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Acute otitis media

definition
Acute otitis media is an inflammation of the ear being that of some or all of the periosteum and lasted less than 3 weeks.



etiology
blockage of the eustachian tube is the principal cause of otitis media. body's defense on mucosal cilia impaired eustachian tube, until the invasion of bacteria into the prevention of ear being disturbed as well. besides that, ARI is also among the factors that trigger very often.
oma that triggers germ pyogenic bacteria, like Streptococcus hemoliticus, Haemophilus influenzae (27%), Staphylococcus aureus (2%), Streptococcus pneumoniae (38%), pneumococcus.
in children, more often attacked by ISPA, the more likely course of acute otitis media (oma). in infants, because the tuba oma eustachiusnya facilitated short, wide, and it was located horizontally.

pathogenesis
otitis media often begins with respiratory infections like strep throat or a cold that spread to the ear canal via the eustachian being. bacteria through the Eustachian canal time, they can cause infections in the channel until the swelling lasts more or less channels, obstruction of channels, as well as the arrival of some white blood cells to fight bacteria. some white blood cells to kill bacteria orbankan themselves. as eventually forming pus in the ear being. besides that less tissue swelling resulting Eustachian canal mucus produced some cells in the ear are collected behind the eardrum.
when mucus and pus be added many, hearing can be impaired due to the eardrum and the small bones connecting the eardrum to the hearing organ in the inner ear can not move freely. facing hearing loss is usually more or less 24 decibels (whisper smooth). but the more fluid can lead to hearing problems to 45 decibels (normal conversation range). besides that the ear will feel pain. and very heavy, too much fluid is then able to tear the eardrum due to the pressure. oma could develop into a critical suppurative otitis media if the sign goes increasingly over 2 bln., regarding the factors associated with the majority of them hygiene, therapy delayed, inadequate healing, and endurance that are less good.
oma has the most clinical stages include:

eustachian tube occlusion stage
No picture of the tympanic membrane retraction.
normal tympanic membrane colored or turbid pale.
difficult to distinguish from viral serous otitis media.
hyperemia stage
vein width and edema seen on the tympanic membrane.
secretions are probably already formed remains a serous exudate to look tough.
stage supurasi
tympanic membrane bulging outwards.
superfisila epithelial cells were destroyed.
formed purulent exudate in the tympanic cavity.
patient looks very ill, pulse and temperature rise, and increasingly severe pain in the ear.
stage perforation
tympanic membrane rupture.
out pus from the ear being.
calmer patients, body temperature drops, and can sleep soundly.
resolution stage
if kept intact tympanic membrane, then slowly return to normal.
if perforation takes place, the secretions can shrink and become dry.
resolution could take place without healing when low virulence and good endurance.

diagnosis
in children, the main complaint is pain in the ear as well as a high body temperature and there is the story of cough and cold at first. children are also restless, difficulty sleeping, a sudden scream of sleep, diarrhea, convulsions, and sometimes a sick child holding ears. when the tympanic membrane rupture takes place, then flows into the ear canal secretions, body temperature drops, and the children fell asleep quietly.
greater in children or adults, not only there is also the problem of pain and feeling full hearing in the ear.
the diagnosis is not difficult oma, to see the clinical signs and the general situation of the tympanic membrane has a diagnosis can be established. assessment can be seen through the tympanic membrane controls the head lights and otoskopi. existing perforation in the tympanic membrane various kinds, including central perforations, marginal, tinkers, subtotal, and overall.

management
oma therapy depends on the stage. on the stage of occlusion, the goal of therapy is devoted to re-open the eustachian tube. given nose drops ephedrine hcl 0, 5% in physiological solution for children 12 yrs and ephedrine hcl 1% in physiologic solution for 12-yr-old child or adult .. in addition, the source of infection should also be treated prescribe antibiotics.
presupurasi on stage, given antibiotics, nose drops and analgesics. when the tympanic membrane was diffuse hyperemia, well done myringotomy. antibiotic was penicillin or erythromycin obtained. if there is resistance, can be given combined with klavunalat acid or cephalosporins. for initial therapy given penicillin im so concentration in the blood adequately. antibiotics are given at least as long as 7 days. in children given ampicillin 4x50-100 mg / kg, amoxicillin 4x40 mg / kg / day, or erythromycin 4x40 mg / kg / day.
supurasi healing stage not only antibiotics, the patient should be referred for myringotomy done if the tympanic membrane remains intact. besides that, analgesics are also given so that pain may need to shrink.
on stage perforation, ear cleaning remedy given H2O2 3% during 3-5 days and adequate antibiotics to 3 weeks.
resolution stage can generally be seen secretions flow out. This situation can be continued on antibiotics to 3 weeks, but if it stays out secretions are considered already underway mastoiditis.

complication
before when no antibiotics, complications are very often at oma subperiosteal abscess to severe complications like meningitis and brain abscess. otitis media were not addressed could also lead to permanent hearing loss.

prevention
many things that seem to reduce the risk oma namely:
. prevention of respiratory infection in infants and children.
2. breast feeding at least 6 months along ..
3. avoidance of bottle feeding at the time the child was lying.
4. avoidance of exposure to tobacco smoke.
swim most likely not increase the risk of oma.

discussion
Otitis media is an inflammation of the ear of the medium. otitis could be partly due to one factor is very often due to infection eustachian tube blockage. besides that, otitis media can also be a result of the complications of other diseases eg rhinitis, sinusitis, pharyngitis, otitis externa, and so on. signs are often caused by otitis media in general is pain, loss shrinks, fever, dizziness, sometimes accompanied also hear buzzing (tinnitus).
the above problems, the patient experienced signs of pain in the left ear since 3 days, coupled with recurrent cough for a long time. patients also complained there was clear discharge from his left ear. for the diagnosis of otitis media, took control otoskopi done. found no central perforation in the left ear membrane is accompanied existing discharge. possible stage is the stage of otitis media perforations.
triggers that perhaps as the originator of otitis media in patients with rhinitis above are long-faced. cough patients have experienced long. of control rinoskopi nasalis anterior inferior turbinate obtained naturally accompanied by edema and hyperemia were no mucous purulent fluid. rhinitis patients likely experienced critical. that it can be interpreted that the trigger of otitis media is a critical complication of rhinitis.
healing was found in patients on antibiotics (bellamox syrup), corticosteroids (somerol), analgesics, antihistamines (salbutamol), and decongestants (lapifed). then the patient is asked to control another week if the signs are not lost.