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Bacterial Otitis Media


Presentation

  • The present study investigated the participation of signaling via the Jun N-terminal protein kinase (JNK) mitogen-activated protein kinase in middle ear mucosal hyperplasia in animal models of bacterial otitis media.[ncbi.nlm.nih.gov]
  • The patient presented with 5-day history of acute otitis media and a 4-day history of headache, vomiting, and high fever.[ci.nii.ac.jp]
  • Patients presenting with these signs require antimicrobials; meningitis can be a complication.[apps.who.int]
  • We hypothesize that bacterial biofilms present differently in patients with different types of chronic otitis media. Our results provide new insights regarding treatment of chronic otitis media.[link.springer.com]
  • […] cause of head tilt. ( B606 .13.w13) A rabbit may hold its head tilted if it has middle or outer ear pain. ( B603 .1.w1) The down-tilted eye may have corneal oedema and ulceration. ( J60 .6.w2) Note: if the condition is bilateral, head tilt may not be present[wildpro.twycrosszoo.org]
Soft Tissue Swelling
  • tissue swelling at the base of the ear canal can sometimes be seen in cases of severe otitis media where there is a build up of pus within the ear. ( B602 .20.w20) Pus in the ear canal may be seen if the tympanic membrane has ruptured ( B606 .13.w13)[wildpro.twycrosszoo.org]
Ulcer
  • B602 .20.w20, B606 .13.w13, J15 .28.w1, J60 .6.w2) Otitis interna is the commonest cause of head tilt. ( B606 .13.w13) A rabbit may hold its head tilted if it has middle or outer ear pain. ( B603 .1.w1) The down-tilted eye may have corneal oedema and ulceration[wildpro.twycrosszoo.org]
Blister
  • Bullous myringitis (rare - caused by mycoplasma pneumonia causing bullous red blisters on the tympanic membrane. It usually settles in a few days). Often children who are unwell have a slightly red eardrum but in AOM it is very red.[patient.info]
Torticollis
  • […] often compensate well and live a normal life except for the changed posture. ( J60 .6.w2) Euthanasia is appropriate for severe torticollis cases with complete loss of balance. ( J60 .6.w2) Associated Techniques Production of Antibiotic-Impregnated Beads[wildpro.twycrosszoo.org]
  • Child presents with neck pain, torticollis, and fever. Treatment: IV antibiotics mastoidectomy drainage of neck abscess Zygomatic abscess Infection spreads to the zygomatic air cells (located at the zygomatic root).[amboss.com]
Muscle Spasm
  • spasms are common and the rabbit's neck should be massaged regularly. ( B601 .11.w11) See: Bulla Osteotomy in Rabbits (Techniques) Symptomatic treatment for torticollis: Consider short-acting corticosteroid (e.g.[wildpro.twycrosszoo.org]
Otalgia
  • Clinical features Persistence/recurrence of otalgia and fever after initial improvement Ear discharge becomes profuse (discharge persisting 3 weeks suggests mastoiditis ).[amboss.com]
  • May present with otalgia, irritability, decreased hearing, anorexia, vomiting, or fever, usually in the presence of an ongoing viral respiratory infection.[bestpractice.bmj.com]
  • Diagnostic criteria for AOM AOM is characterized by acute onset of symptoms (eg, otalgia or suspected otalgia) with middle ear fluid and significant inflammation of the middle ear.[cps.ca]
  • Otalgia is less common in children younger than two years and more common in adolescents and adults. 4 Acute otitis media cannot be reliably differentiated from upper respiratory tract infection on the basis of symptoms alone. 10 However, otalgia, ear[aafp.org]
  • Symptoms include otalgia, often with systemic symptoms (eg, fever, nausea, vomiting, diarrhea), especially in the very young. Diagnosis is based on otoscopy. Treatment is with analgesics and sometimes antibiotics.[merckmanuals.com]
Erythematous Tympanic Membrane
  • Welleschik [CC-BY-SA-3.0], via Wikimedia Commons Fig. 2 – An erythematous Tympanic Membrane in AOM, as viewed on otoscope Common symptoms of AOM include pain, malaise, fever, and coryzal symptoms, lasting for a few days.[teachmesurgery.com]
  • Otoscopic examination can show a bulging, erythematous tympanic membrane (TM) with indistinct landmarks and displacement of the light reflex. Air insufflation (pneumatic otoscopy) shows poor mobility of the TM.[merckmanuals.com]
Suggestibility
  • The results of this study suggest that intracellular signaling via p38 MAPK influences the hyperplastic response of the middle ear mucosa during bacterial otitis media.[ncbi.nlm.nih.gov]
  • Temporal-bone CT showed the suggestion of a partial bone defect in the temporal tegmen. Exploratory tympanotomy of the right ear confirmed the presence of the bone defect in the temporal tegmen and the attic was obliterated with a bone plate.[ci.nii.ac.jp]
  • Bacterial infection is suggested by the presence of acute onset of pain in the ear, fever, and redness and decreased mobility of the tympanic membrane. Patients presenting with these signs require antimicrobials; meningitis can be a complication.[apps.who.int]
  • .3.w3) In pet rabbits, Staphylococcus aureus is commonly cultured. ( V.w122, V.w65 ) Other bacteria ( B602 .20.w20) Mycoplasma infection ( B603 .1.w1) Note: bacterial infection may be secondary to: Psoroptes cuniculi Infection There is no evidence to suggest[wildpro.twycrosszoo.org]
  • Our findings suggest that bacterial biofilms are very common in CSOM and middle ear cholesteatomas. Positive bacterial cultures imply the presence of biofilm formation in CSOM and cholesteatomas.[link.springer.com]
Hunger
  • Well Photo Credit Illustration by Celia Jacobs Outrunning Hunger Intense exercise may change the way certain neurons influence our appetite and metabolism.[nytimes.com]
Ataxia
  • […] horizontal). ( J60 .6.w2) With peripheral disease, nystagmus is horizontal or rotary, does not change direction if the head position is changed, and has the fast phase in the direction of the lesion. ( B601 .11.w11, J15 .28.w1) Torticollis, nystagmus and ataxia[wildpro.twycrosszoo.org]
  • Inner ear infection is accompanied by ataxia (circling, rolling stumbling), leaning to one side and head-tilt. Some rabbit sway their head from side to side.[medirabbit.com]
  • Clinical signs are usually referable to an associated otitis externa (odor, discharge, pain) or otitis interna which may cause vestibular signs such as rolling, ataxia and nystagmus.[medical-dictionary.thefreedictionary.com]

