One of the dangerous conditions that can develop in the middle ear is otogenic sepsis. This anomaly is an infectious disease, in which the middle ear accumulates purulent contents. This phenomenon is accompanied by a constant or periodic entry into the system of blood circulation of infected emboli and pathogenic bacteria.
Pathogenesis of the disease
Infectious processes in the body cause harmful microorganisms to enter the bloodstream. If the immune system works correctly and the person has good reactivity, the disease does not progress. If the defenses are weakened, the infection begins to spread. This is what causes sepsis.
The appearance of otogenic sepsis is a consequence of the active entry of bacteria from the area of otitis localization into the blood stream. This process develops against the backdrop of the inhibition of the body's immune system.
This form of sepsis occurs against the background of an acute form of purulent otitis. It is characterized by a very severe leak. By its nature, the inflammatory process is similar to mastoiditis. At the same time, it spreads through the veins of the mastoid process and reaches the bulb of the jugular vein.
An extradural or perisinus abscess may develop between the sinus wall and the bone site. This is due to the destruction of the ear wall by chronic otitis media. When the sinus wall is involved in the abnormal process, there is a risk of the appearance of a periphlebitis, which subsequently becomes phlebitis.
Subsequently, an occlusive thrombus is formed. This is due to the slowing of blood circulation in the inflamed sinus. With an increase in the abscess, there is a risk of its going beyond the sinus, which creates the prerequisites for spreading to the heart or head.
This pathology is accompanied by the following manifestations:
- Pain syndrome and the appearance of an infiltrate in the mastoid process.
- Painful pain in the jugular vein.
- Skin yellowness.
- Dryness of the tongue, formation of a white coating on it.
- Nausea and vomiting, severe headache amid increased intracranial pressure.
- Temperature increase up to 39-40 degrees.
- Excessive sweating.
- Increased pulse, chills and fever.
- Signs of intoxication.
- Increased size of the spleen and liver.
- Wet wheezing in the lungs.
- Rashes on the skin that can merge, forming hemorrhagic elements.
- Cyanosis of the extremities.
- State of shock, which is characterized by a sharp drop in pressure, shallow breathing, tachycardia.
To make an accurate diagnosis, the doctor primarily examines the symptoms of the pathology. You also need to perform a blood test. For otogennogo sepsis is characterized by neutrophilic leukocytosis and an increase in the rate of erythrocyte sedimentation. Also in the peripheral blood, young immature cells can be detected.
To clarify the diagnosis, blood sowing data will help. It is recommended to take it with increasing temperature. It is during this period that there is every chance to identify pathogenic microorganisms. To assess the volume of destruction of the temporal bone, X-rays are performed.
Diagnosis of otogenic sepsis of different severity
Treatment of otogenic sepsis
Using the operation, it is possible to solve such problems:
- remove purulent contents;
- rinse affected area;
- remove nonviable tissue.
Detection of a purulent secretion in the tympanic cavity is the reason for the implementation of paracentesis. In this case, pierce the membrane and get a purulent secret through the resulting hole. When the pus is located in the mastoid process, the specialist must conduct the drainage of the cells.
Thanks to these procedures, it is possible to significantly improve the patient's well-being and increase the effectiveness of conservative therapy.
In addition, it is necessary to prescribe medication. Its basis is the use of antibacterial agents in high dosage. The doctor can prescribe drugs such as penicillin, nystatin, levorin, levomycetin.
In addition to antibiotics, sulfonamides are prescribed. However, despite the high dosage, this does not help to cope with intracranial complications. With the progression of negative consequences, surgical intervention is necessary.
Another method of therapy is detoxification and dehydration. For this purpose, specialists prescribe intravenous injection of a solution of glucose, lazix, mannitol. Magnesium sulphate and ascorbic acid can also be prescribed.
Symptomatic treatment involves the appointment of such medications as cardiac glycosides, analgesics, analeptics. Of great importance is the general strengthening therapy, which contributes to the increase of the body's defenses. For this purpose, doctors prescribe vitamin preparations and adequate nutrition.
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Otogenic sepsis is considered a very dangerous disorder, which often leads to serious complications. To prevent negative consequences, the patient should be urgently hospitalized. Usually, the surgical intervention helps to cope with the ailment, after which a course of antibacterial therapy is prescribed.