Otitis media ENT and Microbiology

1. Otitis
Media
By Prabhat Kumar Shantanu
4th Semister LMCTH

4. Contents
1) Introduction 3) Pathogenesis
2) Etiology
4) Clinical Manifestation 5) Laboratory Diagnosis 6) Management &
Complication

5. Otitis media (OM) is the second most
common disease of childhood, after upper
respiratory infection (URI)
1) Introduction
Definition
• It is defined as inflammation of the
middle ear.
Otitis Media

6. Small intestine extends A
1. Acute Otitis Media (for <3 weeks)
2. Chronic Otitis Media (for >3 months)
Other
a) Serous Otitis Media
b) Scretory Otitis Media
c) Sppurative Otitis Media
Classification of
Otitis media

8. Age – Common among children due to shorter Eustachian
tube
Etiology Of Otitis Media

9. 1.Tonsillitis
2.Rhinitis
3.Sinusitis
4.Pharyngitis
5.Infection secondary to cleft palate
6.Trauma to the Tympanic Membrane
7.Head Injury
Etiology

10. Acute Otitis Media
A. Caused by upper
respiratory tract
infection causing viruses
(mostly )
a) Rhino Virus
b) Measles Virus
c) Respiratory Syncytial
Virus
d) Influenza Virus
e) Parainfluenza Virus
.
Chronic Otitis Media
A. Aerobes
a) Pseudomonas aeruginosa
b) Streptococcus pneumoniae
c) Staphylococcus aureus
d) Hemophilus influenzae
e) Proteus
B. Anaerobes
a) Bacteroids
b) Peptococcus
c) Peptostreptococcus
Causative agent of Otitis Media

27. Lab Diagnosis
1) Sample Collection
a) Pus Swab from the
discharge
b) Needle aspirate from
middle ear

28. Lab Diagnosis
2) Microscopy
a) Gram Staining – Shows Gram +vs & Gram –ve organism
 Gram +ve
i. Peptococcus
ii. Peptostreotococcus
 Gram Negative
i. Bacteroids
ii. E. Coli
iii. Klebsiella
iv. Proteus
v. Pseudomonas
b) Acid Fast staining :- Mycobacterium tuberculosis

29. Lab Diagnosis
3) Culture
a) Blood agar,
b) Chocolate agar,
c) Mac-Conkey Agar
d) Sabouraud's dextrose Agar For
Fungus
e) Robertson's Cook Meat medium
for anaerobic infections
Mac-conky agar
For Aerobic
Medium

30. Lab Diagnosis
4) Biochemical test
a) Oxidase +ve = Pseudomonas
b) Urease +ve = Proteus
a) Coagulase +ve = Staphylococcus
aureus

31. 1. Fullness or heaviness in the ear
2. Severe ear pain at night
3. Deafness
4. Tinnitus (ringing or buzzing in the ear
5. Autophony (spoken words of Patient echo
in his ears)
Clinical Manifestation

32. Otoscope

33. Management
Antibiotics against Streptococcus
Decongestants to releve the edema to Euestichian
tube
Painkillers

34. Management


35. Management


36. Management


37. Management


39. Post Test
•Q1 Most common organism causing Otitis media ?
•Q2 Most common route of infection ?
•Q3 What is the Typical diagnostic appearance of Tympanic Membrane?
•Q4 What is the indication of Myringotomy in ASOM
•Q5 Primary management of ASOM? (Medical or Surgical)

40. Complication of
Otitis Media

41. Ear Pain and
Irritation

42. Facial Nerve Paralysis
(Fascial Palsy)
Normal

43. Meningitis

44. Deafness

45. Brain Abscess