Acute Otitis Media

This infection is usually caused by S. Pyogenes, Pneumococcus, H. infuenzae, Branhlamella catarrhalis or, in many cases, One of the respiratory tract viruses . The organism spreads to the middle ear via the Eustachian tube from the nasopharynx which is the primary site of infection As the eardrum remains intact, none of the infected exudates can be collected on an ear swab, through culture of a throat swab may give a provisional indication of the causal organism. Antibiotic therapy is urgently required to prevent a possible bacterial infection damaging the hearing mechanism and amoxycillin erythromycin or cotrimoxazole may be used when the causal organism is unknown. Amoxycillin is the drug of choice unless a β-lactamase-producing variety of H. influenzae is the cause, When the absence of a rapid response will indicate the need for a change of drug.
If the eardrum has ruptured spontaneously, or a myringotomy has been performed to relieve pressure exudates may be collected on a thin swab introduced carefully into the external meatus. It should be examined in a Gram film and by aerobic and anaembic Culture plates of heated blood agar and blood agar.