Otitis Media Lecture Notes PDF

Lecture Material is adapted from © 2017 Wolters Kluwer Health, Lippincott Williams & Wilkins Applied Pathophysiology: A Conceptual Approach to the Mechanisms of Disease Chapter 12: Altered Somatic and Special Sensory Function Module 4: Clinical Models Copyright © 2...

Lecture Material is adapted from © 2017 Wolters Kluwer Health, Lippincott Williams & Wilkins Applied Pathophysiology: A Conceptual Approach to the Mechanisms of Disease Chapter 12: Altered Somatic and Special Sensory Function Module 4: Clinical Models Copyright © 2017 Wolters Kluwer Health | Lippincott Williams &Wilkins  Otitis Media Clinical Diagnostic Pathophysiology Treatment manifestations criteria  Otitis Media Pathophysiology Commonly diagnosed condition in children: 75% at least 1 episode by age 3 Acute otitis media (AOM) Infection in the middle ear Effusion (fluid) in middle ear creates an optimal environment for pathogen growth Associated with upper respiratory infections  Otitis Media Pathophysiology Otitis media with effusion (OME) More common than AOM Effusion (fluid) in the middle ear Trapping of fluid by obstruction in the eustachian tube Not associated with inflammation OME may occur either as the aftermath of an episode of AOM as a consequence of eustachian tube dysfunction attributable to an upper respiratory tract infection The 2 forms of OM may be considered segments of a disease continuum  Otitis Media ClinicalManifestations General manifestations Acute pain Enlarged periauricular lymph nodes Rhinorrhea (runny nose) Fever Impaired hearing Perforated tympanic membrane Otoscopic examination Gray or red tympanic membrane Fluid may be present Membrane may be bulging Scarring from previous perforations  Otitis Media Clinical Manifestations(cont’d) AOM Acute onset Middle ear effusion Inflammation Recurrent ≥ 3 episodes in 6 months or ≥ 4 over one year OME Middle ear effusion  Otitis Media DiagnosticCriteria http://pediatrics.aappublications.org/content/131/3/e964.long Diagnosis of AOM History of acute onset Otoscopic exam confirmation Effusion Bulging tympanic membrane Limited or absent mobility Visible air-fluid level Otorrhea (ear canal discharge) Signs of inflammation Redness/erythema of tympanic membrane Otalgia: - Pain referable to ears - Pain that interferes with activity/sleep  Otitis Media Treatment AOM: Acute Otitis Media OME: Otitis Media with Effusion Based on accurate diagnosis AOM versus OME Increasing rates of antibiotic resistance is a concern OME does not represent acute infectious process Does not benefit from antibiotics Observation OME and uncomplicated AOM Antibiotics AOM unresponsive to observation may indicate the need for antibiotics Amoxicillin should be prescribed as the drug of choice if antibiotics are necessary Alternative antibiotic if unresponsive to initial antibiotic therapy