Paediatrics: Acute Otitis Media: Free MSRA Podcast

👶🦻 Deep Dive: Acute Otitis Media – Paediatrics for the MSRA🎧 It’s the middle of the night, your child’s crying with ear pain – could it be AOM? In this episode, we cover everything you need to know about acute otitis media, one of the most common childhood infections.📌 What is AOM?• 🎯 Acute inflammation of the middle ear• Often follows a cold or URTI• Related conditions: glue ear (OME), CSOM, cholesteatoma, mastoiditis• In ~5% of cases, the eardrum may perforate🦠 Causative Organisms🔬 Bacterial:• Strep pneumoniae (pneumococcus)• Haemophilus influenzae (non-flu)• Moraxella catarrhalis🦠 Viral:• RSV, influenza, rhinovirus• SARS-CoV-2 detected in post-mortem studies!⚠️ Risk Factors🧒 Young age (esp. <2 yrs)🚬 Passive smoking🏫 Daycare attendance🍼 Formula feeding🧬 Craniofacial abnormalities (e.g., Down syndrome, cleft palate)📆 Winter season🎯 First AOM at a young age = higher risk of recurrence🔬 Pathophysiology• 🎯 Blocked eustachian tube = fluid builds up behind tympanic membrane• Bacteria/viruses multiply = inflammation & pressure• Kids have shorter, more horizontal tubes = easier for bugs to spread from URTIs🧠 Differentials• OME (glue ear – fluid, but no infection)• Otitis externa (swimmer’s ear)• Referred pain (dental/TMJ)• Cholesteatoma• Bullous myringitis• Foreign bodies• CSOM📊 Epidemiology📈 >2/3 of children will have AOM by age 3🎯 Peak incidence: 6–15 months🌍 ~700 million cases/year globally (🧒 Half in kids <5)🏥 33 deaths per 10 million (mostly in infants <1 in low-income countries)🩺 Clinical Features👶 Ear pain (otalgia)🥵 Fever😢 Irritability, poor feeding, disturbed sleep🔊 Hearing loss💧 Ear discharge if perforation occurs👀 On exam: bulging, red, opaque eardrum, +/- fluid level or perforation🧪 Investigations✅ Diagnosis is clinical🧫 Ear swab: only if discharge, grommets, or recurrent infections🎧 Hearing test: if long-term hearing loss suspected🧠 CT/MRI: if complications suspected (rare)💊 Management🩹 First line: Pain relief (paracetamol/ibuprofen)⏱️ Consider delayed antibiotics for 48–72 hrs if mild💊 Antibiotics:• 1st line: Amoxicillin (5 days)• Allergy: alternatives or co-amoxiclav if worsening🚫 Antihistamines, decongestants & echinacea = not effective🏥 When to Refer📉 No improvement/worsening after a few days👂 Recurrent AOM (ENT referral)🎧 Hearing loss or complications🧪 Grommets or specialist management for chronic issues🧷 Tympanocentesis in select severe cases📈 Prognosis✅ Excellent – most recover in 7–10 days⚠️ Some may develop CSOM or hearing issues🧠 Serious complications (rare): mastoiditis, meningitis, facial nerve palsy, intracranial abscesses, sepsis🛡️ Prevention Tips🚭 Avoid passive smoking🍼 Avoid supine feeding🧸 Limit dummy use after 6–12 months💉 Keep vaccinations up to date (e.g., pneumococcal vaccine)👨‍⚕️ ENT input for frequent or complex AOM📚 Useful MSRA Resources📝 Revision Notes:https://www.passthemsra.com/topic/acute-otitis-media-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/acute-otitis-media-flashcards/❓ Accordion Q&A Notes:https://www.passthemsra.com/topic/acute-otitis-media-accordion-qa-notes/🚀 Rapid Quiz:https://www.passthemsra.com/topic/acute-otitis-media-rapid-quiz/📚 Full Course:https://www.passthemsra.com/courses/paediatrics-for-the-msra/🧠 Final Tip: Not every earache needs antibiotics! Prioritise pain relief & watchful waiting unless red flags present. Educate parents, support kids, and know when to escalate.#MSRA #AcuteOtitisMedia #PaediatricsMSRA #MSRARevision #MSRAFlashcards #MSRAQuiz #OtitisMedia #MSRAQandANotes #ChildHealth #GPTraining #MSRA2025 #ENT #GlueEar #CSOM