tube:?Upper respiratory tract mon cold, acute rhinitis ,acute tonsillitis ?Swim, dive?Acute infectious disease?measles, scarlet fever or influenza ?Breast-feeding?External auditory canal-eardrum?Injury, tympanocentesis?hematogenous infectionРClinical featuresРSymptoms:?General symptoms?fever, malaise, anorexia, vomiting, and diarrhea. ?More evident in child?subside after tympanic membrane perforation occursРClinical featuresРSymptoms:?Local symptoms:?Otalgia: sharp before perforation?Aural fullness、tinnitus, hearing loss?Otorrhea: profuse and mucoid discharge initially, mucopurulent latterРClinical featuresРsigns:?otoscopy:?Hyperemic, bulging, poor mobility?Perforation, purulent dischargeРPalpation: tenderness at mastoid or antrumРStage of congestionРStage of effusionРStage of suppuration
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