Gibney KB

Morris, Peter

Carapetis JR

Skull SA

Smith-Vaughan HC

Stubbs E

Leach AJ

2005-06-14

It is unclear why some children with acute otitis media (AOM) have poor outcomes. Our aim was to describe the clinical course of AOM and the associated bacterial nasopharyngeal colonisation in a high-risk population of Australian Aboriginal children. We examined Aboriginal children younger than eight years who had a clinical diagnosis of AOM. Pneumatic otoscopy and video-otoscopy of the tympanic membrane (TM) and tympanometry was done every weekday if possible. We followed children for either two weeks (AOM without perforation), or three weeks (AOM with perforation), or for longer periods if the infection persisted. Nasopharyngeal swabs were taken at study entry and then weekly. We enrolled 31 children and conducted a total of 219 assessments. Most children had bulging of the TM or recent middle ear discharge at diagnosis. Persistent signs of suppurative OM (without ear pain) were present in most children 7 days (23/30, 77%), and 14 days (20/26, 77%) later. Episodes of AOM did not usually have a sudden onset or short duration. Six of the 14 children with fresh discharge in their ear canal had an intact or functionally intact TM. Perforation size generally remained very small (<2% of the TM). Healing followed by re-perforation was common. Ninety-three nasophyngeal swabs were taken. Most swabs cultured Streptococcus pneumoniae (82%), Haemophilus influenzae (71%), and Moraxella catarrhalis (95%); 63% of swabs cultured all three pathogens. In this high-risk population, AOM was generally painless and persistent. These infections were associated with persistent bacterial colonisation of the nasopharynx and any benefits of antibiotics were modest at best. Systematic follow up with careful examination and review of treatment are required and clinical resolution cannot be assumed.

BMC Pediatr . 2005 Jun 14;5(1):16. doi: 10.1186/1471-2431-5-16.

https://pubmed.ncbi.nlm.nih.gov/15955251/?otool=iaurydwlib

https://hdl.handle.net/10137/5808

Acute Disease

Anti-Bacterial Agents

Australia

Child

Child, Preschool

Disease Progression

Female

Haemophilus influenzae

Humans

Infant

Male

Moraxella (Branhamella) catarrhalis

Nasopharynx

Otitis Media

Streptococcus pneumoniae

Treatment Outcome

Tympanic Membrane Perforation

Oceanic Ancestry Group

The clinical course of acute otitis media in high-risk Australian Aboriginal children: a longitudinal study.

Journal Article

Publication