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MIDDLE EAR INFECTIONS

MIDDLE EAR INFECTIONS. Otitis Media. inflammation of the middle ear In the US, second most common disease of childhood, after URTI, accounting for approximately 20 million physician visits every year. Caused by e ustachian tube (ET) dysfunction. Risk factors.

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MIDDLE EAR INFECTIONS

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  1. MIDDLE EAR INFECTIONS

  2. Otitis Media • inflammation of the middle ear • In the US, second most common disease of childhood, after URTI, accounting for approximately 20 million physician visits every year. • Caused by eustachian tube (ET) dysfunction

  3. Risk factors • Frequent and prolonged URTI • Craniofacial abnormality • Smoking by parents • Bottle feeding

  4. OM with effusion/Serous OM • usually follows an episode of AOM d/t the accumulation of fluid from a block ET • Hearing loss, intermittent otalgia • Gray or brown fluid/bubbles behind an intact eardrum

  5. Chronic OM • chronic inflammation of the middle ear that persists at least 6 weeks • associated with otorrhea through a perforated TM, conductive hearing loss

  6. Complications

  7. Diagnosis • Diagnostic certainty is based on all 3 of the following criteria: • acute onset • middle ear effusion (MEE) • middle ear inflammation

  8. Treatment

  9. Treatment • Observation: • Observe for 48-72 hours, with symptomatic treatment • Antibiotic therapy • DOC: Amoxicillin 80-90 mg/kg/d • 10 days : <6y/o; with severe illness • 5-7 days : >6 y/o • Alternatives: cefdinir, cefpodoxime, or cefuroxime • persistent symptoms or recurrent acute otitis media (AOM) should be referred to an otorhinolaryngologist for evaluation and possible tympanocentesis

  10. Prevention • breastfeed infants for at least 6 months to help to prevent the development of early episodes of ear infections. If a child is bottle-fed, hold the infant at an angle rather than allowing the child to lie down with the bottle. • prevent exposure to secondhand smoke • reduce exposure, if possible, to large groups of other kids, such as in child-care centers. • good hand washing • keep children's immunizations up-to-date, because certain vaccines can help prevent ear infection

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