Acute otitis media

2018 ◽  
Vol 11 (6) ◽  
pp. 305-312 ◽  
Author(s):  
John F Curran ◽  
Hannah L Cornwall ◽  
Miklos Perenyei ◽  
Tobias Moorhouse

Middle ear infection, or acute otitis media (AOM), is a common condition encountered in primary care. Unfortunately, the diagnosis and sequelae of AOM can be overlooked, leading to significant patient morbidity. This article aims to raise awareness of AOM and highlights the relevant anatomy, epidemiology and aetiology. We discuss prevention, diagnosis and management of AOM in primary care, the recognition of complications and when to refer to secondary care.

2002 ◽  
Vol 46 (7) ◽  
pp. 2194-2199 ◽  
Author(s):  
Franz E. Babl ◽  
Stephen I. Pelton ◽  
Zhong Li

ABSTRACT Treatment of acute otitis media (AOM) with azithromycin results in apparent clinical success, but tympanocentesis performed 4 to 6 days after initiation of therapy in children with nontypeable Haemophilus influenzae (NTHI) recovered from initial middle ear cultures demonstrates persistence of infection in more than 50% of episodes. We sought to determine the effect of azithromycin at different doses on the density of middle ear infection due to NTHI to provide additional understanding of this dichotomy between clinical and microbiologic outcome measures in AOM. In a chinchilla model of experimental otitis media (EOM), animals treated with placebo were compared to animals receiving a single daily dose 30 or 120 mg of azithromycin per kg of body weight per day for 5 days. Microbiologic outcome was assessed by obtaining quantitative cultures from the middle ear during a 5-day course and for 1 week following therapy. Azithromycin concentrations were measured to ascertain whether a concentration-dependent effect was present. Azithromycin at 30 and 120 mg/kg/day demonstrated a dose-dependent effect on the quantitative assessment of middle ear infection due to NTHI. A 30-mg/kg dose of azithromycin daily resulted in levels in serum and areas under the serum concentration-time curve at 24 h comparable to published data obtained with children given azithromycin at 5 to 10 mg/kg in multiday regimens. Increased doses of azithromycin (120 mg/kg) achieved 2.5- to 4-fold-higher levels in serum and 3- to 6-fold-higher total levels and levels in extracellular middle ear fluid as well as more rapid reduction in bacterial density and a greater proportion of middle ears with complete sterilization than either placebo or the 30-mg/kg/day regimen.


BMJ ◽  
2020 ◽  
pp. m4238
Author(s):  
Roderick P Venekamp ◽  
Anne G M Schilder ◽  
Maaike van den Heuvel ◽  
Alastair D Hay

1990 ◽  
Vol 9 (12) ◽  
pp. 936
Author(s):  
S. Michael Marcy ◽  
Michael E. Pichichero ◽  
Richard H. Schwartz

2021 ◽  
Vol 27 (1) ◽  
pp. 20-24
Author(s):  
Nurfadhilah Aisyah Murad ◽  
Zalilah Musa ◽  
Kharudin Abdullah ◽  
Irfan Mohamad

Middle ear infection occurs when fluid accumulate in middle ear as a result of inflammatory response to viral or bacterial infection. Infections may spread from the middle ear, resulting in a subperiosteal collection beneath the temporal muscle. Luc abscess is a rare complication of otitis media. The difference of this complication with other extracranial abscesses relating to otitis media is, it may not be associated with mastoid bone involvement. Therefore, it is defined as benign complication of otitis media. Here, we report a case of 10-month-old baby boy diagnosed with Luc abscess with mastoid involvement.


2018 ◽  
Vol 28 (1) ◽  
pp. 15-18
Author(s):  
Mary Ann V. Macasaet ◽  
Emmanuel Tadeus S. Cruz

Objectives:     To present a case of vocal cord paralysis and dysphagia developing in Gradenigo syndrome and to discuss its clinical presentation, differential diagnosis and therapeutic approach.   Methods:             Design: Case Report             Setting:  Tertiary Government Hospital             Patient: One   Results:  A 54-year-old lady was admitted with a six month history of left-sided otorrhea, cheek and jaw pain, three months otalgia, and recent-onset hoarseness, dysphagia and diplopia on a background of mastoidectomy at age 6. Otoscopy revealed granulation tissue and chlolesteatoma occupying the left external auditory canal. There was left vocal cord paralysis with pooling of saliva in the pyriform sinus, left lateral gaze paralysis, and left facial nerve paralysis. CT scan revealed sclerosis of the left petrous apex and leptomeningeal enhancement on the left temporal lobe. Chronic suppurative otitis media with cholesteatoma and Gradenigo syndrome was diagnosed, and canal wall down mastoidectomy was performed Postoperatively, the otalgia and pain over the left jaw diminished in intensity while hoarseness and left lateral gaze palsy remained.   Conclusion: Gradenigo syndrome is known for its triad of retro-orbital pain, lateral gaze paralysis, and chronic middle ear infection due to petrous apicitis. Although rare, vocal cord paralysis and dysphagia may develop when infection traverses and encroaches on the jugular foramen where cranial nerves IX, X, and XI are lodged.  Knowledge of the syndrome should not be limited or confined to the classic triad.  Practicing ear specialists should be vigilant and cognizant of the clinical manifestations and sequelae of chronic middle ear infection. Prompt surgical intervention is crucial while resolution of the disease may vary for different individuals.   Keywords: Chronic otitis media, Gradenigo syndrome, vocal cord paralysis, petrous apicitis  


Author(s):  
Marc R. Safran ◽  
James Zachazewski ◽  
David A. Stone

1995 ◽  
Vol 81 (2) ◽  
pp. 127-134
Author(s):  
A P Newton

AbstractAcute Otitis Media is a common condition of childhood which potentially has a number of significant sequelae including the development of Otitis Media with Effusion (‘Glue Ear’). A general practice based study is described which assesses the implementation of a protocol for the follow up of Acute Otitis Media by the primary care team. The results of this study show that following the introduction of a follow up protocol a significantly improved rate of followup was achieved with resultant improvements in the identification of ‘Glue Ear’ and hence more appropriate referral for ENT care.


1986 ◽  
Vol 20 (9) ◽  
pp. 666-669 ◽  
Author(s):  
Bev Lorraine True ◽  
Dennis K. Helling

Antibiotic treatment of acute otitis media (AOM) accounts for a significant number of all antibiotic prescriptions each year. In the primary care setting, initial antibiotic selection is rarely based on direct evidence, such as cultures of middle ear fluid. Initial antibiotic therapy by the primary care practitioner involves the evaluation and application of information related to prevalence of infecting organisms; in vitro antibiotic spectrum and penetration into middle ear fluid; initial cure rate, relapse and recurrence rates; and antibiotic cost, safety, and convenience. The influence of these factors on the initial antibiotic choice for AOM is reviewed. Several therapeutic dilemmas confronting the prescriber are discussed and a rational approach to initial antibiotic therapy is presented.


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