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Published byMatilda Farmer Modified over 9 years ago
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AOM
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Otitis Media Otitis Media with effusion (OME) Acute Otitis Media (AOM) Recurrent AOM Chronic Otitis Media/Chronic Otitis Media with effusion Chronic Suppurative Otitis Media (CSOM)
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Epidemiology Seasonal Peak: winter months 90% of children have at least one symptomatic or asymptomatic episode by 2yrs of age Incidence Peaks: 6-18months of age
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Risk Factors Age <2yrs Atopy Bottle propping Chronic sinusitis Ciliary dysfunction Cleft palate and craniofacial anomalies Child Care attendance Down Syndrome and other genetic conditions
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Pathogenesis Impaired eustachian tube function Negative pressure increases Nasopharyngeal contents are aspirated into middle ear Increased vascular permeability: development of MEE
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Viruses RSV Paraflu (types 1,2,3) Influenza (type A and B) Adenovirus Coronavirus
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Bacteria Streptococcus Pneumoniae Nontypeable Hemophilus influenza Moraxella catarrhalis S. pyogenes (Group A strep) Staph Aureus (less common)
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PE: OME vs AOM Fluid in middle ear space AOM: inflammation, specifically otalgia and fever OME: TM appears opaque or cloudy AOM: red or dark-yellow discoloration of TM or bulging of TM
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Normal TM
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OME
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AOM
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Management Observation Treatment
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Management <6months: antibacterial therapy 6months to 2years with certain diagnosis: antibacterial therapy 6months to 2 years with uncertain diagnosis: antibacterial therapy or observation 2yrs and up with certain diagnosis: antibacterial therapy or observation 2yrs and up with uncertain diagnosis: observation
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Antibiotic High dose amoxicillin: 80-90mg/kg/day Alternative for penicillin allergy Augmentin 90mg/kg per day of amox component Ceftriaxone Clindamycin
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Complications Mastoiditis Acute labyrinthitis Petrositis Meningitis Brain Abscess Epidural Abscess Otitic hydrocephalus
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