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Laterality of acute otitis media: different clinical and microbiologic characteristics

David P McCormick1, Stephanie M Chandler, Tasnee Chonmaitree

  • 1Department of Pediatrics, University of Texas Medical Branch at Galveston, Galveston, TX 77551, USA. david.mccormick@utmb.edu

The Pediatric Infectious Disease Journal
|June 29, 2007
PubMed

Insights

Children with bilateral acute otitis media (AOM) are younger and more likely to have bacterial infections and severe ear inflammation. This may explain persistent symptoms and guides treatment decisions.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Otolaryngology

Background:

  • Bilateral acute otitis media (AOM) in young children is linked to persistent symptoms without antibiotics.
  • Previous research suggests a higher incidence of bacterial pathogens, particularly Haemophilus influenzae, in bilateral AOM cases.

Purpose of the Study:

  • To identify risk factors associated with bilateral AOM.
  • To determine if specific viral and bacterial pathogens are more prevalent in bilateral versus unilateral AOM.

Main Methods:

  • Secondary data analysis of 1216 AOM cases.
  • Comparison of demographic, clinical, and middle ear fluid (MEF) culture results between unilateral and bilateral AOM groups.
  • 566 subjects underwent tympanocentesis and MEF culture for bacterial and viral analysis.

Main Results:

  • Children with bilateral AOM were younger (P < 0.001).
  • Haemophilus influenzae was more frequently isolated from MEF in bilateral AOM cases (P < 0.0001).
  • More severe tympanic membrane inflammation was observed in bilateral AOM (P < 0.0001).

Conclusions:

  • Bilateral AOM is associated with bacterial presence in middle ear fluid and increased tympanic membrane inflammation.
  • These factors may contribute to the higher risk of persistent symptoms in bilateral AOM without antibiotic treatment.
  • Considering the laterality of AOM is important when discussing treatment options with parents.
Abstract

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