Acute Suppurative Otitis Media

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Acute Suppurative Otitis Media


  • most common 3-6 years old

Pathology

  • usually preceded by upper respiratory tract infection
  • acute inflammatory oedema blocks eustachian tube
  • viral effusion into middle ear

Organisms

  • Haemophilus
  • streptococci
    • inc Strep. pneumoniae

History

  • local symptoms
    • pain
    • conductive deafness
  • general
    • malaise
    • GI upset

Examination

  • red bulging ear drum
  • eventually ruptures with release of pus and reduction of pain

Treatment

  • analgesia
  • oral fluids
  • antibiotics
    • amoxycillin / penicillin (check with lab)

Outcome

  • resolution
  • necrosis
    • retraction pockets → cholesteatoma
    • conductive deafness
  • adhesions
    • conductive deafness
  • chronicity

Complications

  • acute mastoiditis
  • subperiosteal abscess
  • facial paralysis
  • acute suppurative labyrinthitis
  • venous sinus thrombosis
  • extra-dural abscess
  • subdural abscess
  • meningitis
  • brain abscess

 

 

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