Acute Otitis Media
10
Quick facts
by Peter Gill
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What are the most common causes of acute otitis media?
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1. Streptococcus pneumoniae
2. Haemophilus influenzae
3. Moraxella catarrhalis
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What age is acute otitis media in it's peak incidence?
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7 - 12 months of age
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What months of the year have peak's in incidence?
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January and February - correspond to RSV, rhinovirus and influenza seasons
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What are the major risk factors?
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Young age
Bottle feeding
Drinking a bottle in bed
Presence of sibling at home
Exposure to tobacco smoke
Exposure to infectious agents (ex. daycare)
Family history of ear infection
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What are symptoms of AOM?
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Infants: Fever, irritability, poor feeding
Older children: fever, otalgia, otorrhea
Symptoms of common cold are often present
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What are the signs of AOM on otoscopy?
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Middle ear effusion
Hyperemic tympanic membrane
Bulging membrane
Loss of light reflex
Middle ear anatomy obscured
Poor mobility of membrane to pneumatic evaluation
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What is the first line therapy?
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Amoxicillin
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What is the dosing of the first line therapy?
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80 - 90 mg/kg divided in 2 doses daily
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What are complications of AOM?
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Chronic effusion
Hearing loss
Cholesteatoma
Petrositis
Mastoiditis
Brain abscess
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