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Acute Suppurative Otitis Media

Acute suppurative otitis media is an inflammation of the middle ear caused by purulent (pus-forming) bacteria. It is characterized by ear pain, pus discharge from the ear, redness of the eardrum, and potential perforation of the eardrum. Common bacteria that cause it include streptococcus pneumoniae, hemolytic streptococcus, and haemophilus influenzae. Treatment involves antibiotics taken for 10-14 days, analgesics, and local eardrops after perforation of the eardrum to clean the ear.

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3K views20 pages

Acute Suppurative Otitis Media

Acute suppurative otitis media is an inflammation of the middle ear caused by purulent (pus-forming) bacteria. It is characterized by ear pain, pus discharge from the ear, redness of the eardrum, and potential perforation of the eardrum. Common bacteria that cause it include streptococcus pneumoniae, hemolytic streptococcus, and haemophilus influenzae. Treatment involves antibiotics taken for 10-14 days, analgesics, and local eardrops after perforation of the eardrum to clean the ear.

Uploaded by

suci
Copyright
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We take content rights seriously. If you suspect this is your content, claim it here.
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Acute Suppurative Otitis Media

Shixun Zhong Ph.D.


Department of Otolaryngology
The First Affiliated Hospital
Chongqing Medical University
Definition

• Acute otitis media is an acute


purulent inflammation of the
lining of the middle ear caused
by purulent bacteria.
• Characterized by otalgia, purulent discharge, hyperemia
and perforation of eardrum.
• Bacteriology:
– Streptococcus pneumoniae
– hemolytic streptococcus
– haemophilus influenzae
– Staphylococcus
Route of infection

• Eustachian tube：
– Upper respiratory tract
infection
• common cold, acute rhinitis,
acute tonsillitis
– Swim, dive
– Acute infectious disease
• measles, scarlet fever or
influenza
– Breast-feeding
• External auditory
canal-eardrum
– Injury, tympanocentesis
• Hematogenous infection
Clinical features

• Symptoms：
– General symptoms
• fever, malaise, anorexia, vomiting, and diarrhea.
• More evident in child
• subside after tympanic membrane perforation
occurs
Clinical features

• Symptoms：
– Local symptoms：
• Otalgia: sharp before perforation
• Aural fullness，tinnitus, hearing loss
• Otorrhea: mucoid discharge initially, mucopurulent
later
Clinical features

• Signs：
– otoscopy：
• Hyperemic, bulging,
poor mobility
• Perforation, purulent
discharge

- Palpation: tenderness at mastoid or antrum


Stage of congestion
Stage of exudation
Stage of suppuration
convalescence stage
Clinical features

• Audiometry：
– Usually conductive hearing loss
• Blood test：WBC ↑
• Nasopharyngoscopy：
Diagnosis

History + Clinical features + Laboratory


Differential diagnosis

• Acute otitis externa and furuncle：


– Earache, swelling in canal
– No or mild inflammation on
eardrum
– Normal hearing
Differential diagnosis

• Acute myringitis：
– Earache
– No ear discharge
– Bulla on eardrum
Treatment

• General management：
– Antibiotics:
• penicillin, ampicillin, Cefixime etc.
• 10-14 days；
– Analgesics
– Antipyretics
– Oral decongestants, antihistamines
– Supportive treatment
Treatment

• Local management：
– Before perforation：
• Eardrops: 3%
carbolic acid in
glycerin
• myringotomy
– Indication:
• 1% ephedrine nose
drops
Treatment

• Local management
– After perforation：
• aural toilet and eardrops
– 3% hydrogen peroxide solution
– 0.25% chloromycetin solution
– 0.3% ofloxacin solution
– 3% jiemycin solution
Treatment
• Treatment of causative factors：
– Adenoidectomy
– Tonsillectomy
– Rhinitis
– Sinusitis
Thank You

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