Leukocyte counts in children with acute otitis media

Area of Science:

• Pediatric Infectious Diseases
• Hematology
• Clinical Microbiology

Background:

• Acute otitis media (AOM) is a common childhood infection.
• Leukocyte counts are often used to assess infection severity.
• The impact of AOM and its treatment on peripheral blood counts requires further investigation.

Purpose of the Study:

• To investigate peripheral blood leukocyte counts in children diagnosed with acute otitis media.
• To determine the prevalence of leukocytosis at presentation and leukopenia/neutropenia at follow-up.
• To explore potential correlations between leukocyte count abnormalities, age, culture results, and antibiotic treatment.

Main Methods:

• Peripheral blood leukocyte counts were analyzed in 167 children with AOM undergoing myringotomy.
• Middle ear exudate cultures were performed.
• Leukocyte counts were assessed at initial presentation and 10–14 days post-treatment.
• Data were analyzed based on age, culture results, and antibiotic therapy (erythromycin-sulfisoxazole vs. amoxicillin).

Main Results:

• Markedly elevated leukocyte counts (>97th percentile) were observed in 28% of children at presentation.
• Leukocyte counts exceeded 20,000/microL in 9% of cases.
• Relative leukopenia (13% vs. 2%) and absolute neutropenia (10% vs. 2%) were significantly more common at follow-up than at initial presentation.
• No significant difference in leukocyte counts was found between culture-positive and culture-negative AOM.
• Children treated with erythromycin-sulfisoxazole showed a non-significant trend towards higher rates of neutropenia compared to amoxicillin.

Conclusions:

• Acute otitis media can cause significant transient alterations in peripheral blood leukocyte counts.
• Leukopenia and neutropenia are frequently observed at follow-up after AOM treatment.
• Antibiotic therapy, particularly the combination of erythromycin-sulfisoxazole, may influence peripheral blood counts, warranting further investigation.