II. Epidemiology
III. Risk Factors: Recurrent Otitis Media or persistent Effusion
- Age < 5 years old (5 fold Relative Risk)
- Otitis prone (4x) (see below)
- Day care (4x)
- Respiratory Illness (4x)
- Smokers in home (3x)
- Bottle Propped babies (2x)
- Males (2x)
- Pacifier use after 6 months old
- Premature birth before 37 weeks gestation
- Gastroesophageal Reflux
IV. Risk Factors: Protective Factors against Otitis Media
- Summer (0.5x)
- Breast Feeding (0.25x)
V. Risk Factors: Otitis Prone patients
- Age at first episode of Otitis Media <6 months
- Greater than 3 episodes in the last 6 months
- Race
- Sibling history of frequent ear infections
- Immune Deficiency
- Craniofacial abnormalities
VI. Pathophysiology
- Antecedent Event: Upper Respiratory Infection
- Congestion of respiratory mucosa
- Obstruction of eustachian tube typically at the isthmus (narrowest section
- Eustachian tubes in under age 5 years are more likely to obstruct (shorter, more narrow, more horizontal)
- Results in increased eustachian tube negative pressure
- Middle Ear Serous effusion develops
- Serum drawn into the middle ear due to negative pressure
- Effusion colonization with Bacteria
- Suppurative Otitis Media develops
VII. Pathophysiology: Pathogens
-
Streptococcus Pneumoniae
- Incidence: 38%
- Beta Lactamase producing: 15-25%
- Causes more severe cases with Otalgia and fever
-
Haemophilus Influenzae
- Incidence: 27%
- Beta Lactamase producing: 35%
- More often associated with Eye Redness and discharge
-
Moraxella catarrhalis
- Incidence: 10%
- Beta Lactamase producing: 85-100%
- Group-A Beta Hemolytic Streptococcus
- Incidence: 3%
-
Staphylococcus Aureus
- Incidence: 2%
VIII. Findings: Symptoms and Signs
IX. Complications
- Intracranial
- Extracranial
- Hearing Loss
- Tympanic Membrane Perforation
- Chronic Suppurative Otitis Media
- Mastoiditis
- Cholesteatoma
- Facial Paralysis
- Tympanosclerosis
- Labyrinthitis
X. Diagnosis
- See Otitis Media Diagnosis
- See Otalgia
XI. Management
XII. References
- Thomas and Kosoko (2022) Crit Dec Emerg Med 36(12): 12-3
- Daly (1991) Otolaryngol Clin North Am 24:775-86 [PubMed]
- Daly (1999) Pediatrics 103:1158-66 [PubMed]
- Gaddey (2019) Am Fam Physician 100(6): 350-6 [PubMed]
- Klein (1994) Clin Infect Dis 19:823-32 [PubMed]
- Lieberthal (2013) Pediatrics 131(3): e964-99 [PubMed]
- Palmu (2004) Clin Infect Dis 38:234-42 [PubMed]
- Teele (1989) J Infect Dis 160:83-94 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
| Concepts | Disease or Syndrome (T047) |
| ICD10 | H66.9 |
| SnomedCT | 3110003 |
| Italian | Otite media acuta, Otite media acuta NAS |
| Dutch | otitis media acuut NAO, otitis; media, acuut, otitis media acuut |
| French | Otite moyenne aiguë SAI, Otite moyenne aiguë |
| German | Otitis media akut NNB, akute Otitis media |
| Portuguese | Otite média aguda NE, Otite média aguda |
| Spanish | Otitis media aguda NEOM, OMA - otitis media aguda, otitis media aguda (trastorno), otitis media aguda, Otitis media aguda |
| Japanese | 急性中耳炎, 急性中耳炎ＮＯＳ, ｷｭｳｾｲﾁｭｳｼﾞｴﾝ, ｷｭｳｾｲﾁｭｳｼﾞｴﾝNOS |
