Acute Suppurative Otitis Media

American Academy of Pediatrics and American Academy of Family Physicians article regarding acute otitis media is a filtered resource. It is an appropriate source for nursing practice because; it establishes clinical guidelines to diagnose and manage AOM. It also establishes guidelines when to treat the signs and symptoms of AOM, watchful waiting, or to treat with an antibiotic. This article is classified as an evidence based guideline because, it reviews multiple research literatures in a systemic manner and provides

This evidence meets the criteria for a filtered source. It was sourced online from the Official Journal of the American Academy of Pediatrics and Family Physicians. Specialists from multi medical disciplines assembled to create an integrative systematic study and review of the current evidence- based literature available for the treatment and management of Acute Otitis Media (AOM). The conclusions and findings were utilized to devise guidelines and a practice protocol that recommended early diagnosis and makes

The article from the American Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP) that addresses acute otitis media (AOM) is a filtered resource. This article is appropriate for use in nursing practice as it establishes diagnosis and management guidelines for the treatment of AOM. In addition the article recommends treatment options for the symptoms of AOM and addresses the concept of watchful waiting. The is an evidence based guideline as it provides recommendations for practice and was created a systematic review and best clinical research in clinical literature. The Block article, Causative Pathogens,

When CAP occurs, it is determined if the need for hospitalisation is necessary as it depends on the seriousness of the infection. Gram- positive organisms such as S. pneumoniae, naturally occur in the upper respiratory tract, is one cause of lower respiratory infections such as pneumonia, but is also a culprit in causing upper respiratory infections like otitis media. H. influenzae is just one of many bacterial infections that can result in CAP, it therefore can be subacute and present with a low-grade fever and a persistent cough for a few weeks before a patient has a diagnosis. Adults that have very little or no immunity are an easier target for certain viruses such as that of the Cytomegalovirus, which is a viral pathogen that is commonly contracted within the community, other common virus are adenovirus and herpes simplex. When a virus starts to become acute, it starts an infection within the ciliated cells within the airway. When pneumonia occurs from this viral infection, the inflammatory action starts to seep into the alveolar areas and leads to the problem of excess exudation and oedema within the respiratory tract. It is sometimes often difficult to differentiate symptoms of a viral pneumonia from that of bacterial pneumonia (Smeltzer &

Acute Otitis Media (AOM), inflammation or infection of the middle ear, is an illness most parents have had experience with. Countless hours of lost sleep and worry secondary to their child’s pain and distress can keep even the most seasoned parents awake at night. Before the age of 36 months, 83% of children will experience 1 or more ear infections and AOM is the most common reason for office visits of preschoolers in the United States (Zhou, Shefer, Kong & Nuorti, 2008). The graphic below serves as a review of evidence and explores the usefulness of the information in relation to the option of watchful waiting in the management of AOM.

When a patient presents with otitis media it is important to distinguish if the diagnosis is acute otitis media or otitis media with effusion (Woo & Wynne, 2012). According to Woo & Wynne (2012) acute otitis media also known as AOM can be recognized as a fluid that becomes present in the middle ear that is commonly associated with fever, otalgia, otorrhea, or an immobile tympanic membrane. Otitis media with effusion presents with the fluid in the middle ear but is absent of other symptoms of illness as described above. Due to the fact that otitis media only assumes a viral role about 35 percent of the time and it can clear up within 7 to 14 days without treatment, it is important to assess the patient’s true risks and benefits with antibiotic

A condition of the middle ear and it mainly affects the stapes (tiny stirrup) bone is considered as otosclerosis. When the bones (ossicles) combine together into an immovable mass, and does not transmit sound as well as when they are more flexible. It can also affect the other ossicles, the malleus and incus, and the otic capsule as well. Otosclerosis can cause gradual hearing loss and severe inner pain of the ear. Hearing aids and surgery are the best treatments.

Acute inflammation of the middle ear with effusion is treated with one or two courses of antibiotics . Antihistamines and decongestants have been used, but they have not been proven effective unless there is also hay fever or some other allergic inflammation that contributes to the problem. Myringotomy with or

Acute Otitis Media (AOM), is an inflammation with bacterial or viral pathology of the middle ear (Waheem, 2016). AOM commonly

The insertion of tubes is the most common ambulatory surgery performed on children in the U.S.

This is a diffuse inflammation of the external ear canal. The inflammation may be infective or reactive. The infective can be due to viral, bacterial or fungal. The reactive inflammation can be due to allergic, chemical etc (21).

One of the most common abnormalities of the tympanic membrane is called Otitis Media, which is an inflammation of the middle ear. This frequently affects children (particularly those between three months to three years of age) and it is usually caused by a bacterial infection. Treatment is the use of Tylenol or Motrin for pain and with the recent emergence of resistant organisms, pediatric organizations have strongly recommended initial antibiotics only for children at highest risk or for those with recurrent infections. Antibiotics are given if worsening symptoms or no improvement within 72 hours (Miyamoto 2015).

Abnormal function of Eustachian tube appears to be the most important factor in the causation of different types of chronic middle ear pathology, ranging from otitis media with effusion to retraction pockets and frank cholesteatoma.(1,2,3) Eustachian tube dysfunction has been linked to pathology within the cartilaginous portion, more often than those of the bony portion. (4) This could be classified into mechanical or functional dysfunction. The mechanical type of dysfunction is attributable to conditions of infective, allergic or obstructive nature in the nose, nasopharynx or the paranasal sinuses. (3, 4) The functional dysfunction, which is due to inherent weakness of tubal muscle, has recently drawn attention in the causation of middle ear pathology. (5,6)

In the case of otitis externa, neonates exhibit inflammation of the acoustic meatus and fever, while older children may present otalgia, pruritus, and tenderness of the tragus and/ or pinna (Buttaravoli & Leffler, 2012). Adults with otitis externa may have the following symptoms; tinnitus, hearing loss, pruritus. Nonetheless, otitis externa appears is common in older children aged 7-12 and young adult population (Tarazi, Al-Tawfiq, & Abdi,

pneumoniae and there chemotactic signals and the host cell’s alternate pathway, invade the alveoli. Also red blood cells are recruited to this site. In the third stage, mostly neutrophils are packed into the alveoli and very few bacteria remain. In the final stage, macrophages eliminate the remaining residue from the inflammatory response. As one can see, the damage which is done to the lung is largely a result of the host’s inflammatory response, which causes the build up of fluids in the lungs. If S. pneumoniae is allowed to persist in the lungs it can then invade the blood, which causes bacteremia. When in the blood it can traverse the blood-brain barrier and infect the meninges, which results in meningitis. S. pneumoniae is also associated with diseases in other parts of the respiratory tract including the paranasal sinuses, which is better known as sinusitis, and the middle ear can become infected, which is known as otitis media. It has also been known to cause peritonitis, an inflammation of the peritoneum, the membrane that lines the abdominal wall, and it is also implicated in causing arthritis.