Acute Otitis Media in Children

Wednesday, June 16, 2010

a. Definition

Otitis media is an acute inflammation of the middle ear which associated with effusion and a buildup of fluid in the middle ear. Usually, interference occurs the middle ear aeration is caused by a disturbed function of eustachius duct.


b. Etiology

In most cases, Acute otitis media caused by a virus, but it is difficult to distinguish between viral or bacterial etiology based on clinical presentation and examination using otoskop only. Acute otitis media is usually exacerbated by upper respiratory infections caused by viruses that cause edema in the eustachius fallopian. This resulted in an accumulation of fluid and mucous which then is infected by bacteria. The most common pathogens infecting the children are Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis. Bacteria are involved in different chronic infection with acute otitis media, where P. aeruginosa, Proteus species, Staphylococcus aureus, and the combined anaerobic become real.


c. Risk factors

Men
Age under 2 years

White, American Indian

The first attack usually under 6 months

S. Infection Pneumonia.


Acute Otitis Media

d. Clinical manifestations

Classic symptoms include pain, fever, malaise, and sometimes in addition to head pain, ear pain, especially in children can occur anorexia and sometimes nausea and vomiting. Fever may be high but may also not found in 30% of cases. All or part of the tympanic membrane is typically become red and prominent, and blood vessels in the tympanic membrane and stalk malleolus dilates and becomes prominent. It is best diagnosed using pneumatic otoskop. If otoskop not available, should be suspected of an acute otitis media if there is discharge coming out of the ear for less than two weeks, or there is a sudden ear pain, persisten.


e. Diagnosis

Examination of the tympanic membrane showed a reduced movement, convex, reddish and turbid, it can also be found that purulent secretions.

f. Treatment
Oral amoxicillin 40 mg / kg / day, three times a day for 10 days

The second option can be given a combination of erythromycin 50 mg / kg / day with sulphonamides 100 mg / kg / day or sulfiksoksazol 150 mg / kg / day four times a day.

Supportive therapy: analgesics, antipyretics, decongestants.

Patients with severe ear pain conducted miringotomi




2 comments:

Post a Comment

Search