Case Of Acute Otitis Media Research Articles

Case Report: Zygomatic-Malar Abscess

We present a case of acute otitis media complicated by zygomatic-malar abscess in a 25-year-old patient with no previous medical/otorhinolaryngological history, who comes to consultation due to large left temporozygomatic swelling. Its atypical clinical presentation and the applied medical-surgical procedures are reported.

Acute Otitis Media with Intracranial and Intratemporal Complications: A Case Study.

Acute otitis media continues to be one of the most common infections today and a major cause of the prescription of antibiotics in the pediatric age group. Complications of this condition are rare, especially when antibiotic therapy is started early; however, complications related to acute otitis media cause dramatic morbidity. This report provides a review related to a case of acute otitis media with bilateral intracranial and intratemporal complications.

Gradenigo Syndrome. Hutchison. The Journal of Laryngology and Otology 1932 r. No. 10

The author reports on a case of acute otitis media observed by him in a 39-year-old man, which was complicated by pain in the trigeminal nerve region on the side of the diseased ear. Later, an antrotomy was performed, which destroyed the suppuration, but the neuralgic pains continued.

Zygomatic abscess complicating coalescent air cell infection and acute otitis media in a pediatric patient with facial swelling and temporomandibular joint subluxation

Acute otitis media is a localized infection. Advanced cases demonstrate local spread and abscess formation in the mastoid, temporomandibular joint, and zygomatic root if anatomy allows. We present a case of acute otitis media complicated by an abscess of a pneumatized zygomatic root extending into the temporomandibular joint treated by incision and drainage.

A rare case of bilateral acute otitis media leading to bilateral facial paresis in an adult

<p class="abstract">Facial nerve paresis is a known complication of middle ear disease. However it is more commonly seen as a complication of chronic otitis media as compared to acute otitis media (AOM). There are very few reported cases of AOM leading to facial palsy and even fewer ones of bilateral acute otitis media leading to bilateral facial palsy. Since this is a very rare presentation its management and treatment are not very well outlined as per standard guidelines. Here we have presented a very rare case of bilateral AOM leading to bilateral facial paresis, how the case progressed and how it was managed. We have tried to bring forth the salient features of the presentation, the progression and the resolution of the disease due to the successful management<span lang="EN-IN">.</span></p>

Acute otitis media with spontaneous tympanic membrane perforation.

The principal aim of this review is to present the current knowledge regarding acute otitis media (AOM) with spontaneous tympanic membrane perforation (STMP) and to address the question of whether AOM with STMP is a disease with specific characteristics or a severe case of AOM. PubMed was used to search for all studies published over the past 15years using the key words "acute otitis media" and "othorrea" or "spontaneous tympanic membrane perforation". More than 250 articles were found, but only those published in English and providing data on aspects related to perforation of infectious origin were considered. Early Streptococcus pneumoniae infection due to invasive pneumococcal strains, in addition to coinfections and biofilm production due mainly to non-typeable Haemophilus influenzae, seem to be precursors of STMP. However, it is unclear why some children have several STMP episodes during the first years of life that resolve without complications in adulthood, whereas other children develop chronic suppurative otitis media. Although specific aetiological agents appear to be associated with an increased risk of AOM with STMP, further studies are needed to determine whether AOM with STMP is a distinct disease with specific aetiological, clinical and prognostic characteristics or a more severe case of AOM than the cases that occur without STMP. Finally, it is important to identify preventive methods that are useful not only in otitis-prone children with uncomplicated AOM, but also in children with recurrent AOM and those who experience several episodes with STMP.

Corticosteroids for the common cold.

