急性化脓性中耳炎ASO

ACUTESUPPURATIVEOTITISMEDIA

(ASOM)第一页，共十六页。Acutesuppurativeotitismediaresultsfrombacterialinfectionofthemiddleearcleft,oftenasabacterialcomplicationofthecommoncold.Thisismorefrequentinchildrenthaninadults.

第二页，共十六页。Etiology

#Thecommoninfectiveorganismsarebetahemolyticstreptococcus,pneumo-coccus,Hemophilusinfluenzae,andstaphylococcus.

#Eustachiantubes:viralupperrespiratoryinfection,enlargedadenoids,sinusinfections,allergy-causingedemaintheeustachiantuberegion,andcleftpalate.

第三页，共十六页。#Othercause:traumaticrupture,perforationofthetympanicmembrane,frominfectionfollowingearsurgery.

#ASOMisaself-limitingdisease,andwhentreatedadequatelyitrarelyleavesanyresidualchange.

第四页，共十六页。ClinicalFeatures

Symptoms.

Fever,malaise

Otalgia

Decreasein

hearing

Dischargefromtheearcanal:muco-purulentorpurulent.(perforationofthetympanicmembrane).第五页，共十六页。OnExamination

Intheearlystage,thetympanicmembranewillshowretractionandlackofmobility.

Nextwiththeonsetofedemaandexudationthedrumwillloseitslandmarks,appearthickanddull,andmayhaveafluidlevel.

Thefluidisthickandnotclear,asinthecaseofserousotitismedia.

第六页，共十六页。Tympanicmembraneoutwardandcausebulgingofthedrum.

Ifuntreatedthetympanicmembranewillrupture,givingrisetoaserosanguinousandthenmucopurulentorpurulentdischargefromtheear.

Perforationoccursintympanicmembranecentral.第七页，共十六页。TympanicmembranebeforeperforationwithASOM第八页，共十六页。TympanicmembraneafterperforationwithASOM第九页，共十六页。Afterperforation,painandfevermaynotbeasmarkedasintheearlierstages,butthereispersistenceofpurulentdischargeandrecurrenceofpain.

Pressureonthemastoidtipwillproducepain-mastoidtenderness.

Infectionmayspreadtomastoidcausemastoiditis.第十页，共十六页。Tuningforktests:aconductivehearingloss.

X-rayfilmorCTscanexaminationsintheearlystagesmayshowhazinessorcloudiness.

第十一页，共十六页。Treatment

SymptomaticTreatment.

Analgesics:pain

antipyretics:fever.

fluidreplacement:preventofdehydration

第十二页，共十六页。Thecultureandthesensitivityofdischarge

Antibiotictreatment:Penicillingivensystemicallywillmanagemostoftheseinfections.InchildrenthepossibilityofHemophilusinfluenzaeshouldbekeptinmind,andthismayrequireampicillinifthereisnoresponsetopenicillinorifthecultureandthesensitivitytestsoindicate.Antibioticsshouldbegivenfor5to7days,certainlynotless.第十三页，共十六页。Systemicdecongestantshelpreduceswellingandtherebyfacilitatedrainageofthemiddleear.Thesearegivenforaperiodoftwoweeksormore,dependingonhowquicklythemiddleearbecomesfreeoffluid.

Ifthedrumappearsfullandbulging,amyringotomyshouldbecarriedoutfordrainage.第十四页，共十六页。

EardropsalsocanbevalueforinfectioninASOM.0.25%-1%Chloramphenicoland0.3%Ofloxacineardropsarerecommended.

Beforeusingeardrops,

cleaningpurulentdischarge

inearby2%

hydrogehperoxidesolution.

Coldcreamcanbeused

toprotectskinmacerated

fromeardischarge.

Localtreatment第十五页，共十六页。内容梗概ACUTESUPPURATIVEOTITISMEDIA

(ASOM)。Tymp