Infection
Otitis Media
● Pathophysiology & Etiology
● Inflammation of the middle ear. One of the most common childhood illnesses. Most
common in winter months.
○ Peak incidence-6-20 months of age
○ Occurs more frequently in:
■ Males
■ American Indians & Alaska Native children
■ Children in daycare
■ Children exposed to secondhand smoke r/t prolonging inflammatory response.
■ Children who use a pacifier several hours/day r/t creating vacuum in area
■ Children with cleft defects
■ Children with Down Syndrome r/t low set ear and floppy airway
● Breastfeeding provides some protection
Clinical Manifestations (6-20 months):
● Ear pain-pulling at the ear, or rubbing ear into blanket
● May have diarrhea, vomiting
● May have fever
● Irritability & acting out (signs of hearing loss secondary to inflammation)
● Night awakenings with crying due to increase pressure when prone or supine
● Drainage (increased)
Diagnosis
● Direct + careful visualization of tympanic membrane
Therapeutic Management
● Pharmacologic
○ High dose of oral amoxicillin (drug of choice)
○ Ibuprofen or acetaminophen for pain relief
● Surgery - last option
Myringotomy with Tube Insertion - not as common. Tubes can become infected and fall out.
, Nursing Care Mgmt - OM
● Relieve pain (tylenol and motrin)
● Prevent Complications or Recurrence
○ Proper use of antibiotics
○ Monitor for hearing loss
○ Hold upright for feeds
○ No second hand smoke
● Education
● Emotional Support
○ Child & Family
● Non-Pharm
○ Positioning
○ Warm compress
○ No ibuprofen for less than 6 months.
Intracranial Infections: Meningitis
Pathophysiology
● Inflammation of the meninges:
○ Bacterial
○ Viral (aseptic)
○ TB
● Most common causes of bacterial are (do not need to memorize)
○ Streptococcus pneumoniae
○ Haemophilus influenzae type B
○ Neisseria meningitidis
● Usually occurs secondary to other infections:
○ Vascular dissemination
○ Primary infections that can cause meningitis:
■ otitis media
■ Sinusitis
Otitis Media
● Pathophysiology & Etiology
● Inflammation of the middle ear. One of the most common childhood illnesses. Most
common in winter months.
○ Peak incidence-6-20 months of age
○ Occurs more frequently in:
■ Males
■ American Indians & Alaska Native children
■ Children in daycare
■ Children exposed to secondhand smoke r/t prolonging inflammatory response.
■ Children who use a pacifier several hours/day r/t creating vacuum in area
■ Children with cleft defects
■ Children with Down Syndrome r/t low set ear and floppy airway
● Breastfeeding provides some protection
Clinical Manifestations (6-20 months):
● Ear pain-pulling at the ear, or rubbing ear into blanket
● May have diarrhea, vomiting
● May have fever
● Irritability & acting out (signs of hearing loss secondary to inflammation)
● Night awakenings with crying due to increase pressure when prone or supine
● Drainage (increased)
Diagnosis
● Direct + careful visualization of tympanic membrane
Therapeutic Management
● Pharmacologic
○ High dose of oral amoxicillin (drug of choice)
○ Ibuprofen or acetaminophen for pain relief
● Surgery - last option
Myringotomy with Tube Insertion - not as common. Tubes can become infected and fall out.
, Nursing Care Mgmt - OM
● Relieve pain (tylenol and motrin)
● Prevent Complications or Recurrence
○ Proper use of antibiotics
○ Monitor for hearing loss
○ Hold upright for feeds
○ No second hand smoke
● Education
● Emotional Support
○ Child & Family
● Non-Pharm
○ Positioning
○ Warm compress
○ No ibuprofen for less than 6 months.
Intracranial Infections: Meningitis
Pathophysiology
● Inflammation of the meninges:
○ Bacterial
○ Viral (aseptic)
○ TB
● Most common causes of bacterial are (do not need to memorize)
○ Streptococcus pneumoniae
○ Haemophilus influenzae type B
○ Neisseria meningitidis
● Usually occurs secondary to other infections:
○ Vascular dissemination
○ Primary infections that can cause meningitis:
■ otitis media
■ Sinusitis
