1、ACUTE SUPPURATIVE OTITIS MEDIA(ASOM)2021/7/231Acutesuppurativeotitismediaresultsfrombacterialinfectionofthemiddleearcleft,oftenasabacterialcomplicationofthecommoncold.Thisismorefrequentinchildrenthaninadults.2021/7/232 Etiology#Thecommoninfectiveorganismsarebetahemolyticstreptococcus,pneumo-coccus,H
2、emophilusinfluenzae,andstaphylococcus.#Eustachiantubes:viralupperrespiratoryinfection,enlargedadenoids,sinusinfections,allergy-causingedemaintheeustachiantuberegion,andcleftpalate.2021/7/233#Othercause:traumaticrupture,perforationofthetympanicmembrane,frominfectionfollowingearsurgery.#ASOMisaself-li
3、mitingdisease,andwhentreatedadequatelyitrarelyleavesanyresidualchange.2021/7/234Clinical FeaturesSymptoms.Fever,malaiseOtalgiaDecreasein hearingDischargefromtheearcanal:muco-purulentorpurulent.(perforationofthetympanicmembrane).2021/7/235On ExaminationIntheearlystage,thetympanicmembranewillshowretra
4、ctionandlackofmobility.Nextwiththeonsetofedemaandexudationthedrumwillloseitslandmarks,appearthickanddull,andmayhaveafluidlevel.Thefluidisthickandnotclear,asinthecaseofserousotitismedia.2021/7/236Tympanicmembraneoutwardandcausebulgingofthedrum.Ifuntreatedthetympanicmembranewillrupture,givingrisetoase
5、rosanguinousandthenmucopurulentorpurulentdischargefromtheear.Perforationoccursintympanicmembranecentral.2021/7/237TympanicmembranebeforeperforationwithASOM2021/7/238TympanicmembraneafterperforationwithASOM2021/7/239Afterperforation,painandfevermaynotbeasmarkedasintheearlierstages,butthereispersisten
6、ceofpurulentdischargeandrecurrenceofpain.Pressureonthemastoidtipwillproducepain-mastoidtenderness.Infectionmayspreadtomastoidcausemastoiditis.2021/7/2310Tuningforktests:aconductivehearingloss.X-rayfilmorCTscanexaminationsintheearlystagesmayshowhazinessorcloudiness.2021/7/2311TreatmentSymptomatic Tre
7、atment.Analgesics:painantipyretics:fever.fluidreplacement:preventofdehydration 2021/7/2312ThecultureandthesensitivityofdischargeAntibiotictreatment:Penicillingivensystemicallywillmanagemostoftheseinfections.Inchildrenthepossibilityof Hemophilus influenzae shouldbekeptinmind,andthismayrequireampicill
8、inifthereisnoresponsetopenicillinorifthecultureandthesensitivitytestsoindicate.Antibioticsshouldbegivenfor5to7days,certainlynotless.2021/7/2313Systemicdecongestantshelpreduceswellingandtherebyfacilitatedrainageofthemiddleear.Thesearegivenforaperiodoftwoweeksormore,dependingonhowquicklythemiddleearbe
9、comesfreeoffluid.Ifthedrumappearsfullandbulging,amyringotomyshouldbecarriedoutfordrainage.2021/7/2314EardropsalsocanbevalueforinfectioninASOM.0.25%-1%Chloramphenicoland0.3%Ofloxacineardropsarerecommended.Beforeusingeardrops,cleaningpurulentdischargeinearby2%hydrogehperoxidesolution.Coldcreamcanbeusedtoprotectskinmaceratedfromeardischarge.Local treatment2021/7/2315注：注：文档资料素材和资料部分来自文档资料素材和资料部分来自网络，如不慎侵犯了您的权益，请网络，如不慎侵犯了您的权益，请联系文库客服，我们将做删除处理，联系文库客服，我们将做删除处理，感谢您的理解。感谢您的理解。
