This means acute inflammation of the middle ear.

Aetiology

Mostly the inflammation of the middle ear is an extension from the nose and throat via the Eustachian tube e.g. in rhinitis, sinusitis, tonsillitis and adenoiditis.

It is also common in swimmers and divers particularly if the swimming pool is infected.Injuries of the tympanic membrane and fractures of the skull involving the middle ear are causative in certain cases.

The main causative organisms are streptococci, some times staphylococci and pneumococci and rarely H.influenzae.

Symptoms

• Pain, which is made worse by coughing, yawning, stooping or blowing the nose.
• Fever
• Tinnitus
• Vertigo

Signs

• Toxic look i.e. raised temperature and rapid pulse.
• Cart wheel appearance" of the tympanic membrane.
• Tympanic membrane congested and bulging outwards.
• Evidence of nose and throat infection.

Differential Diagnosis

Boil in external meatus