Acute Otitis Media

Acute otitis media (AOM) is inflammation (usually caused by infection) of the middle ear (Figure 8.1). It is the most common infection seen in children. About 90% of children will have had one or more episodes of acute otitis media by their second birthday. Infection is usually initially with a virus and comes from the nose or pharynx ascending via the Eustachian tube. AOM does occur in adults, but much less often. The Eustachian tube in children is shorter, wider and more horizontal than in adults, so that infection tracks upwards much more easily. Additionally, children are also more susceptible to infections in general because of their immature defence mechanisms. Adults may develop otitis media but much less frequently.

The usual organisms are viruses and the ‘pyogenic’ bacteria (e.g. streptococci, Haemophilus influenzae).

Clinical Presentation

The main clinical features of AOM are otalgia (earache), fever and deafness followed by otorrhoea (discharge from the ear, often sticky; if infected with anaerobic organism it may be fetid).

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