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Abstract: Acute suppurative otitis media is a common type of pediatric otitis media, easily followed by pediatric upper respiratory tract infection, with infection by the eustachian tube route being the most common. The 3-year-old child in this paper was diagnosed with acute suppurative otitis media after examination for 3 days due to an upper respiratory tract infection 1 week ago and presented to our hospital with ear pain accompanied by pus. After standard anti-inflammatory and symptomatic treatment, the child’s condition improved and the acute suppurative otitis media gradually healed, and the ear pain disappeared.
Basic information】Female, 3 years old
Disease Type】Acute suppurative otitis media
Hospital】Northern War Zone General Hospital
Date of Consultation】November 2021
Treatment plan】Anti-inflammatory treatment (cefuroxime sodium for injection, lomefloxacin hydrochloride ear drops) + symptomatic treatment (saline rinse, ibuprofen suspension to reduce fever)
Treatment period】7 days of outpatient treatment, review after 3 days
Treatment effect】The condition improved, acute suppurative otitis media gradually healed, and the ear pain disappeared.
I. Initial consultation
The parents brought their 3-year-old child to the clinic, saying that the ear pain had been accompanied by pus for 3 days. The family recalled that the child had developed nasal congestion and runny nose and pain in both ears due to upper respiratory tract infection 1 week ago, and the parents gave the child oral treatment with cold and fever granules and cephalosporin antibiotics on their own. On examination, the child’s body temperature was 38.5℃, and electronic otoscopy showed that a small amount of cerumen was attached deep in the external ear canal, and no new organisms were formed in the ear canal.
II. Treatment history
After the child was diagnosed with acute suppurative otitis media, we actively communicated with the parents, who agreed to apply cefuroxime sodium for injection as an intravenous anti-inflammatory treatment. At the same time, attention was paid to symptomatic treatment, and the child’s nasal cavity was washed with saline when there was a lot of nasal discharge. At the same time, hydrogen peroxide can be used to flush the external ear canal to promote the discharge of secretions from the middle ear cavity, and lomefloxacin hydrochloride ear drops can be used together with ibuprofen suspension to reduce fever. After 7 days of outpatient medication treatment, the child’s condition improved and the acute suppurative otitis media gradually healed.
III. Treatment effect
After 4 days of regular medication treatment, the child’s ear pain was significantly reduced compared with before. It is recommended to discontinue the use of cefuroxime sodium for injection IV, but hydrogen peroxide and lomefloxacin hydrochloride ear drops can consolidate the treatment for 3 days. After 7 days of anti-inflammatory and symptomatic treatment, the child’s condition improved and the acute suppurative otitis media gradually healed, and the ear pain disappeared. Parents are instructed to take the child for a review in 3 days to clarify the recovery of the disease.
IV. Precautions
As an attending physician, we are happy that the child’s condition has improved and the pain has disappeared after standard treatment. However, until the middle ear inflammation has completely recovered, it is necessary to protect the external ear canal to avoid the re-infection and inflammation caused by pollutants accidentally entering the external ear canal. At the same time, pay attention to more nutrients, take the affected child to participate in more outdoor sports and ensure sufficient sleep to help strengthen the body and improve the immune system. Try to avoid getting cold and reduce the number of colds.
V. Personal insight
Acute suppurative otitis media is a common clinical disease, and children are prone to secondary infections after upper respiratory tract infections due to the slightly lower immune function of the body. Therefore, it is important to pay attention to keep warm and avoid catching a cold. If ear pain occurs after a cold, you should be alert to acute suppurative otitis media, and you must seek medical attention in time to actively control the inflammation to avoid causing tympanic membrane perforation, which may affect the normal hearing of the affected child. When bathing or swimming, you must pay attention to avoid water in the ear canal to prevent infection.