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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