Otitis Media
Basics
Description
Otitis media is a general term for middle ear inflammation with or without symptoms. It can be acute or chronic.
- Two specific diagnoses
- Otitis media with effusion, middle ear effusion (MEE)
- Acute otitis media (AOM)
- Uncomplicated/nonsevere
- Severe
- Recurrent
Epidemiology
- Most common condition for which antibacterial agents are prescribed for children in the United States
- Peak incidence between 6 and 12 months of age
- By age 3 years, 50–85% of children have had AOM.
Risk Factors
- Age <2 years
- Gender: male > female
- Family history of AOM
- Anatomic differences, craniofacial abnormalities
- Environmental tobacco smoke exposure
- Exposure to large numbers of other children
- Day care
- Siblings in home
General Prevention
- Breastfeeding for at least 3 to 6 months
- Decreasing pacifier use after 6 months
- Vaccines
- Pneumococcal conjugate vaccine
- Influenza vaccine
- Reduction in secondhand smoke
- Reduction of day care crowding
Pathophysiology
- Eustachian tube dysfunction leads to MEE. If effusion is not cleared by the mucociliary system, bacteria and viruses have a good environment for growth.
- Severe eustachian tube dysfunction occurs during 66% of upper respiratory infections (URIs) in school-aged children and in 75% of URIs in day care–aged children.
Etiology
- Nontypeable Haemophilus influenzae: 35–50%
- Streptococcus pneumoniae: 25–40%
- Moraxella catarrhalis: 5–10%
- Viruses: 40–75%
- High rate of coinfection with bacteria
- Without bacterial coinfection: 5–22%
- Group A Streptococcus (3%)
- Staphylococcus aureus (2%)
- Gram-negative organisms such as Pseudomonas aeruginosa: 1–2%
- More common in neonatal AOM
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Citation
Cabana, Michael D., editor. "Otitis Media." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617217/all/Otitis_Media.
Otitis Media. In: Cabana MDM, ed. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617217/all/Otitis_Media. Accessed November 5, 2024.
Otitis Media. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult (8th ed.). Wolters Kluwer. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617217/all/Otitis_Media
Otitis Media [Internet]. In: Cabana MDM, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2024 November 05]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617217/all/Otitis_Media.
* Article titles in AMA citation format should be in sentence-case
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