Se ha denunciado esta presentación.
Utilizamos tu perfil de LinkedIn y tus datos de actividad para personalizar los anuncios y mostrarte publicidad más relevante. Puedes cambiar tus preferencias de publicidad en cualquier momento.

Otite moyenne aiguë

6.504 visualizaciones

Publicado el

  • DOWNLOAD THAT BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download Full EPUB Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download Full doc Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download PDF EBOOK here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download EPUB Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download doc Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book that can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer that is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story That Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money That the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths that Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Responder 
    ¿Estás seguro?    No
    Tu mensaje aparecerá aquí
  • DOWNLOAD THAT BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://urlzs.com/UABbn } ......................................................................................................................... Download Full EPUB Ebook here { https://urlzs.com/UABbn } ......................................................................................................................... Download Full doc Ebook here { https://urlzs.com/UABbn } ......................................................................................................................... Download PDF EBOOK here { https://urlzs.com/UABbn } ......................................................................................................................... Download EPUB Ebook here { https://urlzs.com/UABbn } ......................................................................................................................... Download doc Ebook here { https://urlzs.com/UABbn } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book that can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer that is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story That Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money That the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths that Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Responder 
    ¿Estás seguro?    No
    Tu mensaje aparecerá aquí
  • DOWNLOAD THAT BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download Full EPUB Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download Full doc Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download PDF EBOOK here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download EPUB Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download doc Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book that can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer that is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story That Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money That the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths that Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Responder 
    ¿Estás seguro?    No
    Tu mensaje aparecerá aquí
  • DOWNLOAD THAT BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { http://bit.ly/2m77EgH } ......................................................................................................................... Download Full EPUB Ebook here { http://bit.ly/2m77EgH } ......................................................................................................................... Download Full doc Ebook here { http://bit.ly/2m77EgH } ......................................................................................................................... Download PDF EBOOK here { http://bit.ly/2m77EgH } ......................................................................................................................... Download EPUB Ebook here { http://bit.ly/2m77EgH } ......................................................................................................................... Download doc Ebook here { http://bit.ly/2m77EgH } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book that can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer that is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story That Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money That the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths that Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Responder 
    ¿Estás seguro?    No
    Tu mensaje aparecerá aquí
  • (Unlimited)....ACCESS WEBSITE Over for All Ebooks ................ accessibility Books Library allowing access to top content, including thousands of title from favorite author, plus the ability to read or download a huge selection of books for your pc or smartphone within minutes ......................................................................................................................... DOWNLOAD FULL PDF EBOOK here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download Full EPUB Ebook here { http://bit.ly/2m6jJ5M } ......................................................................................................................... Download Full PDF EBOOK here { http://bit.ly/2m6jJ5M }
       Responder 
    ¿Estás seguro?    No
    Tu mensaje aparecerá aquí

