ASOM (Acute Suppurative Otitis Media)
A Fluid Filled Ear Infection
Introduction
- Acute Suppurative Otitis Media (ASOM) is an infection of the middle ear.
- It can be caused by bacteria or viruses.
- The infection leads to the formation of pus in the middle ear cavity.
- ASOM is a common condition, especially in children.
- Key symptoms include Ear pain, Fever, Hearing loss.
Causative Organism
- ASOM is usually caused by bacteria, such as: Streptococcus pneumoniae, Haemophilus influenzae & Moraxella catarrhalis
- It often follows upper respiratory infections (colds, throat infections).
- Pathogens travel from the nasopharynx (back of the nose) to the middle ear through the Eustachian tube.
Symptoms
- Ear pain (otalgia): Often severe, worse when lying down.
- Ear discharge (otorrhea): Due to perforation of the tympanic membrane.
- Hearing loss: Temporary conductive hearing loss due to fluid in the middle ear.
Fever: Often associated with the infection.
- Irritability in children: Babies may tug at their ears.
Pathogenesis
- ASOM begins with Eustachian tube dysfunction, often caused by a cold or throat infection.
- Fluid builds up in the middle ear, creating a favorable environment for bacterial growth.
- Inflammation develops, leading to the formation of pus.
- The increasing pressure may cause the eardrum to perforate, resulting in the release of discharge.
Diagnosis
- Endoscopy: Visualization of the eardrum, which may appear bulging, red, or perforated.
- Impedance: Can assess middle ear pressure.
- Pure Tone Audiometry: To evaluate the degree of hearing loss.
Treatment
- Antibiotics: Oral antibiotics like amoxicillin are commonly prescribed to combat bacterial infection.
- Analgesics: Pain relief is crucial, with medications like ibuprofen or acetaminophen.
- Ear Drops: If there is a perforation, antibiotic ear drops may be given.
- Surgery: In recurrent or severe cases, myringotomy (drainage of fluid).
Complications
- Chronic Suppurative Otitis Media (CSOM): If left untreated, ASOM can progress to a chronic condition.
- Mastoiditis: Infection can spread to the mastoid bone.
- Hearing Loss: Persistent fluid or damage can cause long-term hearing impairment.
- Intracranial complications: Rare but serious, including meningitis or brain abscess.