The common cold is a frequent illness, which, although benign and self limiting, results in many consultations to primary care and considerable loss of school or work days. Current symptomatic treatments have limited benefit. Corticosteroids are an effective treatment in other upper respiratory tract infections and their anti-inflammatory effects may also be beneficial in the common cold. This updated review has included one additional study. To compare corticosteroids versus usual care for the common cold on measures of symptom resolution and improvement in children and adults. We searched Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 4), which includes the Acute Respiratory Infections (ARI) Group's Specialised Register, the Database of Reviews of Effects (DARE) (2015, Issue 2), NHS Health Economics Database (2015, Issue 2), MEDLINE (1948 to May week 3, 2015) and EMBASE (January 2010 to May 2015). Randomised, double-blind, controlled trials comparing corticosteroids to placebo or to standard clinical management. Two review authors independently extracted data and assessed trial quality. We were unable to perform meta-analysis and instead present a narrative description of the available evidence. We included three trials (353 participants). Two trials compared intranasal corticosteroids to placebo and one trial compared intranasal corticosteroids to usual care; no trials studied oral corticosteroids. In the two placebo-controlled trials, no benefit of intranasal corticosteroids was demonstrated for duration or severity of symptoms. The risk of bias overall was low or unclear in these two trials. In a trial of 54 participants, the mean number of symptomatic days was 10.3 in the placebo group, compared to 10.7 in those using intranasal corticosteroids (P value = 0.72). A second trial of 199 participants reported no significant differences in the duration of symptoms. The single-blind trial in children aged two to 14 years, who were also receiving oral antibiotics, had inadequate reporting of outcome measures regarding symptom resolution. The overall risk of bias was high for this trial. Mean symptom severity scores were significantly lower in the group receiving intranasal steroids in addition to oral amoxicillin. One placebo-controlled trial reported the presence of rhinovirus in nasal aspirates and found no differences. Only one of the three trials reported on adverse events; no differences were found. Two trials reported secondary bacterial infections (one case of sinusitis, one case of acute otitis media; both in the corticosteroid groups). A lack of comparable outcome measures meant that we were unable to combine the data. Current evidence does not support the use of intranasal corticosteroids for symptomatic relief from the common cold. However, there were only three trials, one of which was very poor quality, and there was limited statistical power overall. Further large, randomised, double-blind, placebo-controlled trials in adults and children are required to answer this question.

A Case of Epidural Abscess Complicated from Acute Mastoiditis Caused byStreptococcus pneumoniae

Acute otitis media (AOM) is one of the most common childhood infectious diseases. Despite antibiotic treatment for AOM, AOM and its complication still continue to develop. Acute mastoiditis is a serious complication of AOM and epidural abscess constitutes the commonest of all intracranial complication of AOM. Neurological complication of acute mastoiditis are rare but can be life threatening. Their presentation may be masked by the use of antibiotics. We report the rare case of acute otitis media progressing to acute mastoiditis, epidural abscess formation and lateral sinus thrombophlebitis caused by Streptococcus pneumoniae in a child. She was admitted with acute otitis media with fever. Despite proper antibiotics, acutemastodititis and epidural abscess were developed, and after surgical drainage and antibiotics therapy she was recovered without sequalae.KeyWords:Epidural abscess, Mastoiditis, Otitis media, Streptococcus pneumoniae

Results of a national study on the awareness of and attitudes toward acute otitis media (AOM) among clinicians and the estimated direct healthcare costs in Turkey (TR-AOM Study)

