case 2 acute suppurative otitis media

Acute suppurative otitis media (ASOM) is caused by upper respiratory tract infections resulting to tympanic membrane perforation with  pus discharge or may be bloody discharge .

two years old  male child

compaint: complaint was giver by his father about unilateral ear discharge bloody and not offensive of two days duration

vital signs: child is vitally stable with no fever and average general condition.

clinical examination : 

in examination left ear pus and no bloody discharge and after removing of pus by suction and moobing tympanic membarane perforation and runny nose and congested nasal mucosa bilaterally

plan of care:

after removing of pus from external ear canal by suction we recommend to give medical treatment for the patient in form of

Augmentin susp and paracetamol syp and nasal drops and ear drops

avoid water in his ear

avoid forcible blowing and change in atmosfere


this patient wase diagnosed as acute suppurative otitis media

patient was dicharged after prescription of mediacal treatment and for follow up in ENT opd or any time at ER


this is acse of URTI mostly from viral infection result in ifection of eustachian tube and infection travel to middle ear through eustachian tube result in acute otitis media with acommulation of pus in middle ear with otalgia and hearing deminution  and compression  result in necrosis of apart of tympanic membrane leading to its perforation and discharging pus wich lead to releave from symptoms like pain and hearing deminution and fever

the first line of treatment is good systemic antibiotic and good loacal antibiotic ear drops and nasal decongestant to keep eustachian tube opened and to releave the middle ear disease

and to avoid more infection patient should keep his ear dry and away from water to avoid exacerbation of infection