How Common Is Bullous Myringitis?

Discussion Bullous myringitis (BM) is felt to be a variation of acute otitis media (AOM) with more severe symptoms. Bullae (blisters or “balloons”) on the tympanic membrane occur between the outer epithelial layer and middle fibrous layers of the tympanic membrane. The exact reason for this is unknown but felt to be probably due to a strong inflammatory reaction in the middle ear begun by viral or bacterial pathogens. The pain is felt to be due to irritation of the highly innervated outer epithelial layer. The most common pathogens are the same as AOM but Streptococcus pneumoniae is detected more often. The bullae can occur on the tympanic membrane but also extend to the proximal aspect of the external ear canal (in about 10% of BM cases). Bullae that only involve the external canal are due to otitis externa and should be distinguished from BM. Symptoms that are present more often in patients with BM than AOM include severe earache and fever, but also ear rubbing, poor sleep, more crying and decreased appetite. While most cases are due to infectious diseases, one case in the literature reported BM due to organic solvent (paint thinner) entering the nasal cavity and into the middle ear with what appeared to be direct cellular damage to the structures. The American Academy of Pediatrics recently updated their clinical practice guidelines for the treatment of acute otitis media in children. See To Learn More below. Learning Point Overall, BM is felt to occur in <...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news