Otitis media is inflammation
of the middle ear,
or a middle ear infection. It occurs in the area between the tympanic
membrane and the inner ear, including a duct known as the Eustachian Tube.
Sometimes present as non-purulent fluid within the middle ear cavity. It
affects more boys than girls, occurs more in cold weather. 1/3 of children will
have 3 or more infections by age 3, 90% of children will have at least one
infection by age 6.
Most common bacteria cause otitis
media are: Streptococcus pneumonia, Haemophilus
influenzae(non-typeable), Moraxella catarrhalis, Group A Streptococcus, Staph
aureus, Pseudomonas aeruginosa, RSV assoc. with Acute Otitis Media. Most
common pathogenesis is following an URI in which there is edema of the Eustachian
Tube, leading to blockage. Stasis of these middle ear secretions leads to
infection and irritation. Other factors include allergic rhinitis, nasal
polyps, and adenoidal hypertrophy.
Physical exams will find an
erythematic, opaque, bulging tympanic membrane with loss of anatomic landmarks
including a dull/absent light reflex. Pneumatic Otoscopy reveals that decreased
tympanic membrane mobility and is the gold standard for the diagnosis.
Complications of otitis media are
serious such as hearing loss, acute mastoiditis, cholesteatoma, bacterial
meningitis, epidural abscess, subdural empyema, brain abscess, otitic
hydrocephalus, Lateral sinus thrombosis, etc. Earlier treatment makes better prognosis.
Teatment often use Amoxicillin: 20-40 mg/kg/day tid for 10-14 days.
It is very interesting to learn how severe some ear infections can get, especially in immunocompromised individuals. I recently read somewhere that you can help reduce the chance of getting otitis media by keeping children away from second hand smoke and making sure they have had all their vaccines. I also read an article that suggests pacifiers and bottle feeding could increase a child's risk for getting otitis media.
ReplyDeleteI found it very interesting in class about why kids are more suspectible to eating this ear infections which is becuase The Eustachian tube, a canal that runs from the middle ear to the back of the nose and throat, is shorter and more horizontal in young children than in older children and adults. This allows easier entry into the middle ear for the microorganisms that cause infection and lead to otitis media. The result is that children are at greater risk of acquiring ear infections than adults. I had to go through a lot of these tubes when i was a baby and never knew why until now.
ReplyDeleteAfter researcing this topic more, I found that a recent study suggests that the chances of getting otitis media has increased becasue of the increase of children in daycare. There seems to be a drect correlation between the two. The close contact between other students increases the chances of respiratory infections, which then leads to otitis media, often recurrent in children.
ReplyDeleteI always wondered why specifically infants and young children were always affected with ear infections. I came across an interesting article that cited a study stating that infants and children who have contact or live in a home with a dog and cats are less likely to experience as many ear infections and breathing problems. While reading this I was surprised. The theory for this happening is said to be because the pet brings in bacteria and therefore, may cause the baby's immune system to mature faster, making it easier to fight against infections. Here is the article link if anyone is interested in reading it in more detail. http://in.news.yahoo.com/babies-dog-owning-families-may-healthier-study-012601969.html
ReplyDeleteThat is very interesting and certainly the opposite of what is generally thought.
Delete