| English | acute otitis media (diagnosis), acute otitis media, Otitis media acute NOS, Acute otitis media NOS, Otitis media;acute, acute media otitis, otitis media acute, Otitis media acute, AOM - Acute otitis media, Acute otitis media, Acute otitis media (disorder), otitis; media, acute, Acute otitis media, NOS |
| Czech | Akutní otitis media NOS, Akutní otitis media |
| Hungarian | acut otitis media, acut otitis media k.m.n. |
Ontology: Acute suppurative otitis media (C0271431)
| Concepts | Disease or Syndrome (T047) |
| ICD9 | 382.0 |
| ICD10 | H66.0 |
| SnomedCT | 42337005, 155226009, 194283000, 194281003 |
| English | ASOM, Acute supp. otitis media NOS, Acute suppurative otitis media NOS, acute suppurative otitis media (diagnosis), acute suppurative otitis media, Otitis media suppurative acute, Otitis media suppurative acute NOS, Otitis media;suppurative;acute, acute purulent otitis media, Acute suppurative otitis media NOS (disorder), Acute purulent otitis media, ASOM - Acute suppurative otitis media, Acute suppurative otitis media (disorder), otitis; media, acute, purulent, otitis; media, acute, suppurative, otitis; media, purulent, acute, otitis; media, suppurative, acute, suppurative; otitis media, acute, Acute suppurative otitis media, NOS, Acute suppurative otitis media (disorder) [Ambiguous], Acute otitis media, purulent, Acute suppurative otitis media |
| Dutch | otitis media etterend acuut, etterende otitis media acuut NAO, acute etterende otitis media, etterig; otitis media, acuut, otitis; media, acuut, etterig, otitis; media, acuut, purulent, otitis; media, etterig, acuut, otitis; media, purulent, acuut, Acute etterige otitis media |
| French | Otite moyenne suppurée aiguë, Otite moyenne suppurée aiguë SAI |
| German | akute eitrige Otitis media, Otitis media eitrig akut NNB, Otitis media eitrig akut, Akute eitrige Otitis media |
| Italian | Otite media suppurativa acuta, Otite media acuta suppurativa, Otite media suppurativa acuta NAS |
| Portuguese | Otite média purulenta aguda, Otite média supurativa aguda NE |
| Spanish | Otitis media purulenta aguda NEOM, Otitis media supurativa aguda, Otitis media aguda supurativa, otitis media aguda supurativa, SAI, otitis media aguda supurativa, SAI (trastorno), otitis media aguda purulenta, otitis media aguda supurativa (concepto no activo), otitis media aguda supurativa (trastorno), otitis media aguda supurativa |
| Japanese | 急性化膿性中耳炎, 急性化膿性中耳炎ＮＯＳ, ｷｭｳｾｲｶﾉｳｾｲﾁｭｳｼﾞｴﾝNOS, ｷｭｳｾｲｶﾉｳｼｮｳﾁｭｳｼﾞｴﾝ, ｷｭｳｾｲｶﾉｳｾｲﾁｭｳｼﾞｴﾝ |
| Czech | Akutní hnisavá otitis media, Akutní hnisavá otitis media NOS |
| Korean | 급성 화농성 중이염 |
| Hungarian | heveny gennyes középfülgyulladás, Otitis media suppurativa acuta, Otitis media suppurativa acuta k.m.n. |
Ontology: Bacterial otitis media (C1698510)
| Concepts | Disease or Syndrome (T047) |
| SnomedCT | 703469002 |
| Dutch | otitis media bacterieel |
| French | Otite interne bactérienne |
| German | bakterielle Otitis media |
| Italian | Otite media batterica |
| Portuguese | Otite média bacteriana |
| Spanish | Otitis media bacteriana |
| Japanese | 細菌性中耳炎, ｻｲｷﾝｾｲﾁｭｳｼﾞｴﾝ |
| Czech | Bakteriální otitis media |
| Hungarian | bacterialis otitis media |
| English | Bacterial otitis media (disorder), Bacterial otitis media, Otitis media bacterial |
