Acute middle ear infection in children

Otitis media ili upala srednjeg uha naziv je za različite upalne bolesti koje zahvaćaju srednje uho. Upale srednjeg uha mogu biti akutne i kronične. Akutnom upalom srednjeg uha najčešće nazivamo kratkotrajnu upalu povezanu sa naglim nastankom simptoma poput boli u uhu, povišene temperature, otoreje, iritabilnosti itd. U upale srednjeg uha ubrajaju se i pojedina neupalna stanja poput seroznog, odnosno sekretornog otitisa Akutna upala srednjeg uha jedna je od najčešćih bolesti dječje dobi, isto tako jedan je od vodećih razloga posjeta liječniku i propisivanja antibiotika. Vrh incidencije bolesti je između šest mjeseci i druge godine života. Uzročnici bolesti su virusi i bakterije. Najčešći bakterijski uzročnici su: Streptococcus pneumoniae, Haemophillus influenzae i Moraxella catarrhalis. Uz bakterije bitnu ulogu u nastanku imaju i respiratorni virusi, čije infekcije najčešće prethode bakterijskoj, ali i sami mogu izazvati bolest. Simptome možemo podijeliti na specifične i nespecifične. Specifični simptomi su otalgija, učestalo dodirivanje ili češkanje uške, otoreja i nagluhost. Nespecifični simptomi su povišena tjelesna temperatura, promjene u spavanju, hranjenju, neutješan plač i iritabilnost. U dijagnozi bolesti ključnu ulogu ima otoskopija. Na otoskopskom pregledu bubnjić je ispupčen, zamućen, crvene boje i smanjene mobilnosti. Liječenje ovisi o kliničkoj slici i dobi djeteta. Kod djece sa teškom kliničkom slikom i mlađih od dvije godine propisuju se analgetici i antibiotici, dok kod pacijenata sa lakšom kliničkom slikom pažljivo se prati daljnji razvoj bolesti i propisuju analgetici. Prva linija antimikrobnog liječenja je amoksicilin u dozi od 80-90 mg/kg/dan podijeljen u 2 doze.Otitis media or middle ear infection is the name for various ear diseases which affect the middle ear. Middle ear infections can be acute and chronic. An acute middle ear infection is a short-lasting middle ear infection with a sudden rise of symptoms such as ear pain, high fever, otorrhea, irritability and others. Acute middle ear infections are common in children and if a child has three or more cases of infections, we call it a recurrent form of middle ear infection. Non-infection states such as otitis media with effusion count as middle ear infections as well. The acute middle ear infection is one of the most common diseases in children and the major cause for doctor visits and antibiotics. The infection usually presents between the 6th month and 2nd year of life. Causes of the acute middle ear infection are bacteria: most commonly Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. Besides bacterial causes, another causative factor are respiratory viruses; viral infections usually precede the bacterial ones, and they themselves can cause the disease. The symptoms of acute middle ear infection can be divided in two categories: specific and nonspecific. Specific symptoms are: otalgia, constant touching or scratching of the ear, otorrhea and deafness. Nonspecific symptoms are high fever, changes in the child's sleep and feeding patterns, and constant crying and irritability. The key in diagnosing the infections is otoscopy, with additional methods such as tympanometry. In the otoscopic exam tympanic membrane is bulged and blurred with colouring and reduced mobility. Curing AOM depends on the child's age and clinical presentation. In children with a more complicated clinical presentation and those younger than 2 years antibiotics and analgesics are prescribed, while in those with an uncomplicated clinical presentation observation is advised along with analgesics. The first line of antibiotic treatment is a dose of 80-90 amoxicillin divided into 2 doses