Otitis media – What are the signs and symptoms, relevant dDx., sequelae, work up, and treatment options?

January 5, 2021 5:31 am Published by

Otitis media is a bacterial or viral infection of the middle ear, and is most common in children between 3 months and 3 years old.

Sn. & Sx.:

  • Triad: otalgia, fever, conductive hearing loss
  • Bulging tympanic membrane
  • Displaced cone of light and bony landmarks

dDx.:

  • Otitis (AOE, effusion)
  • Cerumen impaction
  • Cholesteatoma
  • Tympanic membrane perforation
  • Otosclerosis
  • Tympanoscherosis
  • Mastoiditis
  • Myringitis
  • Foreign body obstruction

Sequelae:

  • Tympanic membrane perforation
    Chronic suppurative otitis media
  • Ossicular necrosis
  • Cholesteatoma
  • Mastoiditis
  • Labyrinthitis
  • Meningitis
  • CN VII paralysis

Work up:

  • Otoscopic exam

Tx.:

  • Antibiotics*
  • Homeopathics: Belladonna, Chamomilla, Pulsatilla, Tuberculinum

*Aminoglycosides are contraindicated if tympanic membrane is perforated due to potential for ototoxicity

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This post was written by Omar Rifai