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In this section : Ear, Nose and Throat
Management of Epistaxis Sore Throat Differential Diagnosis Dizziness Differential Diagnosis Peritonsillar Abscess/Quinsy Acute Tonsillitis Acute Mastoiditis Otitis Media Otitis Externa WoS Paediatric Drooling and Aspiration Guideline Voice clinic Ear Wax Admitting Patients with Tracheostomy/Laryngectomy to DGRI Emergency Laryngectomy Management Emergency Tracheostomy Management Safe Transfer of Patients with Tracheostomy/Laryngectomy within DGRI Other Tracheostomy Documents
Home | Articles | Ear, Nose and Throat | Otitis Media

Otitis Media

Last updated 10th October 2023

Definition

  1. Inflammation of the middle ear cleft associated with purulent discharge.
  2. OM common organisms: Pneumococcus, Haemophilus, Moraxella

Symptoms

  1. Otalgia
  2. Hearing loss
  3. Otorrhoea
  4. Fever
  5. Systemic upset

On Otoscopic Examination

  1. A distinctly red, yellow, or cloudy tympanic membrane.
  2. Moderate to severe bulging of the tympanic membrane, with loss of normal landmarks and an air-fluid level behind the tympanic membrane (indicates a middle ear effusion).
  3. Perforation of the tympanic membrane and/or discharge in the external auditory canal.

Colour image showing otitis media. The middle ear is filled with a creamy white mucopurulent exudate which is causing the tympanic membrane to bulge laterally. Note the dilatation of the radial blood vessels of the tympanic membrane which appear like the spokes of a wheel.

Treatment

  1. Analgesia
  2. Usually AOM resolves in 60% within 24 hour without antibiotics.
  3. If no improvement after 3-4 days, then give antibiotics: amoxicillin or erythromycin if penicillin allergic
  4. Children <2 years need prescription of ABX

Links

  1. Oxford Handbook of Clinical Specialties – Baldwin, Oxford Academic 2020 – Page 394 [Available via Knowledge Network]
  2. How to Make a Diagnosis of Otitis Media – NICE July 2023
  3. Image of Otitis Media used under Creative Commons Licence

Content by Alexandra Barabas and Marissa Botma