AimsAcute otitis media (AOM) is one of the most frequent diagnoses and reasons for prescribing antibiotics in children. The aims of this prospective study were the following: (1) to assess the continuing education of physicians and the sources of information about AOM; (2) to assess the current knowledge of and attitudes toward AOM as well as the compliance with AOM guidelines; (3) to evaluate opinions about vaccines against AOM; and (4) to estimate the potential costs of AOM on the healthcare system in Turkey. MethodsThis is a web-based cross-sectional survey of a national convenience sample of 600 physicians in Turkey (325 pediatricians (PEDs), 214 family physicians/general practitioners (FP&GPs) and 61 otolaryngologists (ENTs)). ResultsApproximately 38.6% of participants (39.4% of PEDs, 44.3% of GP&FPs and 14.7% of ENTs) stated that pneumatic otoscopy is essential for AOM diagnosis. Regarding the most common etiological agents of AOM in children, 54.2% of PEDs, 51.4% of FP&GPs and 57.4% of ENTs stated that the most common causative agents of AOM are Streptococcus pneumoniae and non-typeable Haemophilus influenzae. Nearly 76% of participants indicated they use direct antibiotic therapy when they diagnose AOM in certain situations. The first-line choice of antibiotic therapy is amoxicillin clavulanate, and 67% of participants prefer to use antibiotic therapy for 7–10 days. Approximately 31% of all participants stated that “viruses” are the main cause of AOM; however, 62% of these participants reported using antibiotic therapy. In comparison, 32% participants from private clinics prefer to treat AOM primarily with observation, a rate that is significantly higher than that of other clinical settings. Physicians who prefer to use observation strategy also prefer the combination of paracetamol and NSAIDs. Approximately 41% of participants have undergone postgraduate medical education on the topic of AOM. In total, 73% of all participant physicians believe that otitis media is a vaccine-preventable disease. With the information from all of the participants, the calculated mean cost per case of AOM is 28±4 USD. In Turkey, the estimated incidence of AOM is 24000–33000 cases per 100000 children <5 years of age (1820000–2100000 cases per year), and the estimated total cost of AOM is 61152000 USD (not including acute otitis media-related complications and otitis media-related hospitalizations). ConclusionThe medical and economic burden of AOM to the health economics in Turkey is considerable. Specific educational programs and evidence-based national guidelines concerning AOM should be implemented. Improving diagnostic accuracy with education will lead to improved management, judicious use of antibiotics, decreased antibiotic resistance, and potential economic benefits. A more prudent use of antibiotics would also lower the economic burden of this disease. Vaccination seems to be promising for the prevention of AOM.

Temporal Myositis with Middle Fossa Epidural Abscess as the Complications of Acute Otitis Media

Acute otitis media is an inflammatory process involving the mucoperiosteum of the middle ear cleft. The clinical spectrum can be extended from a self-limiting benign condition to a complicated disease with intracranial involvement. Intracranial and extracranial complications of acute otitis media is still occur in the modern antibiotic era and has potentially serious consequences with high mortality rate. We report a case of acute otitis media with temporal myositis and middle fossa epidural abscess which is rarely seen as the complications from the disease. DOI: http://dx.doi.org/10.3329/bjms.v11i2.8472 Bangladesh Journal of Medical Science Vol. 11 No. 02 April 2012: 126-128

中耳非結核性抗酸菌症例

We encountered a case of acute otitis media caused by non-tuberculous mycobacterial infection. A 13-year-old girl presented with right ear pain and discharge lasting for 1 week despite treatment with a standard antibiotic. Physical examination revealed a small perforation of the right tympanic membrane and swollen external ear canal mucosa. Ear computed tomography showed a soft tissue shadow occupying the right middle ear and the mastoid cavity. Audiometry revealed right sensory hearing loss. She received treatment with eardrops (OFLX), administration of antibiotic (intravenous PIPC 2.0 g/day) and steroid (intravenous dexamethasone sodium phosphate tapering from 6.0 mg/day). Right ear pain, discharge and hearing loss improved. Initial otorrhea cultures yielded non-tuberculous mycobacteria (Mycobacterium fortuitum). After treatment, her symptoms resolved, and she has remained well without evidence of reinfection. On the basis of our experience with this patient, we recommend conservative management (for example, antibiotic administration) for the initial treatment of cases of acute otitis media caused by non-tuberculous mycobacteria.

Failure to Diagnosis a Complication of Acute Otitis Media

Failure to diagnose a complication of acute otitis media (AOM) can potentially have disastrous consequences. Emergency physicians should be aware of potential complications that may be affected by current practice patterns. We present a case of AOM complicated by facial paralysis (FP) in a 13-month-old boy. The patient was initially thought to have FP secondary to Lyme disease vs. Bell's palsy. He was later found to have concurrent otitis media and mastoiditis. This article describes the complications of otitis media, with an emphasis on FP and its epidemiology, pathology, clinical diagnosis, and treatment options. In addition, questions regarding current treatment of AOM are briefly addressed.

Abordaje conservador de los pacientes con otitis media aguda

After the description of a case of acute otitis media (AOM) in a child, the author discuss the most used management strate-gies for this group of patients, stressing the evidence about immediate or postponed antibiotic prescription. She concludesthat there is enough evidence to support initial symptomatic treatment without antibiotic prescription in low risk population -non severe symptoms, no co-morbilities and accessibility for another control visit two days later- waiting spontaneous res-olution of the illness, what happens in more than 80% of patients. At the end of this article we summarize the Guide from United Kingdom about prescribing antibiotics for self-limitingrespiratory tract infections in adults and children in primary care, published during 2008.

