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Acute Otitis Media and Otitis Media With Effusion in Adults
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
The term otitis media describes inflammation of the middle ear space. ‘Acute’ otitis media indicates a time frame of inflammation resolution within 12 weeks. Clearly, timely diagnosis is required to manage such conditions, and thus in practice the term acute otitis media (AOM) is used to describe an acute infection of the middle ear space. Clinical differentiation of AOM from an initial presentation of otitis media with effusion (OME) is important, as overtreatment of OME with antibiotics in primary or secondary care is common.
Ear, Nose and Throat
Published in Kristen Davies, Shadaba Ahmed, Core Conditions for Medical and Surgical Finals, 2020
Ear syringing is indicated if the wax is causing symptoms of deafness or pain. Avoid syringing if perforation or chronic middle ear disease. If syringing is contraindicated or unsuccessful, refer to ENT for removal under direct vision (microsuction).
Infection and immunology
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
5.13. Which of the following statements is/are true of Mycoplasma pneumoniae respiratory tract infections in children?They are diagnosed by demonstrating cold agglutinins in the blood.They are a most common cause of pneumonia in school age children.The organism is easily grown from sputum cultures.The infections are associated with middle ear disease.They are treated with erythromycin.
Features of Turner syndrome in patients managed at the adult endocrinology clinic, Steve Biko Academic Hospital
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2023
Otological disease is part of the widely variable phenotype in Turner syndrome patients. It varies from external morphologic abnormalities to recurrent middle ear infections as well as sensorineural or conductive hearing loss. Hearing loss is a common feature of Turner syndrome with a prevalence ranging from 36% to 84%. The auditory phenotype in Turner syndrome is complex and seems to be dynamic, with conductive hearing loss due to middle ear disease at an early age and sensorineural hearing loss later in life. Importantly, the presence of the mid-frequency dip is prognostic for the development of further progression of sensorineural hearing loss. In our population, hearing loss was detected in only three patients (17.6%), much lower than the prevalence described in the literature. Two patients had chronic otitis media, complicated by hearing loss.
New insights into the treatment of acute otitis media
Published in Expert Review of Anti-infective Therapy, 2023
Rana E. El Feghaly, Amanda Nedved, Sophie E. Katz, Holly M. Frost
Infection with S. pneumoniae is more likely to result in TM rupture than other pathogens and continues to be most common pathogen isolated from children with TM rupture in the PCV era [27,110]. TM rupture can also be associated with H. influenzae, S. aureus, and S. pyogenes, though it is rarely associated with M. catarrhalis [111]. Thus, we recommend amoxicillin as first-line therapy for children with TM rupture. No studies have systematically evaluated the effectiveness of otic versus oral antibiotics for children with TM rupture; only data on children with tympanostomy tubes have been reported. We recommend oral antibiotics for these children because otic antibiotics may not adequately reach the middle ear in the presence of copious drainage and would not reach the middle ear after the perforation heals.
Infant botulism: an underestimated threat
Published in Infectious Diseases, 2021
Luca Antonucci, Cristian Locci, Livia Schettini, Maria Grazia Clemente, Roberto Antonucci
In the absence of serious hospital-acquired complications, the prognosis for IB patients is excellent, with anticipated full and complete recovery. In the United States, the mortality rate for IB is less than 1% [40,104]. The course of recovery from IB usually proceeds with a gradual improvement in muscle function, usually without relapses. The worsening of clinical symptoms during the recovery of the patient should let the physician suspect a complication or inadequate respiratory or nutritional support. Infection is the most common complication and can affect the middle ear (otitis media), lungs (aspiration pneumonia) and urinary and intestinal tracts. Regarding intestinal involvement, patients should be carefully monitored for signs of secondary C. difficile infection (diarrhea, change in stool colour, abdominal tenseness, or distention), which can result from colonic stasis due to botulism. Bacteraemia and sepsis may also develop from indwelling venous lines [40,104,106]. Among complications, concomitant intestinal viral infections (mostly caused by enteroviruses) have been also described [125]. Infections and other potential causes of clinical deterioration are listed in Table 5 [72]. Sedatives or other drugs potentially resulting in CNS depression are relatively contraindicated [40].