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Acutesuppurativeotitismediaresultsfrombacterialinfectionofthemiddleearcleft,oftenasabacterialcomplicationofthecommoncold.Thisismorefrequentinchildrenthaninadults.
Acutesuppurativeotitismedia1Etiology
#Thecommoninfectiveorganismsarebetahemolyticstreptococcus,pneumo-coccus,Hemophilusinfluenzae,andstaphylococcus.
#Eustachiantubes:viralupperrespiratoryinfection,enlargedadenoids,sinusinfections,allergy-causingedemaintheeustachiantuberegion,andcleftpalate.
Etiology
#Thecommoninfecti2#Othercause:traumaticrupture,perforationofthetympanicmembrane,frominfectionfollowingearsurgery.
#ASOMisaself-limitingdisease,andwhentreatedadequatelyitrarelyleavesanyresidualchange.
#Othercause:traumaticruptur3ClinicalFeatures
Symptoms.
Fever,malaise
Otalgia
Decreasein
hearing
Dischargefromtheearcanal:muco-purulentorpurulent.(perforationofthetympanicmembrane).ClinicalFeatures
Symptoms.4OnExamination
Intheearlystage,thetympanicmembranewillshowretractionandlackofmobility.
Nextwiththeonsetofedemaandexudationthedrumwillloseitslandmarks,appearthickanddull,andmayhaveafluidlevel.
Thefluidisthickandnotclear,asinthecaseofserousotitismedia.
OnExamination
Intheearlys5Tympanicmembraneoutwardandcausebulgingofthedrum.
Ifuntreatedthetympanicmembranewillrupture,givingrisetoaserosanguinousandthenmucopurulentorpurulentdischargefromtheear.
Perforationoccursintympanicmembranecentral.Tympanicmembraneoutwardand6TympanicmembranebeforeperforationwithASOMTympanicmembranebeforeperfo7TympanicmembraneafterperforationwithASOMTympanicmembraneafterperfor8Afterperforation,painandfevermaynotbeasmarkedasintheearlierstages,butthereispersistenceofpurulentdischargeandrecurrenceofpain.
Pressureonthemastoidtipwillproducepain-mastoidtenderness.
Infectionmayspreadtomastoidcausemastoiditis.Afterperforation,painandfe9Tuningforktests:aconductivehearingloss.
X-rayfilmorCTscanexaminationsintheearlystagesmayshowhazinessorcloudiness.
Tuningforktests:aconducti10Treatment
SymptomaticTreatment.
Analgesics:pain
antipyretics:fever.
fluidreplacement:preventofdehydration
Treatment
SymptomaticTreatm11Thecultureandthesensitivityofdischarge
Antibiotictreatment:Penicillingivensystemicallywillmanagemostoftheseinfections.InchildrenthepossibilityofHemophilusinfluenzaeshouldbekeptinmind,andthismayrequireampicillinifthereisnoresponsetopenicillinorifthecultureandthesensitivitytestsoindicate.Antibioticsshouldbegivenfor5to7days,certainlynotless.Thecultureandthesensitivit12Systemicdecongestantshelpreduceswellingandtherebyfacilitatedrainageofthemiddleear.Thesearegivenforaperiodoftwoweeksormore,dependingonhowquicklythemiddleearbecomesfreeoffluid.
Ifthedrumappearsfullandbulging,amyringotomyshouldbecarriedoutfordrainage.Systemicdecongestantshelpre13
EardropsalsocanbevalueforinfectioninASOM.0.25%-1%Chloramphenicoland0.3%Ofloxacineardropsarerecommended.
Beforeusingeardrops,
cleaningpurulentdischarge
inearby2%
hydrogehperoxidesolution.
Coldcreamcanbeused
toprotectskinmacerated
fromeardischarge.
Localtreatment
Eardropsalsocanbevaluef14ENDEND15急性化膿性中耳炎ASOM課件16Acutesuppurativeotitismediaresultsfrombacterialinfectionofthemiddleearcleft,oftenasabacterialcomplicationofthecommoncold.Thisismorefrequentinchildrenthaninadults.
Acutesuppurativeotitismedia17Etiology
#Thecommoninfectiveorganismsarebetahemolyticstreptococcus,pneumo-coccus,Hemophilusinfluenzae,andstaphylococcus.
#Eustachiantubes:viralupperrespiratoryinfection,enlargedadenoids,sinusinfections,allergy-causingedemaintheeustachiantuberegion,andcleftpalate.
Etiology
#Thecommoninfecti18#Othercause:traumaticrupture,perforationofthetympanicmembrane,frominfectionfollowingearsurgery.
#ASOMisaself-limitingdisease,andwhentreatedadequatelyitrarelyleavesanyresidualchange.
#Othercause:traumaticruptur19ClinicalFeatures
Symptoms.
Fever,malaise
Otalgia
Decreasein
hearing
Dischargefromtheearcanal:muco-purulentorpurulent.(perforationofthetympanicmembrane).ClinicalFeatures
Symptoms.20OnExamination
Intheearlystage,thetympanicmembranewillshowretractionandlackofmobility.
Nextwiththeonsetofedemaandexudationthedrumwillloseitslandmarks,appearthickanddull,andmayhaveafluidlevel.
Thefluidisthickandnotclear,asinthecaseofserousotitismedia.
OnExamination
Intheearlys21Tympanicmembraneoutwardandcausebulgingofthedrum.
Ifuntreatedthetympanicmembranewillrupture,givingrisetoaserosanguinousandthenmucopurulentorpurulentdischargefromtheear.
Perforationoccursintympanicmembranecentral.Tympanicmembraneoutwardand22TympanicmembranebeforeperforationwithASOMTympanicmembranebeforeperfo23TympanicmembraneafterperforationwithASOMTympanicmembraneafterperfor24Afterperforation,painandfevermaynotbeasmarkedasintheearlierstages,butthereispersistenceofpurulentdischargeandrecurrenceofpain.
Pressureonthemastoidtipwillproducepain-mastoidtenderness.
Infectionmayspreadtomastoidcausemastoiditis.Afterperforation,painandfe25Tuningforktests:aconductivehearingloss.
X-rayfilmorCTscanexaminationsintheearlystagesmayshowhazinessorcloudiness.
Tuningforktests:aconducti26Treatment
SymptomaticTreatment.
Analgesics:pain
antipyretics:fever.
fluidreplacement:preventofdehydration
Treatment
SymptomaticTreatm27Thecultureandthesensitivityofdischarge
Antibiotictreatment:Penicillingivensystemicallywillmanagemostoftheseinfections.InchildrenthepossibilityofHemophilusinfluenzaeshouldbekeptinmind,andthismayrequireampicillinifthereisnoresponsetopenicillinorifthecultureandthesensitivitytestsoindicate.Antibioticsshouldbegivenfor5to7days,certainlynotless.Thecultureandthesen
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