Workup

  • Tympanostomy Tubes 242 Eardrops for Otorrhea 246 Ototoxicity owing to Eardrops 254 Oral Antibiotic Treatment for Purulent Ear Discharge 258 Intravenous Antibiotics for Otorrhea 261 Evaluation and Treatment of Recurrent PostTympanostomy Otorrhea 266 Workup[books.google.de]
  • One study described a relation between laryngopharyngeal reflux and chronic OM (COM); the authors concluded that reflux workup should be performed as part of COM investigations and that if reflux is confirmed, reflux treatment should be initiated in addition[emedicine.medscape.com]
  • This should be part of any septic workup in neonates.[emedicine.medscape.com]

Treatment

  • In addition, developments in scientific and medical information and technology in the treatment of ABOM are included in this guidance.[federalregister.gov]
  • […] for Purulent Ear Discharge 258 Intravenous Antibiotics for Otorrhea 261 Evaluation and Treatment of Recurrent PostTympanostomy Otorrhea 266 Workup and Management of Chronic Otorrhea 271 MethicillinResistant Staphylococcus aureus Otorrhea 278[books.google.de]
  • Lead Poisoning in Waterfowl (with notes on elephants, bears and lagomorphs) ; Neoplasia of the brain, ear wall or neck (rare). ( J60 .6.w2) Treatment Long term systemic antibiotic treatment is needed - often four to six weeks or longer. ( B601 .11.w11[wildpro.twycrosszoo.org]
  • The patient was started on intravenous prednisolone and meropenem for empiric treatment of both the BM and sensorineural hearing loss. These treatments led to rapid relief of the patient's symptoms without any sequela.[ci.nii.ac.jp]
  • For this reason, higher doses of amoxicillin and amoxicillin clavulanic acid are the treatment of choice. However, these penicillin-resistant strains are frequently also resistant to sulfamethoxazole trimethoprim.[apps.who.int]

Prognosis

  • […] recurrent cases Otitis media with effusion if the child does not have risk for speech and language development or other learning disabilities, observation may be appropriate Steroids, decongestants and antihistamines do not completely resolve effusion Prognosis[medbullets.com]
  • Prognosis The outlook in most people with a middle ear infection is very good. The infection and its symptoms usually go away completely.[drugs.com]
  • Otitis media: Course and Prognosis Usually otitis media heals without any negative consequences. About 80 percent of patients are free of symptoms after 2 to 7 days. Sometimes however,chronic otitis media develops or there are other complications.[ims.uniklinik-freiburg.de]
  • Prognosis of surgical drainage, e.g. bulla osteotomy, is poor and is accompanied by post-operative complications in rabbits.[medirabbit.com]
  • Prognosis With treatment, the prognosis for acute otitis media is very good.[medical-dictionary.thefreedictionary.com]

