Association of Clinical Signs and Symptoms with Bacterial Findings in Acute Otitis Media

• Published in: Clinical infectious diseases Vol. 38; no. 2; pp. 234 - 242
• Main Authors: Palmu, Arto A. I., Herva, Elja, Savolainen, Heljä, Karma, Pekka, Mäkelä, P. Helena, Kilpi, Terhi M.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15.01.2004; University of Chicago Press
• Subjects: Acute Disease; Bacteria; Bacterial diseases; Biological and medical sciences; Child; Children; Earaches; Ears; Ent and stomatologic bacterial diseases; Etiology; Female; Fever; Haemophilus influenzae; Hepatitis B Vaccines - administration & dosage; Human bacterial diseases; Humans; Infectious diseases; Major Articles; Male; Medical sciences; Moraxella (Branhamella) catarrhalis; Moraxella catarrhalis; Otitis media; Otitis Media - microbiology; Otitis Media - physiopathology; Otitis Media - prevention & control; Pathogens; Pneumococcal Vaccines - administration & dosage; Predictive Value of Tests; Staphylococcal infections, streptococcal infections, pneumococcal infections; Streptococcus pneumoniae; Symptoms; Tympanic membrane; Finland; Cell culture; Middle ear disease; Check; Antimicrobial agent; Haemophilus influenzae; Prevention; Streptococcal infection; Bacteria; Micrococcales; ENT disease; Middle ear; Child; Pneumococcal infection; Age; Human; Aspiration; Acute; Vaccine; Streptococcus pneumoniae; Infection; Pasteurellaceae; Streptococcaceae; Immunoprophylaxis; Symptomatology; Treatment; Bacteriosis; Moraxella catarrhalis; Otitis media; Predictive factor; Arm
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/380642

In acute otitis media (AOM), a means of prediction of the bacterial pathogen based on symptoms and signs would be valuable in selecting appropriate antimicrobial treatment. Children in the control arm (n = 831) in the Finnish Otitis Media Vaccine Trial were prospectively observed in a study clinic setting from the age of 2 to 24 months. In patients with AOM, myringotomy with aspiration was performed, and middle ear fluid samples were cultured for bacterial pathogens. Symptoms and signs of respiratory infections were thoroughly recorded. Streptococcus pneumoniae, Moraxella catarrhalis, and Haemophilus influenzae were the most common bacterial pathogens. Pneumococcal AOM was associated with more-severe AOM characterized by fever and earache. AOM due to H. influenzae was associated with eye symptoms and findings. Accurate prediction of a bacterial cause of infection based on symptoms and signs of AOM was not possible, but a specific cause was predicted in some situations, with a high probability of applicability to clinical practice.