Pediatr. praxi. 2008;9(3):171-176

Middle ear infection, diagnosis and treatment

prof. MUDr. Ivo Šlapák CSc

Klinika dětské ORL, LF MU a FN Brno

Acute middle ear infection-otitis media acuta (OMA) is the most frequent inflammatory disease in early childhood all the year round. Causes of OMA are dysfunction of Eustachian tube, penetration of infection, insufficient immune system. Symptoms and signs of OMA are ear ache, decreased hearing, fever, restlessness. Diagnosis is based on otologic examination, especially on otoscopy. Differential diagnosis must include external ear infection, obstructing cerumen or a foreign body in the ear canal. OMA may be complicated by tympanic necrosis, acute mastoiditis (with or without abscess formation), thrombophlebitis or thrombosis of sagittal sinuses or intracranial complications. Treatment of OMA: systemic analgetics, paracenthesis, antibiotics. Antibiotics are indicated in cases of inflammation with associated respiratory disease and high fever. Wide spectrum antibiotics are also indicated if suspicion of a complication is raised and in cases of recurrent OMA. Antibiotics must be given to patients with OMA involving the only hearing ear. In recurrent OMA it is necessary to treat focal infection (most frequently adenotomy) and implant a pressure equilibrating tube. Intratemporal and intracranial complications are treated as acute diseases surgically (mastoidectomy) in case of a failure of parenteral antibiotics. For diagnosis of complications an imaging with HRCT is decisive.

Keywords: otitis media acuta, otoscopy, paracenthesis, antibiotics, mastoiditis, prevention

Published: August 1, 2008  Show citation