//fpnotebook.com/
Otitis Media
Aka: Otitis Media, Acute Otitis Media, Acute Suppurative Otitis Media, Acute Purulent Otitis Media, Acute Bacterial Otitis Media
- See Also
- Otitis Media Diagnosis
- Otitis Media Acute Treatment
- Observation Protocol for Acute Otitis Media Management
- Otitis Media Prophylaxis
- Epidemiology
- Incidence of infection
- All children by 1 year of age: 62%
- All children by 3 years of age: 83%
- Average of 1.5 Acute Otitis Media episodes per year
- Peak Incidence at age 6-15 months (decreases after 24 months)
- Risk Factors: Recurrent Otitis Media or persistent Effusion
- Age < 5 years old (5 fold Relative Risk)
- Otitis prone (4x) (see below)
- Day care (4x)
- Respiratory Illness (4x)
- Smokers in home (3x)
- Bottle Propped babies (2x)
- Males (2x)
- Pacifier use after 6 months old
- Premature birth before 37 weeks gestation
- Gastroesophageal Reflux
- Risk Factors: Protective Factors against Otitis Media
- Summer (0.5x)
- Breast Feeding (0.25x)
- Risk Factors: Otitis Prone patients
- Age at first episode of Otitis Media <6 months
- Greater than 3 episodes in the last 6 months
- Race
- Native American higher Incidence
- African American lower Incidence
- Sibling history of frequent ear infections
- Immune Deficiency
- Craniofacial abnormalities
- Down Syndrome
- Cleft Palate
- Pathophysiology
- Antecedent Event: Upper Respiratory Infection
- Congestion of resp mucosa
- Obstruction: isthmus-narrowest part of tube
- Increased tube negative pressure
- Development of effusion (serum pulled in)
- Effusion colonization
- Pathophysiology: Pathogens
- Streptococcus Pneumoniae
- Incidence: 38%
- Beta Lactamase producing: 15-25%
- Causes more severe cases with Otalgia and fever
- HaemophilusInfluenzae
- Incidence: 27%
- Beta Lactamase producing: 35%
- More often associated with Eye Redness and discharge
- Moraxella catarrhalis
- Incidence: 10%
- Beta Lactamase producing: 85-100%
- Group-A Beta Hemolytic Streptococcus
- Incidence: 3%
- Staphylococcus aureus
- Incidence: 2%
- Findings: Symptoms and Signs
- See Otitis Media Symptoms and Signs
- Complications
- Intracranial
- Meningitis
- Subdural Empyema
- Brain Abscess
- Lateral Sinus Thrombosis
- Focal Otitis Encephalitis
- Extracranial
- Hearing Loss
- Tympanic Membrane Perforation
- Chronic Suppurative Otitis Media
- Mastoiditis
- Cholesteatoma
- Facial Paralysis
- Tympanosclerosis
- Labyrinthitis
- Diagnosis
- See Otitis Media Diagnosis
- See Otalgia
- Management
- See Otitis Media Acute Treatment
- See Otitis Media Prophylaxis
- References
- Daly (1991) Otolaryngol Clin North Am 24:775-86 [PubMed]
- Daly (1999) Pediatrics 103:1158-66 [PubMed]
- Gaddey (2019) Am Fam Physician 100(6): 350-6 [PubMed]
- Klein (1994) Clin Infect Dis 19:823-32 [PubMed]
- Lieberthal (2013) Pediatrics 131(3): e964-99 [PubMed]
- Palmu (2004) Clin Infect Dis 38:234-42 [PubMed]
- Teele (1989) J Infect Dis 160:83-94 [PubMed]