Definition

Bacterial or viral infection of the mucosal lining of the middle ear and mastoid air-cell system.

Etiology

1.      Bacteria- Haemophilus influenza, Moraxella catarrhalis, Streptococcus pyogenes, Staphylococcus pyogenes, aureus

2.      Environmental factors: Poor socio-economic status, Overcrowding.

Clinical Features

•           Otalgia

•           Hearing Loss

•           Otorrhoea

•           Fever

•           Tympanic membrane is opaque, bulging, congested or red.

Lab Diagnosis

Bacterial swab for persistent otorrhoea and nasopharyngeal swab.

Management

A.       Non-Pharmacological

•           Improve socio-economic status

•           Vaccination against viruses and bacteria

B.       Pharmacological

1.   Antibiotic

•           Amoxicillin

Adults                                                            500- 875 mg POTDS

Children                                            30-40 mg/kg/day in 3 divided doses

•           For penicillin sensitive

Erythromycin                                                          30-50mg/kg In divided Oral doses

2.   Decongestant And Antihistaminics

•   Ephedrine nose drops

•   Pseudoephedrine (Oral)

Adults                                                            60 mg P0 q4-6 hrs

Children                                            5-30 mg P0 q4-6 hrs Syrup: 3mg/ml

•   Oxymetazoline or Xylometazoline nose drops

3.   Analgesics (Oral, IM)

•   Paracetamol

Adults                                                            0.5-1 gm every 4-6 hours upto maximum of 4 gms

Children                                            10mg/kg every 4-6 hours

•   Ibuprofen(Oral)

Adult                                                  400 mg 4-6 hrs

Children(6-l2yrs)                               10mg/kg8 hourly

C.    Surgical

Myringotomy in severe cases.