Middle ear infection Fluid present in middle ear Very uncommon in children
Causes/Factors
- Viruses
- Similar bacteria as Otitis Externa
- Strep. pneumoniae
Symptoms
Uncomplicated
- <72 hours of mild pain
- Absence of severe systemic symptoms
- Temp <39
- No ear discharge
Complicated
- Severe pain
- Perforated eardrum
- And/or purulent discharge
- Bilateral infection
Signs
Diagnostic Tests
- Swab any pus
Management
- If not unwell watch and treat symptomatically
- Amoxicillin
Recurrent acute otitis media defined as: 3 or more episodes in 6 months, 4+ episodes in 12 months
For children a surgical option may be grommets and myringotomy
Complications/red Flags
Mastoiditis
- Most common complication - inflammation of the mastoid Bone and air cells
- CT scan always required
- Analgesia, IV antibiotics +/- mastoidectomy