How to Treat Otitis Media
Acute ear infections are a common problem in children and are responsible for considerable morbidity (Table 1.1). Acute middle ear infection or otitis media is the main disease, but this can lead to chronic otitis media or mastoiditis (chronic infection of the bony air cells below the ear) or meningitis. The ear is joined to the nasopharynx by the eustachian tube through which infecting organisms pass, so ear infections are generally associated with respiratory infections. Organism S. pneumoniae and H. influenzae are the most common causative organisms, but various viruses may initiate infection and Pseudomonas aeruginosa and Staphylococcus aureus are common in the discharges of chronic otitis media.
Occurrence and distribution This is a very common condition throughout the world and many children develop ear infections during the course of their childhood. Where the drum has ruptured, deafness will result, leading to problems at school, so what started off as a seemingly insignificant problem can lead to poor development and disability throughout the life of the individual. Otitis media and deafness occurring in the first 2-3 years of life can interfere with spoken language acquisition, leading to difficulties in communication, understanding and a barrier to education. There is a particularly high level of otitis media in Australian aboriginals and the Inuit people of the Arctic with Pacific Islanders and native North Americans next in order of magnitude. This may be due to these people having larger eustachian tubes, which offer lower resistance to the passage of organisms. Control and prevention Upper respiratory infections should be adequately treated and the eardrum always...
MPS I is due to the deficiency of alpha-L-iduronidase. As a result of this deficiency, heparan sulfate and dermatan sulfate, two mucopolysaccharides or GAGs, build up in the body and gradually cause organ damage. The first symptoms are enlargement of the liver and spleen, inguinal hernias, and chronic otitis media. Later the cardiac and respiratory function are affected, corneal clouding develops, and conductive hearing loss occurs. Orthopedic problems develop later and become quite severe. During the first and second year of life, facial features coarsen and airway problems become more severe.
Pyoderma and impetigo are superficial skin infections with vesicles, pustules and crusts. Erysipelas is a red, tender, oedematous cellulitis of the infected part of the body, originating from the point of infection. Scarlet fever presents as a generalized rash that blanches on pressure with high fever, strawberry tongue and flushing of the cheeks. In some cases, there is an appreciable mortality or else it can result in otitis media, glomer-ulonephritis or acute rheumatic fever (ARF, Section 13.10). Although not a skin infection, streptococci can also cause puerperal fever due to post-delivery infection of the female genital tract.
A disease is a morbid condition of the body (e.g. measles or plague). As the cause of diseases were discovered, they became identified by the causative organism, such as trypanosomiasis or pneumococcal meningitis, but confusion arose because there are two forms of African trypanosomiasis and one of American, while the pneumococ-cus is an important cause of pneumonia as well as meningitis. This confusion continues. Instead of settling on one system or another, I have tried to list all the communicable diseases by either the disease state or the organism by which they are best identified. For example, in the case of gastroenteritis, one of the commonest causes of diarrhoea in developing countries, it is preferable to separately list the various organisms that can cause it. Where these are particularly distinct, such as rotavirus infection, then they are put into the list. On the other hand, the streptococcus is responsible for such an array of diseases that just to put down...
The pneumococcus causes a variety of diseases, including ARI (Section 13.2), pneumonia (Table 13.1), meningitis (Table 13.2) and otitis media (Section 13.9), which are more conveniently covered under the various diseases they cause, but in view of the availability of a vaccine, its possible use in preventing these diseases will be discussed here. infants and the elderly. S. pneumoniae is also the commonest cause of otitis media, causing fever and pain in the ear. If untreated, this can lead to bacteremia and fulminant meningitis, with a high fatality rate. There is a high fever, lethargy and the patient rapidly descends into coma. S. pneumoniae is also a common cause of conjunctivitis.