Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content +++ Key Features ++ Persistent otorrhea in a child with tympanostomy tubes or tympanic membrane (TM) perforation Starts with an acute infection that becomes chronic with mucosal edema, ulceration, granulation tissue, and eventual polyp formation Risk factors include a history of multiple episodes of otitis media, living in crowded conditions, day care attendance and being a member of a large family Most common associated bacteria include Pseudomonas aeruginosa, Staphylococcus aureus, Proteus species, Klebsiella pneumoniae, and diphtheroids +++ Clinical Findings ++ Ongoing purulent ear drainage Nonintact TM: perforation or tympanostomy tubes May be associated with cholesteatoma +++ Diagnosis ++ Clinical +++ Treatment ++ Visualization of the TM, meticulous cleaning with culture of the drainage, and appropriate antimicrobial therapy, usually topical, are the keys to management Culture-directed treatment, imaging, and biopsy may be needed to rule out other possibilities when patient does not respond to treatment Patients with facial palsy, vertigo, or other CNS signs should be referred immediately to an otolaryngologist + +Roland PS, et al: Chronic suppurative otitis media. http://emedicine.medscape.com/article/859501-overview. Updated March 27, 2015. Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth