Otolaryngology Book


Otitis Media

Aka: Otitis Media, Acute Otitis Media, Acute Suppurative Otitis Media, Acute Purulent Otitis Media, Acute Bacterial Otitis Media
  1. See Also
    1. Otitis Media Diagnosis
    2. Otitis Media Acute Treatment
    3. Observation Protocol for Acute Otitis Media Management
    4. Otitis Media Prophylaxis
  2. Epidemiology
    1. Incidence of infection
      1. All children by 1 year of age: 62%
      2. All children by 3 years of age: 83%
    2. Average of 1.5 Acute Otitis Media episodes per year
    3. Peak Incidence at age 6-15 months (decreases after 24 months)
  3. Risk Factors: Recurrent Otitis Media or persistent Effusion
    1. Age < 5 years old (5 fold Relative Risk)
    2. Otitis prone (4x) (see below)
    3. Day care (4x)
    4. Respiratory Illness (4x)
    5. Smokers in home (3x)
    6. Bottle Propped babies (2x)
    7. Males (2x)
    8. Pacifier use after 6 months old
    9. Premature birth before 37 weeks gestation
    10. Gastroesophageal Reflux
  4. Risk Factors: Protective Factors against Otitis Media
    1. Summer (0.5x)
    2. Breast Feeding (0.25x)
  5. Risk Factors: Otitis Prone patients
    1. Age at first episode of Otitis Media <6 months
    2. Greater than 3 episodes in the last 6 months
    3. Race
      1. Native American higher Incidence
      2. African American lower Incidence
    4. Sibling history of frequent ear infections
    5. Immune Deficiency
    6. Craniofacial abnormalities
      1. Down Syndrome
      2. Cleft Palate
  6. Pathophysiology
    1. Antecedent Event: Upper Respiratory Infection
    2. Congestion of resp mucosa
    3. Obstruction: isthmus-narrowest part of tube
    4. Increased tube negative pressure
    5. Development of effusion (serum pulled in)
    6. Effusion colonization
  7. Pathophysiology: Pathogens
    1. Streptococcus Pneumoniae
      1. Incidence: 38%
      2. Beta Lactamase producing: 15-25%
      3. Causes more severe cases with Otalgia and fever
    2. HaemophilusInfluenzae
      1. Incidence: 27%
      2. Beta Lactamase producing: 35%
      3. More often associated with Eye Redness and discharge
    3. Moraxella catarrhalis
      1. Incidence: 10%
      2. Beta Lactamase producing: 85-100%
    4. Group-A Beta Hemolytic Streptococcus
      1. Incidence: 3%
    5. Staphylococcus aureus
      1. Incidence: 2%
  8. Findings: Symptoms and Signs
    1. See Otitis Media Symptoms and Signs
  9. Complications
    1. Intracranial
      1. Meningitis
      2. Subdural Empyema
      3. Brain Abscess
      4. Lateral Sinus Thrombosis
      5. Focal Otitis Encephalitis
    2. Extracranial
      1. Hearing Loss
      2. Tympanic Membrane Perforation
      3. Chronic Suppurative Otitis Media
      4. Mastoiditis
      5. Cholesteatoma
      6. Facial Paralysis
      7. Tympanosclerosis
      8. Labyrinthitis
  10. Diagnosis
    1. See Otitis Media Diagnosis
    2. See Otalgia
  11. Management
    1. See Otitis Media Acute Treatment
    2. See Otitis Media Prophylaxis
  12. References
    1. Daly (1991) Otolaryngol Clin North Am 24:775-86 [PubMed]
    2. Daly (1999) Pediatrics 103:1158-66 [PubMed]
    3. Gaddey (2019) Am Fam Physician 100(6): 350-6 [PubMed]
    4. Klein (1994) Clin Infect Dis 19:823-32 [PubMed]
    5. Lieberthal (2013) Pediatrics 131(3): e964-99 [PubMed]
    6. Palmu (2004) Clin Infect Dis 38:234-42 [PubMed]
    7. Teele (1989) J Infect Dis 160:83-94 [PubMed]

Acute otitis media (C0271429)

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, キュウセイチュウジエン, キュウセイチュウジエン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.
Derived from the NIH UMLS (Unified Medical Language System)

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ジエンNOS, キュウセイカノウショウチュウジエン, キュウセイカノウセイチュウジエン
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.
Derived from the NIH UMLS (Unified Medical Language System)

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ジエン
Czech Bakteriální otitis media
Hungarian bacterialis otitis media
English Bacterial otitis media (disorder), Bacterial otitis media, Otitis media bacterial
Derived from the NIH UMLS (Unified Medical Language System)

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