急性化脓性中耳炎asom.pptxVIP

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.?; 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 palate. ;#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.?;Clinical Features?Symptoms. Fever, malaiseOtalgiaDecrease in hearingDischarge from the ear canal: muco-purulent or purulent . ( perforation of the tympanic membrane).;On ExaminationIn the early stage, the tympanic membrane will show retraction and lack of mobility. 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. ;Tympanic membrane outward and cause bulging of the 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.;Tympanic membrane before perforation with ASOM;Tympanic membrane after perforation with ASOM;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 produce pain-mastoid tenderness. Infection may spread to mastoid cause mastoiditis.;Tuning fork tests : a conductive hearing loss. X-ray film or CT scan examinations in the early stages may show haziness or cloudiness. ;Treatment?Symptomatic Treatment. Analgesics