Etiology, Pathogenesis, Clinical Features, and Management of Acute Otitis Media (AOM)

Clinical Presentation and Symptoms of Acute Otitis Media (AOM)

Acute Otitis Media (AOM) is a common condition, primarily affecting children. It is characterized by middle ear infection, leading to inflammation and accumulation of fluid behind the tympanic membrane.

Etiology

AOM is most commonly caused by bacterial infections, including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Viral pathogens such as respiratory syncytial virus (RSV) and rhinoviruses may also contribute.

Pathogenesis

The pathophysiology involves dysfunction of the Eustachian tube, leading to inadequate drainage and ventilation of the middle ear. This results in bacterial colonization and subsequent infection.

Clinical Features

• Otalgia (ear pain)
• Fever
• Hearing loss
• Otorrhea (if tympanic membrane perforation occurs)
• Irritability and disturbed sleep (common in children)

Management

Standard treatment for AOM includes:

• Analgesia with acetaminophen or ibuprofen
• Antibiotic therapy (amoxicillin as the first-line treatment)
• Surgical intervention in recurrent cases (tympanostomy tube placement)

Prevention

Preventive strategies include pneumococcal vaccination, annual influenza vaccination, and breastfeeding during infancy to enhance immune defense.