Otitis Media

What is the cause of an earache?
Otitis media is a term for inflammation of the middle ear, located behind the eardrum. The inflammatory reaction is caused by an infection in the middle ear that leads to build up and an accumulation of fluid. This fluid build up can be perceived as a sensation of fullness in the middle ear. When too much fluid accumulates, it produces pressure on the tympanic membrane and causes pain. Otitis media can be acute or chronic, with or without symptoms. It can take two forms: acute otitis media (AOM), or otitis media with effusion (OME). AOM is a more severe form of otitis media, with pus present in the middle ear, whereas, OME is less severe, without pus in the middle ear. OME occurs more frequently than AOM. It is not always possible to distinguish between these two forms using physical examination (4). Otitis media is the most common illness in preschool-aged children and is responsible for the most visits to the doctor’s office. About 50% of American infants will have their first episode of otitis media by 6 months of age and 90% of children will have developed one or more episodes of otitis media by the age of 2 years (1). As a result, more children in this age group see doctors for otitis media, than for well child care (2). Immaturity of the immune system and age-related difference in middle ear anatomy makes young children more prone to developing otitis media following infections with respiratory microbes. Other factors that put children at higher risk of developing otitis media include day care attendance and exposure to tobacco smoke. Frequency of otitis media declines as children mature.

WHAT CAUSES AN INFANT EAR INFECTION?

Microbes most commonly responsible for otitis media include bacteria, such as Streptococcus pneumoniae (also known as pneumococcus); Haemophilus influenzae; Moraxella Catarrhalis; and less often group A streptococcus—the same bacteria that frequently causes “strep throat;” Staphylococcus aureus; Pseudomonas aeruginosa; and many viruses, especially respiratory syncytial virus, also known as RSV; parainfluenza; influenza; entero; and adenoviruses (3).

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