Otitis Media- Acute otitis media, Otitis media with effusion Symptoms and treatment скачать в хорошем качестве

Otitis Media- Acute otitis media, Otitis media with effusion Symptoms and treatment

#otitis #otitismedia media is a group of diseases of the middle ear. Two main types exist: one acute otitis media (AOM) is most common in children and associated with ear pain. And Second: Otitis media with effusion (OME), typically not associated with symptoms, although occasionally a feeling of fullness is described; non-infectious fluid is presented in the middle ear which may persist for weeks or months often after an episode of acute otitis media. Acute otitis media is the second most common pediatric diagnosis in the emergency department following upper respiratory infections. It is very common among young children. 80 % of children will experience otitis media during their lifetime. It is especially common between the ages of 6 to 24 months. Otitis media can be caused by Viruses, bacteria or coinfection. The most common bacterial organisms include: Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. They are presented in 95 % of cases. Signs and Symptoms: Although one of the best indicators for otitis media is otalgia, pain in the ear but many children with otitis media can present with non-specific signs and symptoms, which can make the diagnosis challenging. These symptoms include pulling or tugging at the ears, irritability, headache, disturbed or restless sleep and poor feeding. Fever is presented in 70 % of cases, but it is low grade. Otitis media begins as an inflammatory process following a viral upper respiratory tract infection, involving the mucosa of the nose, nasopharynx, middle ear mucosa, and Eustachian tubes. Due to the constricted anatomical space of the middle ear, the edema caused by the inflammatory process obstructs the narrowest part of the Eustachian tube leading to a decrease in ventilation. This leads to a cascade of events resulting in an increase in negative pressure in the middle ear, increasing exudate from the inflamed mucosa, and buildup of mucosal secretions, which allows for the colonization of bacterial and viral organisms in the middle ear. Usually, No lab test or imaging is needed. Otitis media is diagnosed clinically via objective findings on physical exam (otoscopy) combined with the patient's history and presenting signs and symptoms. According to guidelines set forth by the American Academy of Pediatrics, evidence of moderate to severe bulging of the tympanic membrane, or new onset of otorrhea not caused by otitis externa, or mild tympanic membrane bulging with recent onset of ear pain, or erythema is required for the diagnosis of acute otitis media. Otoscopic examination should be the first and most convenient way of examining the ear and will yield the diagnosis to the experienced eye. Hearing loss, although not always present, is the most common complaint in Otitis media with effusion patients. Patients or parents of patients may complain of communication difficulties, withdrawal, and lack of attention. Risk Factors for otitis media: Genetic predisposition, Upper respiratory tract infection, Vitamin A deficiency, Bacterial pathogens, Allergies, Lack of breastfeeding Passive smoke exposure, Daycare attendance, Lower socioeconomic status Treatment: Treatment of otitis media with antibiotics is controversial. In Europe initially watchful waiting is more common, and if unresolved, antibiotics are warranted. In USA, Treatment is Antibiotics: When a bacterial etiology is suspected, the antibiotic of choice is high-dose amoxicillin for ten days in both children and adult patients who are not allergic to penicillin. Amoxicillin has good efficacy in the treatment of otitis media due to its high concentration in the middle ear. For those patients whose symptoms do not improve after treatment with high dose amoxicillin, high-dose amoxicillin-clavulanate (90 mg/kg per day of amoxicillin component, with 6.4 mg/kg per day of clavulanate in 2 divided doses) should be given. In children who are vomiting or if there are situations in which oral antibiotics cannot be administered, ceftriaxone (50 mg/kg per day) for three consecutive days, either intravenously or intramuscularly, is an alternative option. Non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen can be used to achieve pain control. Without proper treatment, suppurative fluid from the middle ear can extend to the adjacent anatomical locations and result in complications such as tympanic membrane perforation, mastoiditis, labyrinthitis, petrositis, meningitis, brain abscess, hearing loss, lateral and cavernous sinus thrombosis, and others By B. Welleschik - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index... By BruceBlaus - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index...