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Acute otitis media caused by Streptococcus pyogenes in children
Nili Segal1, Noga Givon-Lavi, Eugene Leibovitz
1Department of Otorhinolaryngology, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Summary
Group A Streptococcus (GAS) causes acute otitis media (AOM) in children, particularly older ones. GAS AOM presents with ear drainage and a higher risk of mastoiditis compared to other AOM pathogens.
Area of Science:
- Pediatric Infectious Diseases
- Otolaryngology
- Microbiology
Background:
- Streptococcus pyogenes (group A beta-hemolytic Streptococcus, GAS) is a significant pathogen causing various infections.
- While GAS is implicated in acute otitis media (AOM), its precise role and characteristics in this condition require further elucidation.
Purpose of the Study:
- To investigate the role and clinical features of GAS in pediatric acute otitis media.
- To compare GAS AOM with AOM caused by other common pathogens.
Main Methods:
- A retrospective study of pediatric patients (0-18 years) with AOM from 1999-2003.
- Middle-ear fluid cultures were analyzed for pathogens including Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and GAS.
- Demographic, clinical, and symptom data were collected and analyzed.
Main Results:
- GAS was identified in 3.1% of 11,311 AOM episodes.
- Older age and Jewish ethnicity were risk factors for GAS AOM; fall season was a negative risk factor.
- GAS AOM episodes were less frequently febrile or bilateral but had a higher risk of mastoiditis (11.6/1000 episodes) compared to other pathogens.
Conclusions:
- GAS AOM is associated with older children and presents with distinct clinical features, including ear drainage.
- GAS AOM demonstrates increased local aggressiveness, characterized by lower rates of systemic symptoms but higher rates of tympanic perforation and mastoiditis.