Acute otitis media in children. Clinical and etiologic study

Background: To know in our country the etiology of acute otitis media (AOM) in children by tympanocentesis and study the symptoms of this disease. Methods: One hundred twenty healthy children diagnosed of AOM were studied between June 1989 and December 1998. Tympanocentesis was performed on each patient with an Abbocath-20G needle connected to a sterile syringe. Otic exudates were cultured for aerobic, anaerobic and fungi. Results: A total of 126 isolates were recovered, in 6 children there was mixed flora. One pathogen was isolated in 97 exudates (77 %) and in 29 (23 %) the culture was sterile or with saprophyte flora of the external otic canal. The isolated was: Streptococcus pneumoniae 46 (36%); Haemophilus influenzae 33 (26%); Streptococcus pyogenes 5 (4%); E. coli 4 (3,3%); Pseudomonas aeruginosa 3 ( 2,5 %); Staphylococcus aureus 2 (1,5%); anaerobics 2 (1,5%), Moraxella catarrhalis 1 (0,8%) and Sphingomona paucimobilis 1 (0,8%). In six cases there was mixed flora. The most frequent symptom was otalgia (85%) followed by fever (56%) and upper respiratory tract infection (49%). In 41 cases AOM was bilateral (34%), 45 in the right ear (37%) and 34 in the left ear. Conclusions: In our series, the positive cultures and the pathogens found in exudates of AOM are similar to what is described in international literature. S. Pneumoniae and H. Influenzae are the most frequent pathogens while M. catarralis is exceptional.