Causes
Otogenic sepsis. clinical picture
Diagnostics
Otogenic sepsis treatment
Prevention of otogenic sepsis
Sepsis is a serious disease characterized by the penetration of pathogenic microorganisms into the bloodstream and leads to the development of a pronounced systemic response of the body.
Otogenic sepsis is a generalization of an infectious and inflammatory process, the primary focus of which is in the ear. This disease is considered as a severe complication of external, acute middle, purulent and other forms of otitis media.
Causes
The penetration of bacteria and pathogens into the blood is observed in most infectious processes, however, normally, good reactivity and full functioning of the immune system prevent the development of a severe clinical picture. Otherwise, the aggressiveness of the infection prevails over the protective forces and sepsis develops.
Thus, the key moment in the occurrence of otogenic sepsis is the weakening or suppression of the general resistance of the organism or its immunity against the background of massive penetration of bacteria from the otitis media into the bloodstream.
The most common route of infection is intracranial venous sinuses (sigmoid and stony). These large veins have direct contact with the bony boundaries of the middle and inner ear, therefore, in the presence of severe otitis media, the inflammatory process also affects the veins - this is how phlebitis develops.
As a result of phlebitis, blood clots form in the lumen of the veins, blood flow slows down, the permeability of the vascular wall increases, which contributes to the generalization of infection from the middle or inner ear.
Otogenic sepsis. clinical picture
The clinical picture of otogenic sepsis is distinguished by its severity. This is due to the close proximity of the primary inflammation focus to the brain.
The very first sign of the development of sepsis is a sharp increase in body temperature up to 40 C o . Such fluctuations greatly exhaust the patient, accompanied by pouring sweat and severe chills.
Excessive sweat leads to rapid dehydration of the body and a significant deterioration in the condition. In this case, a rapid heartbeat, a weak pulse, a drop in blood pressure, dry mucous membranes, a white coating on the tongue, and an earthy skin color are determined.
With the defeat of the membranes of the brain, severe headaches, nausea, vomiting, and possibly meningeal symptoms appear.
Locally, in the area of the mastoid process of the skull (behind the ear), there is swelling, redness, or a rash on the skin.
Diagnostics
Suspicion of the development of otogenic sepsis should arise immediately after a critical increase in body temperature, and the presence of sharp temperature fluctuations is already a reliable sign of this serious disease.
Unfortunately, the patient's condition does not always allow finding out information about the previous otitis media. In such situations, relatives are asked or diagnostics of the outer and middle ear is performed.
To identify pathogenic microorganisms in the systemic circulation, a blood sample is taken for inoculation on nutrient media. This allows you to identify a specific pathogen and prescribe an effective antibiotic.
In order to establish the shape of otitis media and the volume of ear lesions, a complex of ENT studies is performed: otoscopy, otomicroscopy, endoscopy, tympanometry, X-ray of the skull, CT or MRI of the temporal bones.
Otogenic sepsis treatment
Otogenic sepsis is an indication for immediate hospitalization of the patient. When a purulent focus is detected in the middle ear cavity or in the cells of the mastoid process, an urgent surgical intervention is being prepared, its main purpose is to remove pus, rinse the affected cavity, and excise non-viable tissues.
If pus is found in the tympanic cavity, then paracentesis is performed - a small puncture of the tympanic membrane in order to extract the purulent contents. In the presence of pus in the mastoid process, its surface plate is opened and the cells are drained. After such procedures, the patient's well-being significantly improves and the effectiveness of conservative therapy increases.
Drug treatment involves the appointment of large doses of antibacterial drugs, taking into account the sensitivity of microflora, infusion and detoxification therapy, restoration of lost fluid. Also, general strengthening treatment, immunity support (vitamin therapy, good nutrition) plays an important role.
Prevention of otogenic sepsis
To maintain health for you and to exclude the development of otogenic sepsis, you must promptly seek specialized medical help and not self-medicate. For any diseases of the ear, first of all, you need to consult an ENT doctor, for example, at the K + 31 clinic. We keep the health of our patients in focus, so here a specialist will make the right diagnosis and prescribe the right treatment.
