Otitis Media

Basics

Description

  • 2nd most common disease of childhood, after upper respiratory infection (URI)
  • Inflammation of the middle ear
  • Most commonly occurs in children 6–36 mo
  • Rapid onset of local and/or systemic symptoms
  • More than 1/3 of children experience >5 episodes by the age of 7 yr
  • Incidence decreased significantly following international lockdowns due to COVID-19 pandemic, likely due to social distancing, decrease exposure at schools and daycare, and decreased health care utilization

Etiology

  • Associated with eustachian tube (ET) obstruction or dysfunction
  • Usually associated with (or as a result of) upper respiratory tract infections
  • Viral:
    • Parainfluenza
    • Respiratory syncytial virus
    • Influenza
    • Adenovirus
    • Rhinovirus
  • Bacterial:
    • Streptococcus pneumoniae
    • Moraxella catarrhalis
    • Haemophilus influenzae
    • Streptococcus pyogenes
    • Mycoplasma pneumoniae
  • Associated with blockage of ET
  • Predisposing factors:
    • Deficient mucus, cilia, or antibodies
    • Intubation, esp nasotracheal
    • American Indians, Eskimos
    • Down syndrome
    • Cleft palate
    • Diabetes
    • Vitamin A deficiency
    • HIV
  • Risk factors:
    • Family history
    • Daycare
    • Parental smoking
    • Pacifier use
    • Bottle-feeding

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