Etiology

  • Etiology Etiology Bacterial superinfection following a viral URT infection ( 95% of cases) S. pneumoniae (most common: 35% of cases) Haemophilus influenzae ( 25% of cases) Moraxella catarrhalis ( 15% of cases) Group A ß- hemolytic streptococci (in older[amboss.com]
  • Although much evidence suggests that allergies contribute to the pathogenesis of OM in older children, extensive evidence refutes the role of allergies in the etiology of middle ear disease.[emedicine.medscape.com]
  • Antihistamines and decongestants are not recommended for children; oral or nasal decongestants may help adults, but antihistamines are reserved for adults with an allergic etiology.[merckmanuals.com]
  • Common bacterial pathogens in neonatal period In the perinatal period, the Escherichia coli, Enterococcus species, and group B streptococci are the etiologic agents most commonly responsible for sepsis and meningitis.[emedicine.medscape.com]
  • Etiologic agents The most common causes of otitis media are Streptococcus pneumoniae (40 %) Hemophilus influenzae (30%) Moraxella catarrhalis (15%) Group A streptococcus and Staphylococcus aureus are rare causes of otitis media Viruses Virologic and epidemiologic[meddean.luc.edu]

Epidemiology

  • Epidemiology Highest incidence between 6–24 months of age Immunization of infants against pneumococci has decreased the incidence of AOM Most common cause of prescribing antibiotics in children 5 years References: [1] [2] Epidemiological data refers to[amboss.com]
  • Epidemiology Incidence of infection All children by 1 year of age: 62% All children by 3 years of age: 83% Average of 1.5 Acute Otitis Media episodes per year III.[fpnotebook.com]
  • Epidemiology and pathogenesis of chronic suppurative otitis media: implications for prevention and treatment. Int J Pediatr Otorhinolaryngol 42 : 207– – 223 [CrossRef] [PubMed]. [Google Scholar] Brook I.. ( 1994 ;).[jmm.microbiologyresearch.org]
  • Etiologic agents The most common causes of otitis media are Streptococcus pneumoniae (40 %) Hemophilus influenzae (30%) Moraxella catarrhalis (15%) Group A streptococcus and Staphylococcus aureus are rare causes of otitis media Viruses Virologic and epidemiologic[meddean.luc.edu]
  • Epidemiology More than two thirds of children will experience one or more attacks of AOM by the age of 3 and about half experience more than three episodes [ 6 ] : The peak age of incidence is 6-15 months and decreases with age.[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology Antecedent Event: Upper Respiratory Infection Congestion of resp mucosa Obstruction: isthmus-narrowest part of tube Increased tube negative pressure Development of effusion (serum pulled in) Effusion colonization VII.[fpnotebook.com]
  • References: [2] [6] Complications Complications are rare and are usually only seen in the following cases: Intratemporal complications Mastoiditis Definition : inflammation of the mastoid air cells Epidemiology : often occurs in children 5 years Pathophysiology[amboss.com]
  • For acute otitis media, the bacteria to blame for causing the infection are most frequently: Streptococcus pneumonia Haemophilus influenzae Moraxella catarrhalis Pathophysiology All forms of otitis media are usually caused by a dysfunction of the Eustachian[news-medical.net]
  • Pathophysiology Bacterial infection of the middle ear results from nasopharyngeal organisms migrating via the Eustachian tube. The anatomy of the Eustachian tube in younger children is more horizontal, only becoming more oblique as the child grows.[teachmesurgery.com]
  • Pathophysiology Infecting organisms reach the middle ear from the nasopharynx. Children are particularly vulnerable to the transfer of organisms from the nasopharynx to the ear.[patient.info]

Prevention

  • […] of Acute Otitis Media 134 Mucosal Immunity and Nasal Immunization in the Treatment of Infectious Diseases of the Upper Respiratory Tract 138 Allergy TestingTreatment for Otitis Media 146 Prevention of Acute Otitis Media during the Common Cold 152 Rhinosinusitis[books.google.de]
  • Understanding how bacteria form these biofilms will be an important step in learning to better diagnose, prevent, and/or treat chronic infections.[grantome.com]
  • […] inflammation. ( J60 .6.w2) Supportive care, including feeding if necessary. ( J60 .6.w2) Note: minimise handling, as loss of balance when the rabbit is picked up may cause it to twist frantically. ( J60 .6.w2) Anti-emetic drugs These can be useful for preventing[wildpro.twycrosszoo.org]
  • Prevention In order to prevent otitis media, it is logical to try and reduce the risk factors that are associated with the condition.[news-medical.net]
  • There are also vaccines to prevent infections caused by particular strains of bacteria. Many otitis media episodes can be prevented by breastfeeding during the first six months of life.[theconversation.com]

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