Table of Contents
Acute Bacterial Otitis Media in the Pediatric Setting
Goals of the Presentation
DEFINITIONS OTITIS MEDIA (MIDDLE EAR INFECTION)
Epidemiology of ABOM
Emerging consensus… ABOM is both overdiagnosed and overtreated in the U.S.
Middle Ear Anatomy
PPT Slide
Eustachian Tubes in Adults versus Children
Bacterial Etiologies of Acute Bacterial Otitis Media
Bacterial Etiologies of Acute Bacterial Otitis Media
Intrinsic Risk Factors for ABOM
Extrinsic Risk Factors for ABOM
Symptoms of ABOM
Evaluation of the Ear
Signs of ABOM
Chief Complaint: 2 year old Caucasian male presents with right ear pain of 1 day duration as well as tactile fever, malaise, nonproductive cough, and sore throat each of three days duration
Differential Diagnosis
Differential Diagnosis
Pertinent Questions for the Clinical History
Case Presentation - History
Case Presentation - History continued...
Pertinent Aspects of the Physical Examination
Case Presentation - Physical Exam
Stages of Acute Bacterial Otitis Media
Case Presentation - Labs
Differential Diagnosis
Differential Diagnosis
Red tympanic membrane in a crying child
Tympanosclerosis
Cholesteatoma
Foreign body in external ear canal
Otitis externa
Mastoiditis
Dental Caries
Recurrent AOM and otitis media with effusion (OME)
Case Presentation - Assessment
Treatment: to treat or not to treat, is there a question?
Treatment: to treat or not to treat, is there a question?
Treatment: General Measures
Treatment: First line
Treatment: Alternative antibiotics to be considered if...
Treatment: Examples of alternative antibiotics for ABOM
Average cost for a 10-day course of oral antibiotics for ABOM
Symptomatic/supportive therapy for the unhappy kiddos
Prophylactic Antibiotic Therapy for Recurrent AOM:
Types of Surgical Measures Indicated if 3 or more recurrences of ABOM with chemoprophylaxis
Back to the Case...
Prognosis
Complications
Social implications
Follow up
Back to the Case...
Prevention
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Author: Jason A. Watts
Email: mottolin@cnmc.org
Home Page: http://home.gwu.edu/~mottolin
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