode
The drum looks abnormal and will show reduced mobility of the membrane.
