Otis media and Reyes syndrome

• Acquired Disorders

  • Otitis Media
  • Reye Syndrome
• Otitis Media


  • Middle ear infection behind the eardrum
  • Happens when ear infection keeps fluid from draining from middle ear
• Causes of Otitis Media


  • Haemophilus influenzae
  • Streptococcus pneumoniae
  • Viruses: RSV, colds
• Risk Factors for Otitis Media

  • Upper respiratory illness
  • Chronic respiratory illness
  • Native American, Hispanic, and Alaska Natives
  • Air pollution
  • Children have more ear infections
  • Children with Down Syndrome
  • Infants sleeping with bottles in their mouth
• Otitis Media Treatment

  1. Viral: warm compress, analgesics

  2. Bacterial: Antibiotics (amoxicillin)

  3. Analgesics

  4. Antipyretics

  5. Anti-inflammatory

  6. Surgical Intervention: Tympanostomy, Myringotomy
• Complications of Otitis Media

  • Hearing loss
  • Perforation of eardrum
  • Mastoiditis
• Otitis Media: Tips for reinforcing family teaching

  1. Use heating pad on low setting for comfort with adult supervision

  2. Provide soft foods and liquids

  3. Comfort child

  4. Schedule follow-up hearing test as advised
• Prevention tips for Otitis Media

  • Stay up to date with vaccines
  • Complete full course of antibiotics
  • Don’t place anything in the ear
  • Prevent upper respiratory infections
  • Hold infant upright to feed
  • Never prop the bottle
  • Breastfeed
  • Keep child away from cigarette smoke
  • Remove allergens from home
• Reye Syndrome

  • Usually occurs after a viral illness
  • Characterized by acute encephalopathy and fatty degeneration of the liver and other abdominal organs
  • Administration of aspirin during viral illness has been implicated as contributing factor
• Risk Factors for Reye Syndrome

  • Using aspirin to treat viral infection
  • Having an underlying metabolic disorder
• Diagnosis of Reye Syndrome

  1. History of viral illness, liver function tests

  2. Other tests: liver biopsy, lumbar puncture, coagulation studies, blood glucose, ammonia levels; hypoglycemic, delayed PTT
• Reye Syndrome Clinical Manifestations

  1. Symptoms appear 3 to 5 days after initial illness

  2. Child recuperates unremarkably when symptoms of severe vomiting, irritability, lethargy, confusion, and disorientation appear
• Reye Syndrome Treatment

  1. Goal: improve respiratory function, reduce cerebral edema, control hypoglycemia

  2. Osmotic diuretics (mannitol)

  3. Nursing care: careful observation, accurate I&O, monitor blood glucose level, bleeding time
• Complications of Reye Syndrome

  • Most children and teenagers survive
  • Without treatment, can cause death within a few days
• Family Teaching for Reye Syndrome

  1. AAP recommends aspirin or aspirin compounds NOT be given to children during viral infections

  2. Exception to general rule about aspirin is aspirin given for Kawasaki Disease as long-term treatment
• Otitis Media


  Middle ear infection behind the eardrum
• Causes of Otitis Media


  • Haemophilus influenza
  • Streptococcus pneumonia
  • Viruses like RSV and colds
• Risk Factors for Otitis Media

  • Upper respiratory illness
  • Chronic respiratory illness
  • Native American
  • Hispanic
  • Alaska Natives
  • Air pollution
  • Children with Down Syndrome
  • Infants sleeping with bottles
• Pathophysiology of Otitis Media

  • Thick mucous in middle ear
  • Swollen eustachian tube
  • Bulging inflamed eardrum
• Diagnosis for Otitis Media


  1. Physical examination of the ear

  2. Otoscope to look for redness, fluid, or pus

  3. Tympanometry to assess eardrum movement

  4. Audiometry for hearing tests

  5. Imaging studies if needed
• Signs and symptoms of Otitis Media

  • Ear pain
  • Fever
  • Irritability
  • Difficulty hearing
  • Drainage from the ear
  • Loss of balance
  • Headache
• Treatment for Otitis Media

  1. Surgical intervention: Tympanostomy, Myringotomy

  2. Warm compress on low setting

  3. Analgesics (no aspirin)

  4. Antibiotics

  5. Antipyretics

  6. Anti-inflammatory

  7. Schedule follow-up hearing test as advised
• Complications of Otitis Media

  • Hearing loss
  • Perforation of eardrum
  • Mastoiditis
• Prevention Tips for Otitis Media

  • Vaccines
  • Antibiotics
  • Avoiding placing objects in the ear
  • Breastfeeding
  • Avoid cigarette smoke
• Reye Syndrome

  Usually occurs after a viral illness, characterized by acute encephalopathy and fatty degeneration of the liver and other abdominal organs
• Causes of Reye Syndrome

  • Administration of aspirin during viral illness
• Signs and Symptoms of Reye Syndrome

  • Persistent vomiting
  • Confusion
  • Seizures
  • Loss of consciousness
  • Behavioral changes
  • Rapid breathing
  • Liver dysfunction
  • Coma
• Risk Factors for Reye Syndrome

  • Using aspirin to treat viral infection
  • Having an underlying metabolic disorder
• Diagnosis of Reye Syndrome

  1. History of viral illness

  2. Liver function tests

  3. Liver biopsy

  4. Lumbar puncture

  5. Coagulation studies

  6. Blood glucose

  7. Ammonia levels

  8. Hypoglycemic

  9. Delayed PTT
• Clinical Manifestations of Reye Syndrome

  • Symptoms appear 3-5 days after the initial illness
  • Severe vomiting
  • Irritability
  • Confusion
• Treatment for Reye Syndrome

  1. Improve respiratory function

  2. Reduce cerebral edema

  3. Control hypoglycemia with osmotic diuretics (mannitol)
• Nursing care for Reye Syndrome

  1. Careful observation

  2. Accurate I&O

  3. Monitor blood glucose level

  4. Bleeding time
• Complications of Reye Syndrome

  • Most children and teenagers survive
  • Can cause death within a few days without treatment
• Family Teaching for Reye Syndrome

  • Avoid giving aspirin to children during viral infections
  • The exception for this is for the treatment of Kawasaki Disease