Otitis Media: Diagnosis and Treatment


Added on  2022-08-20

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Name of the Student
Name of the University
Author’s Note

This case study is about a patient who is 8 years old and suffers from slight upper
respiratory disturbances that began 5 days ago. The symptoms were mild sore throat,
nonproductive cough and sneezing. Gradually he started suffering from fever and then
complained of right ear pain (Venekamp, Damoiseaux and Schilder 2014). The child has healthy
all these years without the susceptibility of any chronic disease and he was not prescribed any
medicine except for an over the counter vitamin. Her mother notified that he missed his last
MMR vaccine before he was admitted to school because she was unable to remember. His vitals
were almost normal and his nasal turbinates were mild pink, nasal discharge was clear, pre-
auricular swelling of the lymph gland was identified on the right side. The tympanic membrane
of the right side was red, light reflex was absent and an immobile slight bulge was seen. All these
suggested that he was suffering from acute otitis media.
The diagnosis of this disease is possible through several instruments that are used for
looking inside the ear. It can be diagnosed with the help of otoscope, which is used for looking
into the ears during checkups or investigating ear symptoms as it gives a clear view of the ear
drum and ear canal. Tympanometry is used for tests that detects the air pressure inside the child’s
ear to find if the ear drum is damaged. Reflectometry is a small instrument that creates sound
inside the ear of the child, which helps in determining fluid content inside the ear when the sound
reflects back from the ear. An ear test can be performed to find out if the child is not suffering
from hearing loss due to acute otitis media (Kitamura et al. 2015).

Treatment Plan
The most common management for this infection is antibiotic therapy. Administration of
analgesics and antipyretics are also recommended for the treatment of acute otitis media. In the
initial stages, home care is recommended by applying warm and moist cloth around the infected
area, including over the counter drugs or ear drops for the pain and taking pain relievers such as
acetaminophen and ibuprofen. Children who are severely ill with a bulging tympanic membrane
and middle ear effusion should be medicated with antibiotics. Children with mild fever or illness
including mild or moderate bulging of the tympanic membrane and mild otalgia can be given
antipyretics. These medications should be provided only after a watchful waiting or when there
is no end to pain for 24-48 hours. Surgical procedures are also recommended in severe cases
(Sakulchit and Goldman, 2017).
Drugs of Choice
The most recommended antibiotic for the treatment of this disease is amoxicillin. The
dose given is 45 to 60 mg/kg per day divided between 3 doses. Amoxicillin-clavulanate is
considered when there is a conjunctivitis with concurrent purulent. If the child has allergies from
this medicine then second generation or third generation cephalosporin is prescribed for acute
otitis media. Sometimes when oral medication is not suitable then intravenous administration is
given with ceftriaxone. Amoxicillin acts on the bacterial growth during an ear infection, which is
found in acute otitis media. It prevents the growth and kills them from increasing the infection by
creating a cell wall (Marchisio et al. 2014). This antibiotic is similar to penicillin as it works
against susceptible bacteria when it is on the stage of active multiplication. The site of action is
the cell wall biosynthesis and it inhibitions all sources of production leading to bacterial death.
The half-life of this medicine is 61.3 minutes and around 60% of the orally administered dose is

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