Arthrite septique temporomandibulaire de l’enfant

Objective To report a clinical case of acute otitis media in a child, complicated by septic temporomandibular arthritis and to present a review of the literature. Patient and methods We report a case of a 7-year-old boy who presented an altered general condition, major hyperthermia, associated with a left temporozygomatic mass in a context of recurrent bilateral acute otitis media lasting for 2 months. Emergency computed tomodensitometry (CT scan) showed left temporomandibular joint arthritis. Treatment consisted of a parenteral double antibiotic therapy and prevention of temporomandibula (TM) ankylosis. Results After 20 months of follow-up, the child showed a normal ORL examination with no maxillofacial sequelae. Conclusion All temporozygomatic masses presenting in a septic context should suggest the diagnosis of TM arthritis; computed tomodensitometry should be done immediately.

Arterial brain infarction in complicated acute otitis media

We report a rare case of acute otitis media (AOM) complicated by arterial brain infarction, meningitis and orbital cellulitis. Computed tomography (CT) initially showed suspected epidural abscess, coalescent mastoiditis, and orbital cellulitis. Further clinical deterioration occurred following mastoidectomy and evacuation of the abscess. Magnetic resonance imaging (MRI) revealed subacute brain infarction and an extra-axial brainstem abscess. Revision of the initial CT revealed subtle signs suggestive of arterial brain infarction. Although CT with contrast is the standard of care for suspected AOM complications, MRI should be considered as an adjunct when CT is not definitive and neurological signs are present.

A quartet of lateral sinus thrombosis, extradural abscess, subdural abscess and occipital abscess: complications of acute mastoiditis in a pre-adolescent child

Neurological complications of acute mastoiditis are rare but can be life threatening. Their presentation may be masked by the use of antibiotics. We present a unique case of acute otitis media progressing to occipital, extradural and subdural abscess formation and lateral sinus thrombosis in a child. The clinical course and management of a pre-adolescent male is presented and discussed. We review the incidence, presentation and treatment of occipital abscesses and lateral sinus thrombosis with acute mastoiditis. Following extended cortical mastoidectomy, neck exploration and broad spectrum intravenous antibiotics, the patient made a full recovery. This is the first reported case of acute mastoiditis associated with occipital abscess in a child. Early, aggressive treatment is required for a successful outcome. The rarity of neurological complications, in addition to the insidious onset and subtle symptoms associated with antibiotic therapy, can make diagnosis extremely difficult. Patients with acute otitis media who fail to respond fully to treatment should be referred early for a specialist otology opinion.

Facial Nerve Palsy with Acute Otitis Media During the First 2 Weeks of Life

A full-term male newborn presented to us at the age of 2 weeks with left facial weakness that had started at the age of 4 days and steadily progressed over a 10-day period. Physical examination revealed a complete unilateral left peripheral facial nerve paralysis, with an erythematous dull and bulging left tympanic membrane. Computed tomography and magnetic resonance imaging were normal. The patient underwent left myringotomy and placement of a pneumatic equalization tube within 24 hours of presentation. He also received a 5-day course of prednisone and a 2-week course of antibiotics and acyclovir. Improvement of the facial paralysis was rapid, with near-complete resolution at the time of discharge home and complete resolution 6 weeks later. To our knowledge, this is the only reported case of acute otitis media with associated facial nerve palsy in a newborn during the first 2 weeks of life.

