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1、ACUTESUPPURATIVEOTITISMEDIA(ASOM)Acutesuppurativeotitismediaresultsfrombacterialinfectionofthemiddleearcleft,oftenasabacterialcomplicationofthecommoncold.Thisismorefrequentinchildrenthaninadults.Etiology#Thecommoninfectiveorganismsarebetahemolyticstreptococ
2、cus,pneumo-coccus,Hemophilusinfluenzae,andstaphylococcus.#Eustachiantubes:viralupperrespiratoryinfection,enlargedadenoids,sinusinfections,allergy-causingedemaintheeustachiantuberegion,andcleftpalate.#Othercause:traumaticrupture,perforationofthetympanicmembr
3、ane,frominfectionfollowingearsurgery.#ASOMisaself-limitingdisease,andwhentreatedadequatelyitrarelyleavesanyresidualchange.ClinicalFeaturesSymptoms.Fever,malaiseOtalgiaDecreaseinhearingDischargefromtheearcanal:muco-purulentorpurulent.(perforationofthetympani
4、cmembrane).OnExaminationIntheearlystage,thetympanicmembranewillshowretractionandlackofmobility. Nextwiththeonsetofedemaandexudationthedrumwillloseitslandmarks,appearthickanddull,andmayhaveafluidlevel. Thefluidisthickandnotclear,asinthecaseofserousotitisme
5、dia.Tympanicmembraneoutwardandcausebulgingofthedrum. Ifuntreatedthetympanicmembranewillrupture,givingrisetoaserosanguinousandthenmucopurulentorpurulentdischargefromtheear. Perforationoccursintympanicmembranecentral.TympanicmembranebeforeperforationwithASO
6、MTympanicmembraneafterperforationwithASOMAfterperforation,painandfevermaynotbeasmarkedasintheearlierstages,butthereispersistenceofpurulentdischargeandrecurrenceofpain. Pressureonthemastoidtipwillproducepain-mastoidtenderness. Infectionmayspreadtomastoidca
7、usemastoiditis.Tuningforktests:aconductivehearingloss. X-rayfilmorCTscanexaminationsintheearlystagesmayshowhazinessorcloudiness.TreatmentSymptomaticTreatment.Analgesics:pain antipyretics:fever. fluidreplacement:preventofdehydrationThecultureandthesensitivi
8、tyofdischarge Antibiotictreatment:Penicillingivensystemicallywillmanagemostoftheseinfections.InchildrenthepossibilityofHemophilusinfluenzaeshouldbekeptinmind,andthismayrequireampicillinifthereisnoresp
