AOM

Question 1

When is peak age for otitis media?

Answer 1

6 - 18m

Question 2

Causes of AOM?

Answer 2

• Viral (25%)
• Step pneuma (35%)
• Haemophilus (25%)
• Moraxella (15%)

Question 3

Hx features AOM?

Answer 3

• Fever
• Ear pain / irritability
  +/-
• anorexia
• Vomiting
• Lethargy

Question 4

PEx features AOM?

Answer 4

• Poor landmarks of middle ear
• TM dull and opaque +/- bulging
• URTI signs

Question 5

Does red TM always mean AOM?

Answer 5

No. Many febrile or crying children have red TMs (just as they have red cheeks)

Question 6

Complications AOM?

Answer 6

• TM perforation: purulent otorrhoea, relief of pain
• Febrile convulsions
• Suppurative complications (mastoiditis, suppurative labyrinthitis, intracranial infection) UNCOMMON

Question 7

Which children should receive ABx in AOM?

Answer 7

Only children who are NOT:

• 12m+
• Mildly unwell
• Immunocompetent

Question 8

What is first line management if children are 12m+, mildly unwell and otherwise immunocompetent?

Answer 8

• Analgesia
• Reassurance
• Consider no ABx for 24 - 48h.
• Review in 24/48h or if not improving.

Question 9

Regime if ABx indicated in AOM?

Answer 9

• Amoxicillin 15mg/kg TDS

- Analgesia