The potential effect of widespread use of pneumococcal conjugate vaccines on the practice of pediatric otolaryngology: the case of acute otitis media

This review provides the otolaryngologist with the evolving understanding of various aspects of pneumococcal conjugate vaccines (PCVs) that are related to their effect on the respiratory tract The efficacy of PCVs against invasive pneumococcal disease and pneumonia is well established and is documented in several well-conducted studies. However, the effect of PCVs on otitis media is less obvious and more complex. PCVs clearly reduce diseases caused by vaccine-type (VT) pneumococci, but replacement of VT serotypes by non-VT serotypes in nasopharyngeal carriage of Streptococcus pneumoniae is responsible for the increase in acute otitis media (AOM) caused by non-VT serotypes. Furthermore, an increased rate of AOM caused by Haemophilus influenzae and Moraxella catarrhalis was found. Since most antibiotic-resistance in S. pneumoniae is confined to VT serotypes, vaccine use also reduces antibiotic resistance. The reduction of carriage by PCVs is responsible for the reduction of spread of VT pneumococci (herd immunity). Thus a modification of AOM rather than just a simple reduction is seen with the widespread use of PCV. Acute otitis media in the era of widespread use of PCV is modified. A disease with reduced VT serotypes, reduced antibiotic resistance, and a lower rate of sequelae is to be expected. However, replacement with potential virulent organisms and development of antibiotic resistance in non-VT pneumococci is a possibility that needs careful monitoring.

Otitis Media During Early Life: How Hazardous to Development? A Critical Review of the Evidence

In a number of recent reports1-3 developmental impairments of a lasting nature have been attributed to prolonged or repeated episodes of otitis media occurring during the first one to three years of life. The impairments described include intellectural and learning difficulties,1,2,4-8,10-13 impaired speech and language,3,5,8,9,11-13 and disturbed behavior.7,8 In some of the reports1,12 the impairments have been referred to as permanent or irreversible. These reports, having appeared in publications directed respectively to physicians,2-4,6,8-13 speech-language-hearing professionals,1-3,5 educators,11 and psychologists,7,12 and in some instances having been cited in widely disseminated professional and lay news media (reference 14; Newsweek, June 14, 1976, p 47; New York Times, Dec 26, 1978, p C2) quite naturally have aroused broad anxiety and concern. The reports also have served to provide the impetus, or the justification, not only for aggressive casefinding programs, but also, in infants and children with recognized middle-ear effusions, for early recourse to aggressive modes of treatment, most often in the form of myringotomy and tympanostomy tube insertion. The purpose of the present report is to review critically the body of evidence on which the supposed relationship between early otitis media and later developmental impairments is based. DISEASE PROCESS In the typical case of acute otitis media, pus fills the middle-ear cavity. Sooner or later the infection begins to subside—with or without the help of antimicrobial drugs—and the initially purulent middle-ear liquid changes in character, coming to resemble serum, mucus, or even glue. With continued healing the Eustachian tube gradually recovers its ventilatory function, and the middle-ear liquid eventually is resorbed, or drains, and becomes replaced by air.

Otitis Media During Early Life: How Hazardous to Development? A Critical Review of the Evidence

In a number of recent reports1-3 developmental impairments of a lasting nature have been attributed to prolonged or repeated episodes of otitis media occurring during the first one to three years of life. The impairments described include intellectural and learning difficulties,1,2,4-8,10-13 impaired speech and language,3,5,8,9,11-13 and disturbed behavior.7,8 In some of the reports1,12 the impairments have been referred to as permanent or irreversible. These reports, having appeared in publications directed respectively to physicians,2-4,6,8-13 speech-language-hearing professionals,1-3,5 educators,11 and psychologists,7,12 and in some instances having been cited in widely disseminated professional and lay news media (reference 14; Newsweek, June 14, 1976, p 47; New York Times, Dec 26, 1978, p C2) quite naturally have aroused broad anxiety and concern. The reports also have served to provide the impetus, or the justification, not only for aggressive casefinding programs, but also, in infants and children with recognized middle-ear effusions, for early recourse to aggressive modes of treatment, most often in the form of myringotomy and tympanostomy tube insertion. The purpose of the present report is to review critically the body of evidence on which the supposed relationship between early otitis media and later developmental impairments is based. DISEASE PROCESS In the typical case of acute otitis media, pus fills the middle-ear cavity. Sooner or later the infection begins to subside—with or without the help of antimicrobial drugs—and the initially purulent middle-ear liquid changes in character, coming to resemble serum, mucus, or even glue. With continued healing the Eustachian tube gradually recovers its ventilatory function, and the middle-ear liquid eventually is resorbed, or drains, and becomes replaced by air.