Otitis media

Question 1

Signs and symptoms of otitis media?

Answer 1

Viral URTI followed with…
Ear pain
Reduced hearing
Fever
Vertigo
Balance issues
Discharge if tympanic membrane perforation

Otoscopy - bulging red inflamed tympanic membrane

Question 2

Most common bacterial causes of otitis media?

Answer 2

Streptococcus pneumoniae
Haemophilius influenzae
Moraxella catarrhalis

Question 3

What are the complications of otitis media?

Answer 3

Mastoiditis
Otitis media with effusion

Question 4

Management of otitis media?

Answer 4

Self limiting - 3 days. Offer delayed prescription.
Paracetamol, ibuprofen

If immunocompromised/systemically unwell/under 2yo/otorrhoea ->amoxcillin/clairythromycin/erythromycin depending on contraindications and allergy to either abx

Recommend keeping ears dry and avoiding swimming in cases of perforation

Question 5

When should children with otitis media be admitted?

Answer 5

Under 3 months old and temperature of 38 and above

Meningitis, mastoiditis, facial nerve palsy complications

Systemically unwell