Otitis Media

Overview

75% of children have 3 episodes by 2

caused by

BacteriaS.pneunomia

H.influenza

Moraxella caterhalis

VirusInfluenza A

RSV

Parainfluenza

Presentation

Ear pain/tugging on ears

Fever

Irritability

Difficulty feeding/sleeping

Vomiting/diarrhea

Diagnosis

Otoscope

Erythema

Bulging or retraction

Loss of TM light reflex

Decreased TM mobility

Differential Diagnosis

Viral otitis media ¼

Otitis ExtrenaTM not affected

Otitis Media with EffusionFluid level no erythema, hearing loss only symptom

Chronic Otitis Media

Teething

Treatment

Ibuprofin or acetaminophen

Topical benzocaine over 2Under 2 risk of methemoglobinemia

No antihistamines

High dose amoxicillin: 80-90 mg

Resistant cases- Augmentin

Tympanostomy tubes3 infections in 6 months or 4 in 12 months

Complications

TM perforation

Mastoiditis

Meningitis

Chesteatomas

Chronic otitis media

Hearing loss

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