By ULY CLINIC
Otitis media
Introduction
It is an inflammation of the middle ear cavity. It is considered acute when the inflammation is of less than 2 weeks duration, and chronic when the inflammation is of more than 2 weeks duration with tympanic membrane perforation.
Diagnostic Criteria
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Examine the pinna;
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Using an otoscope carefully examine the external auditory canal and the tympanic membrane
Acute Otitis Media
Diagnostic Criteria
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Previous upper respiratory tract infection
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Painful ear
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Restlessness
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Fever
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Hearing often reduced
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Inflamed, bulged tympanic membrane
Non-Pharmacological Treatment:
Acute otitis media should be treated with analgesics, antibiotics and/or paracentesis (to reduce pain and to obtain pus for culture and sensitivity)
Pharmacological treatment:
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Phenoxymethylpenicillin (PO). Adults: 500mg 6 hourly for 10days; Children up to 5 years: 6 mg/kg 6 hourly for 10 days
OR
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Amoxicillin+Clavulanic acid 375–625mg 12 hourly for 10 days
OR
(for patients who are allergic to penicillin)
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Azithromycin (PO). Adults: 500mg once daily for 5 days and Children 10mg/kg once daily for 5 days
AND
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Paracetamol (PO). Adults: 1g 6 hourly for 3 days and Children: 10 mg/kg 6 hourly for 3 days
Note: Treatment periods shorter than 10 days increase the risk of treatment failure
Referral:
Referee this case to higher centre for further management by ENT specialist when;
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Children with high fever, severe ear pain, headache, altered state of consciousness
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A chronically discharging ear that persists in spite of proper treatment.
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Foul smelling ear discharge
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Mastoiditis
Otitis in the normal (or better hearing) ear combined with permanent hearing loss in the other ear
Updated on, 30.10.2020
References
1. STG