is an inflammation of the middle ear, sometimes associated with upper respiratory tract infection.
it can be classified as follows:
acute suppurative
chronic suppurative
serous / secretory
acute suppurative otitis media
may be caused by viral or bacterial infections, or bacterial infection complicating a viral illness,
it causes ear pain and tenderness
chronic suppurative otitis media conditions are not usually painful
manifests as persistent drainage from the ear associated with tympanic membrane perforation and some degree of conductive hearing loss. Chronic ear
serous or secretory otitis media
refers to non-suppurative fluid accumulation in the middle ear
this condition is frequently associated with dysfunction or obstruction of the eustachian tube, such as may result from tonsillar hyperplasia or recurrent infection
this condition is an important cause of hearing problems in children.
in adults, a unilateral serous effusion may be due to a nasopharyngeal tumour which should be excluded
A review concluded that (1):
suspect acute otitis media in children with ear pain (ear symptoms can be subtle especially in young pre-verbal children), with or without fever
the presence of middle ear effusion on otoscopy is a prerequisite for diagnosis of acute otitis media
antibiotic treatment
offer oral antibiotics to children with acute otitis media who are systemically unwell and to those at high risk of complications because of pre-existing comorbidity
oral antibiotics can be considered in children under 2 with bilateral acute otitis media and in children of any age with acute otitis media and acute ear discharge a spontaneous rupture of the eardrum
Reference:
Venekamp RA et al. Acute otitis media in children.BMJ 2020;371:m4238 http://dx.doi.org/10.1136/bmj.m4238
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