Otite moyenne aiguë

  1. 1. Les otites moyennes aigues
  2. 2. I-/ Définitions et généralités - Infection aiguë de la muqueuse de l’OM. - OMA = raison principale de prescription d’ATB chez l’enfant. - Diagnostic (OMA) = Clinique - Clinique: otalgie, fièvre, agitation - TRT : médical +/- ATB
  3. 3. II-/ Rappel anatomophysiologique
  4. 4. Tympans normaux
  5. 5. III-/ Etiopathogénie 1- Étiologies: ■ Épidémiologie: - Plupart des enfants font au moins 1 épisode d’OMA. - Incidence: maximale 6 -11 mois. - Avant 3 ans, 50 à 85 % enfants= OMA - Otite récurrente (3 épisodes d’OMA)= 10 à 20 % avant l’âge de 1 an. ■ Germes: pneumocoque , hæmophilus influenzae , moraxella catarrhalis.
  6. 6. 2- Pathogénie ■ OMA= maladie infectieuse = interférence entre charge microbienne et réaction immunitaire. ■ Facteurs favorisants multiples: mise en évidence = prévention. - Sexe et âge - Hôte (âge, prédisposition génétique, atopie) - Environnement (même fratrie, crèche, saison) - Réponse immunitaire - Dysfonctionnement tubaire - Prédisposition génétique
  7. 7. IV-/ Étude clinique 1- Signes cliniques: • Diagnostic = clinique : - Otalgie d’apparition brutale ou équivalents (frottement ou traction du pavillon, irritabilité et troubles du sommeil avec pleurs inhabituels) - Otorrhée purulente= perforation fait céder l’otalgie • Avant 2 ans = otalgie peut manquer Symptomatologie abdominale (diarrhée, vomissement).
  8. 8. 2- Examen clinique: * Congestion du conduit auditif * Tympan : 3 stades habituellement décrits: - Otite au stade congestif - Otite au stade collecté - Otite au stade perforé
  9. 9. 3- Examens par cliniques: a- Paracentèse: - Seule permet diagnostic de certitude (suppuration + germe causal - Réservée: * Échecs thérapeutiques 5 à 10 % cas. * Récidives 4 jours après 1er épisode b- Autres examens = 0
  10. 10. Point important ►02 critères otoscopiques indispensables au dg: - Épanchement dans l’oreille moyenne - Inflammation de l’oreille moyenne ► Examen bilatéral = nécessaire chez le nourrisson OMA= bilatérale (40 % des cas)
  11. 11. V-/ Diagnostics 1- Diagnostic positif: Clinique+++ 2- Diagnostic différentiel:
  12. 12. VI-/ Formes cliniques 1- Formes de l’adulte 2- OMA récidivantes
  13. 13. VII-/ Évolution et complications 1- Évolution favorable - 4e jour : signes diminuent - 8e jour l’otite a disparue - Parfois liquide résiduel 2- Complications - Mastoïdite - Labyrinthite - OMC - Méningite - Cholestéatome - Paralysie faciale - Complications méningo-encéphaliques
  14. 14. VII/ Traitement 1- Indication de l’antibiothérapie ► ATB probabiliste recommandée d’emblée - Chez enfants < de 2 ans - Si > 2 ans mais à risque infectieux particulier (immunodépression,malformation de la face, antécédent de mastoïdite), ou encas de manifestations bruyantes évoquant une infection par le pneumocoque (fièvre élevée, otalgie aiguë) 2- Durée de l’antibiothérapie - 8 à 10 jours chez l’enfant < 2 ans - 5 jours chez l’enfant > 2 ans ► ATB non recommandée (réévaluation 2-3 jrs): - Age supérieur ou égal à 2 ans sans signes bruyants - OMA congestive ► Antibiothérapie non indiquée C otite séreuse ou séromuqueuse.
  15. 15. 3- Traitement de l’OMA ► Antalgique- antipyrétique : - Paracétamol : 1er intention, 4 à 6 x jrs et - 80 mg/kg/j - Codéine + paracétamol (âge autorisé) si douleur+++ ► Efficacité non démontrée ou absence d’indications: - AINS - Corticoïdes - Gouttes auriculaires contenant des antibiotiques 4- Prévention des récidives Pas de stratégie de prévention
  16. 16. 1] Niemela M, Uhari M, Jounio-Ervasti K, Luotonen J, Alho OP,Vierimaa E. Lack of specific symptomatology in children with acuteotitis media. Pediatr Infect Dis J 1994;13:765-8. [2] AFSSAPS. (Agence française de sécurité sanitaire des produits de santé). Antibiothérapie par voie générale en pratique courante dans les infections respiratoires hautes. Octobre 2005. http://agmed.sante.gouv.fr/pdf/5/rbp/irh_reco.pdf. [3] American Academy of Pediatrics Subcommittee on Management of Acute Otitis Media. Diagnosis and management of acute otitis media.Pediatrics 2004;113:1451-65. [4] Rosenfeld RM, Kay D. Natural history of untreated otitis media. Laryngoscope 2003;113:1645-57. [5] TeeleDW, Klein JO, Rosner B. Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study. J Infect Dis 1989;160:83-94. [6] Rovers MM, Schilder AG, Zielhuis GA, Rosenfeld RM. Otitis media. Lancet 2004;363:465-73. [7] Joki-Erkkila VP, Laippala P, Pukander J. Increase in paediatric acute otitis media diagnosed by primary care in two Finnish municipalities (1994-5 versus 1978-9). Epidemiol Infect 1998;121:529-34. [8] Auinger P, Lanphear BP, Kalkwarf HJ, Mansour ME. Trends in otitis media among children in the United States. Pediatrics 2003;112(3Pt1):514-20. [9] Bluestone CD. Pathogenesis of otitis media: role of eustachian tube. Pediatr Infect Dis J 1996;15:281-91. [10] Lim DJ, Chun YM, Lee HY, Moon SK, Chang KH, Li JD, et al. Cell biology of tubotympanum in relation to pathogenesis of otitis media: a review. Vaccine 2000;19(suppl1):S17-S25. Bibliographie

×