CSOM TREATMENT

 

Chronic suppurative otitis media (CSOM)

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CSOM full form is Chronic suppurative otitis media.

Chronic bacterial infection of the middle ear with persistent purulent discharge through a perforated tympanic membrane.
The principal causative organisms are Pseudomonas aeruginosa, Proteus sp, staphylococcus, other Gram negative and anaerobic bacteria.

Clinical features

• 1. discharge for more than 2 weeks, often
• 2. associated with hearing loss or even deafness; 
• 3.absence of pain and
• 4. fever
• Otoscopy: perforation of the tympanic membrane and purulent exudate
• Complications:
  • Consider a superinfection (AOM) in the case of new onset of fever with ear pain, and treat accordingly.
  • Consider mastoiditis in the case of new onset of high fever, severe ear pain and/or tender swelling behind the ear, in a patient who appears significantly unwell.
  • Consider brain abscess or meningitis in the case of impaired consciousness, neck stiffness and focal neurological signs (e.g. facial nerve paralysis).

Treatment

• 1. MEDICAL CARE - Consult with a doctor of ent 

• Remove secretions from the auditory canal by gentle dry mopping (use a dry cotton bud or a small piece of dry cotton wool).
• Apply ciprofloxacin ear drops until no more drainage is obtained (approximately 2 weeks, max. 4 weeks):

Children 1 year and over: 3 drops 2 times daily
Adults: 4 drops 2 times daily

• Complications:
• Chronic mastoiditis is a medical emergency that requires prompt hospitalisation, prolonged antibiotherapy that covers the causative organisms of CSOM (ceftriaxone IM for 10 days + ciprofloxacin PO for 14 days), atraumatic cleaning of the ear canal; surgical treatment may be required. Before transfer to hospital, if the patient needs to be transferred, administer the first dose of antibiotics.

• 2. PREVENTION OF EAR DISCHARGE

• 1. DON'T PUSH FORIEGN OBJECT 
  
• 2.KEEP YOUR EAR DRY
• 3. AVOID BATHING IN POND
• 4.Increase your immunity - by eating more healthy fruits , milk etc.
• 5.Protect your ear from extreme sounds.