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Otitis Media and Otitis Externa

Acute otitis media (AOM) is an infection of the middle ear cavity and is one of the most common bacterial infections in childhood.1 Seventy-five percent of children experience at least 1 episode prior to entering school.2 To diagnose AOM, 3 criteria need to be met: 1) signs and symptoms of middle ear inflammation 2) the presence of middle ear effusion and 3) acute onset (often abrupt) of signs and symptoms of middle ear inflammation and effusion.1 Symptoms include acute ear pain (often unilateral and developing over a few hours), fever and reduced hearing.1 Tugging or pulling on the ears is often described, but this is a very nonspecific sign.1 Children too young to complain of pain or pressure in the ears may display irritability, excessive fussiness, poor feeding and disrupted sleep patterns. Acute otitis media is more common in the winter months. A recent history of viral upper respiratory tract infection is often present.2 The microorganisms most commonly associated with AOM are Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis.1,2