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Otitis Media[edit]

Suppurative Otitis Media[edit]

Acute suppurative otitis media is distinguished from secretory (serous) otitis media by the presence of purulent fluid in the middle ear. Pathogenic bacteria may be cultured from the majority of needle aspirates of this purulent fluid. In secretory otitis media, relatively few polymorphonuclear cells are present in the middle ear fluid, which is either thin and straw-colored (serous) or thick and translucent grey (mucoid). The fluid has the chemical characteristics either of a transudate of plasma or of a mucoid secretion, presumably produced by goblet cells and mucous glands which are greatly increased in the middle ear mucosa of patients with secretory otitis media. Cultures of this middle ear fluid are usually negative for pathogenic bacteria and viruses. - AAP.


  1. "Neck mass, deafness/otalgia, progressive nasal obstruction and epistaxis are the cardinal symptoms of nasopharyngeal carcinoma." - PubMed. Symptoms of nasopharyngeal cancer may include:
    1. Blurry or double vision.
    2. Difficulty speaking, including hoarseness.
    3. Ear infections that keep coming back.
    4. Face pain or numbness.
    5. Headache.
    6. Hearing loss, ringing in the ears, or a feeling of fullness in the ear.
    7. Lump in neck or nose.
    8. Nosebleeds.
  2. "Causes of epistaxis can be divided into local causes (eg, trauma, mucosal irritation, septal abnormality, inflammatory diseases, tumors), systemic causes (eg, blood disorders, arteriosclerosis, hereditary hemorrhagic telangiectasia), and idiopathic (unknown) causes. Local trauma is the most common cause; followed by facial trauma, foreign bodies, nasal or sinus infections, and prolonged inhalation of dry air. Tumors and vascular malformations are also important causes of nose bleeds. Epistaxis is also associated with septal perforations (holes in the nasal septum). ", "Direct pressure is usually effective for stopping epistaxis by applying pressure to the front of the nose. Nasal decongestants such as oxymetazoline or neosynephrine may also be used. In general, non-surgical treatments are effective for control of most cases of nosebleeds. Holding pressure, nasal packing, chemical cautery, and use of nasal decongestant sprays represent the first line of treatment for a majority of nasal bleeding. For persistent epistaxis, embolization and surgical ligation is sometimes required." - American-Rhinologic.
  3. Most cases of acute sinusitis, those caused by a viral infection, resolve on their own. Acute sinusitis is most often caused by the common cold, which is a viral infection. In some cases, a bacterial infection develops. You may be at increased risk of getting sinusitis if you have:
    1. Hay fever or another allergic condition that affects your sinuses
    2. A nasal passage abnormality, such as a deviated nasal septum, nasal polyps or tumors
    3. A medical condition such as cystic fibrosis or an immune system disorder such as HIV/AIDS. - Mayo Clinic.
  4. Risk factors for pharyngitis include:
    1. Cold and flu seasons
    2. Having close contact with someone who has a sore throat or cold
    3. Smoking or exposure to secondhand smoke
    4. Frequent sinus infections
    5. Allergies
    6. Attending daycare or crowded schools. - UMM.edu.
  5. Second-generation antihistamines like: Loratadine, cetirizine.