Acute Otitis Media: Pathogenesis and Clinical Findings (in Children)

Upper Respiratory Tract Infection: 

 - Bacterial: Streptococcus pneumoniae (SP) (40-50%), haemophilus influenzae (25%), moraxella catarrhalis (10%). 

 - Viral (25%): Respiratory syncytial virus, influenza, rhinovirus. 

 - Non-tvpeable: 25-45%.

 - 2/3 both bacterial and viral. Bilateral AOM mostly bacterial.

=> Inflammation & edema of respiratory mucosa of the nose, nasopharynx, and eustachian tube

=> Obstruction of the eustachian tube isthmus

=> Obstruction results in accumulation of secretions normally produced in middle ear

=> Air from middle ear is resorbed into the circulation creating negative pressure

=> Negative pressure in the middle ear pulls viruses and bacteria into it, infecting and inflaming the middle ear

=> Most (75-80%) resolve by 72 hours

Complications of AOM:

TM perforation, hearing loss, mastoiditis, febrile seizures, abscess (see relevant slide for full mechanisms)



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