1. Definitions, Terminology, and Classification of Otitis Media

Bluestone, Charles D.; Gates, George A.; Klein, Jerome O.; Lim, David J.; Mogi, Goro; Ogra, Pearay L.; Paparella, Michael M.; Paradise, Jack L.; Tos, Mirko

doi:10.1177/00034894021110s304

Cited by 152 publications

(96 citation statements)

References 14 publications

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“…The frequent opacification and edema of the tympanic membrane may hinder the identification of the type of effusion. 1 OME often is considered a direct extension of the inflammatory process that occurs during long-lasting or recurrent episodes of acute otitis media (AOM), which is confirmed by the fact that almost all cases of OME follow episodes of AOM , and also corroborated by experimental animal studies. 2,3 The observations above suggest that OME has an infectious etiology.…”

Section: Introductionmentioning

confidence: 84%

Prevalência de bactérias em crianças com otite média com efusão

Pereira¹,

Pereira²,

Cantarelli³

et al. 2004

J. Pediatr. (Rio J.)

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Objectives: 1) To determine the prevalence of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis in middle ear effusions of children with otitis media with effusion undergoing myringotomy; 2) to compare the results obtained by culture and PCR; and 3) to determine the susceptibility of bacterial isolates to penicillin. Methods:We analyzed 128 middle ear effusion specimens from 75 children (age = 11 months to 10 years; mean = 34.7 months). Patients with recurrent otitis media had documented middle ear effusion for = 6 weeks, and chronic otitis media with effusion for = 3 months. The patients had no signs of acute otitis media or respiratory tract infection and were not on antibiotic therapy. Aspiration was done through tympanocentesis with an Alden-Senturia trap. Bacteriological studies were initiated less than 15 minutes after specimen collection. Part of the sample was stored at -20 o C for later multiplex PCR analysis. Statistical analysis employed McNemar s χ 2 test.Results: Bacteria were cultured in 32 (25.1%) out of 128 samples and the pathogens under investigation were found in 25 (19.6%). PCR was positive for bacteria in 73 (57.0%) specimens: 50 (39.1%) for H. influenzae, 16 (12.5%) for S. pneumoniae, and 13 (10.2%) for M. catarrhalis. All the culture-positive samples were PCR-positive, but 48 (65.7%) of the PCR-positive specimens were culture-negative. PCR was significantly more sensitive than culture (p < 0.01) to identify bacteria. Resistance to penicillin was as follows: M. catarrhalis = 100%; S. pneumoniae = 62.5% and H. influenzae = 23% of the isolates. Conclusions:The prevalence of bacteria in otitis media with effusion in a group of Brazilian children was similar to that reported for other countries. H. influenzae was the most frequent microorganism observed. This suggests that bacteria may play a role in the pathogenesis of otitis media with effusion. In addition, PCR was more sensitive to detect bacteria in middle ear effusion as compared to conventional culture methods. Penicillin resistance was similar to that reported for other countries for pneumococci and moraxella, but beta-lactamase production by H. influenza was lower than that reported for other countries.J Pediatr (Rio J). 2004;80(1):41-8: Otitis media, otitis media with effusion/microbiology, ear, middle/ microbiology, PCR, prevalence studies, child.

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Section: Introductionmentioning

confidence: 84%

Prevalência de bactérias em crianças com otite média com efusão

Pereira¹,

Pereira²,

Cantarelli³

et al. 2004

J. Pediatr. (Rio J.)

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“…AOM-the rapid onset of signs and symptoms of inflammation in the middle ear 9,10 middle ear, mastoid, inner ear, or intracranial cavity…”

Section: Glossary Of Termsmentioning

confidence: 99%

The Diagnosis and Management of Acute Otitis Media

Tunkel

Rosenfeld²,

Sevilla³

et al. 2013

Pediatrics

1,060

832

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This evidence-based clinical practice guideline is a revision of the 2004 acute otitis media (AOM) guideline from the American Academy of Pediatrics (AAP) and American Academy of Family Physicians. It provides recommendations to primary care clinicians for the management of children from 6 months through 12 years of age with uncomplicated AOM.In 2009, the AAP convened a committee composed of primary care physicians and experts in the fields of pediatrics, family practice, otolaryngology, epidemiology, infectious disease, emergency medicine, and guideline methodology. The subcommittee partnered with the Agency for Healthcare Research and Quality and the Southern California Evidence-Based Practice Center to develop a comprehensive review of the new literature related to AOM since the initial evidence report of 2000. The resulting evidence report and other sources of data were used to formulate the practice guideline recommendations.The focus of this practice guideline is the appropriate diagnosis and initial treatment of a child presenting with AOM. The guideline provides a specific, stringent definition of AOM. It addresses pain management, initial observation versus antibiotic treatment, appropriate choices of antibiotic agents, and preventive measures. It also addresses recurrent AOM, which was not included in the 2004 guideline. Decisions were made on the basis of a systematic grading of the quality of evidence and benefit-harm relationships.The practice guideline underwent comprehensive peer review before formal approval by the AAP.This clinical practice guideline is not intended as a sole source of guidance in the management of children with AOM. Rather, it is intended to assist primary care clinicians by providing a framework for clinical decision-making. It is not intended to replace clinical judgment or establish a protocol for all children with this condition. These recommendations may not provide the only appropriate approach to the management of this problem. Pediatrics 2013;131:e964-e999

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“…The diagnosis and classification of the types of otitis media were based on: (i) clinical data of otalgia and otomicroscopic findings of opacity and bulging of the intact tympanic membrane for AOM; [15] (ii) a wet, swollen and contourless eardrum for perforated AOM; (iii) evidence of seromucoid effusion in the middle ear (completely filled or air-fluid level or bubbles), with an intact tympanic membrane without symptoms of acute infection for OME; [15] and (iv) evidence of a perforation or cholesteatoma with or without purulent discharge for CSOM. [5] …”

Section: Data Collectionmentioning

confidence: 99%

Paediatric otitis media at a primary healthcare clinic in South Africa

et al. 2014

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Background.No published studies on the prevalence of paediatric otitis media at primary healthcare clinics (PHCs) in South Africa (SA) are available. Objective. To examine the point prevalence of otitis media in a paediatric population in a PHC in Johannesburg, SA, using otomicroscopy. Methods. A sample of 140 children aged 2 -16 years (mean 6.4; 44.1% females) were recruited from patients attending the PHC. Otomicroscopy was completed for each of the participants' ears by a specialist otologist using a surgical microscope. Results. Cerumen removal was necessary in 36.0% of participants (23.5% of ears). Otitis media with effusion was the most frequent diagnosis (16.5%). Chronic suppurative otitis media (CSOM) was diagnosed in 6.6% of children and was the most common type of otitis media in participants aged 6 -15 years. Acute otitis media was only diagnosed in the younger 2 -5-year age group (1.7%). Otitis media was significantly more prevalent among younger (31.4%) than older children (16.7%). Conclusion. CSOM prevalence, as classified by the World Health Organization, was high. Consequently diagnosis, treatment and subsequent referral protocols may need to be reviewed to prevent CSOM complications.

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1. Definitions, Terminology, and Classification of Otitis Media

Cited by 152 publications

References 14 publications

Prevalência de bactérias em crianças com otite média com efusão

Prevalência de bactérias em crianças com otite média com efusão

The Diagnosis and Management of Acute Otitis Media

Paediatric otitis media at a primary healthcare clinic in South Africa

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