Otitis Media - Acute (Pediatric)

Definition

Acute otitis media (AOM) is an infection of the middle ear characterized by rapid onset of ear pain, fever, and inflammation, commonly occurring in children due to anatomical and immunological factors.

Epidemiology

• Most common in children aged 6 months to 3 years
• Peak incidence between 6–18 months
• Higher prevalence in boys
• Frequently occurs during winter and early spring
• Risk factors include daycare attendance, exposure to tobacco smoke, bottle-feeding, and upper respiratory tract infections

Etiology

• Bacterial: Streptococcus pneumoniae, Haemophilus influenzae (non-typeable), Moraxella catarrhalis
• Viral: RSV, influenza, adenovirus, rhinovirus, parainfluenza
• Eustachian tube dysfunction due to viral infection, allergy, or anatomical factors
• Predisposing factors: prematurity, immunodeficiency, cleft palate, craniofacial anomalies

Pathophysiology

• Eustachian tube obstruction leads to fluid accumulation in the middle ear
• Microbial invasion triggers inflammatory response in middle ear mucosa
• Edema and exudate cause increased pressure and pain
• Infection can spread to mastoid air cells causing mastoiditis
• Recurrent inflammation may lead to tympanic membrane perforation or chronic otitis media
• Impaired hearing may occur due to effusion and conductive hearing loss