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

Etiology of Acute Otitis Media

Acute Otitis Media (AOM) is primarily caused by bacterial or viral infections that affect the middle ear. The most common bacterial pathogens include Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Viral infections such as influenza, rhinovirus, and respiratory syncytial virus (RSV) also play a significant role in AOM pathogenesis.

Pathogenesis

AOM typically develops following an upper respiratory tract infection (URTI). The infection leads to inflammation and blockage of the Eustachian tube, resulting in fluid accumulation and bacterial proliferation in the middle ear. This causes increased pressure, pain, and potential tympanic membrane perforation.

Clinical Features

• Ear pain (otalgia)
• Fever
• Hearing loss
• Irritability in children
• Fluid discharge if tympanic membrane perforates

Management

Management of AOM includes pain relief, antibiotics (if bacterial cause suspected), and watchful waiting in mild cases. Common antibiotics prescribed include **amoxicillin**, **azithromycin**, and **cefuroxime**. In recurrent cases, tympanostomy tube placement may be considered.