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1、ACUTE SUPPURATIVE OTITIS MEDIA (ASOM),2021/7/23,1,ACUTE SUPPURATIVE OTITIS MED,Acute suppurative otitis media results from bacterial infection of the middle ear cleft, often as a bacterial complication of the common cold. This is more frequent in children than in adults.,2021/7/23,2,Acute suppurativ
2、e otitis media,Etiology#The common infective organisms are beta hemolytic streptococcus, pneumo-coccus, Hemophilus influenzae, and staphylococcus. #Eustachian tubes: viral upper respiratory infection, enlarged adenoids, sinus infections, allergy-causing edema in the eustachian tube region, and cleft
3、 palate.,2021/7/23,3,Etiology#The common infecti,#Other cause: traumatic rupture , perforation of the tympanic membrane , from infection following ear surgery. #ASOM is a self-limiting disease, and when treated adequately it rarely leaves any residual change.,2021/7/23,4,#Other cause: traumatic rupt
4、ur,Clinical FeaturesSymptoms. Fever, malaiseOtalgiaDecrease in hearingDischarge from the ear canal: muco-purulent or purulent . ( perforation of the tympanic membrane).,2021/7/23,5,Clinical FeaturesSymptoms.,On ExaminationIn the early stage, the tympanic membrane will show retraction and lack of mob
5、ility. Next with the onset of edema and exudation the drum will lose its landmarks, appear thick and dull, and may have a fluid level. The fluid is thick and not clear, as in the case of serous otitis media.,2021/7/23,6,On ExaminationIn the early s,Tympanic membrane outward and cause bulging of the
6、drum. If untreated the tympanic membrane will rupture, giving rise to a serosanguinous and then mucopurulent or purulent discharge from the ear. Perforation occurs in tympanic membrane central.,2021/7/23,7,Tympanic membrane outward and,Tympanic membrane before perforationwith ASOM,2021/7/23,8,Tympan
7、ic membrane before perfo,Tympanic membrane after perforation with ASOM,2021/7/23,9,Tympanic membrane after perfor,After perforation, pain and fever may not be as marked as in the earlier stages, but there is persistence of purulent discharge and recurrence of pain. Pressure on the mastoid tip will p
8、roduce pain-mastoid tenderness. Infection may spread to mastoid cause mastoiditis.,2021/7/23,10,After perforation, pain and fe,Tuning fork tests : a conductive hearing loss. X-ray film or CT scan examinations in the early stages may show haziness or cloudiness.,2021/7/23,11,Tuning fork tests : a con
9、ducti,TreatmentSymptomatic Treatment. Analgesics : painantipyretics : fever. fluid replacement : prevent of dehydration,2021/7/23,12,TreatmentSymptomatic Treatm,The culture and the sensitivity of discharge Antibiotic treatment : Penicillin given systemically will manage most of these infections. In
10、children the possibility of Hemophilus influenzae should be kept in mind, and this may require ampicillin if there is no response to penicillin or if the culture and the sensitivity test so indicate. Antibiotics should be given for 5 to 7 days, certainly not less.,2021/7/23,13,The culture and the se
11、nsitivit,Systemic decongestants help reduce swelling and thereby facilitate drainage of the middle ear. These are given for a period of two weeks or more, depending on how quickly the middle ear becomes free of fluid.If the drum appears full and bulging, a myringotomy should be carried out for drain
12、age.,2021/7/23,14,Systemic decongestants help re,Ear drops also can be value for infection in ASOM. 0.25%-1% Chloramphenicol and 0.3% Ofloxacin ear drops are recommended. Before using ear drops, cleaning purulent discharge in ear by 2% hydrogehperoxidesolution. Cold cream can be used to protect skin macerated from ear discharge.,Local treatment,2021/7/23,15,Ear drops also can be value f,注：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，请联系文库客服，我们将做删除处理，感谢您的理解。,注：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,
