| Acute otitis media in the first two months of life: characteristics and diagnostic difficulties. | |
| | |
MedLine Citation:
|
PMID: 18337275 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To assess the clinical and laboratory features of acute otitis media (AOM) in infants younger than 2 months, to look for factors predicting bacterial otitis, and to evaluate the accuracy of AOM diagnosis among paediatricians. METHODS: The study population comprised a cohort of 277 hospitalised infants up to 61 days old that were treated for the first episode of AOM in a paediatric department. We reviewed their medical records and analysed the demographic, clinical and laboratory data, and the diagnosis made by both paediatricians and otolaryngologists. RESULTS: Presenting symptoms were mainly respiratory (70.0%) and fever (62.5%). The most common pathogens were Streptococcus pneumoniae and Haemophilus influenzae. Gram-negative bacilli grew in 10.5% of the infants. Multivariate analysis revealed that AOM in the second month of life was associated with male gender, concurrent bronchiolitis and diarrhea. Although high leukocyte count was associated with bacterial pathogen, more than 70% of the patients with positive culture had normal white blood cell counts. The paediatrician diagnosed only 45% of the patients subsequently diagnosed with AOM by an otolaryngologist. CONCLUSIONS: The absence of predictors for bacterial infection in more than 70% of bacterial AOM suggests that empirical antibiotic treatment should be advised for the young infants with AOM even when afebrile and with normal laboratory profile. A low diagnostic rate of AOM by the paediatrician emphasizes the need for improvement in examination skills and instrumentation to allow a thorough ear evaluation in children of a very young age. |
| | |
Authors:
|
Y Berkun; R Nir-Paz; A Ben Ami; A Klar; E Deutsch; H Hurvitz |
Related Documents
:
|
16685545 - Proposal of "evolution theory in cerebrospinal fluid dynamics" and minor pathway hydroc... 3130365 - Antibacterial and pharmacokinetic properties of m14659, a new injectable semisynthetic ... 3969365 - Neonatal septicemia and meningitis in göttingen, west germany. 651085 - Candida meningitis in newborn infants: a review and report of combined amphotericin b--... 9891625 - Antenatal hormone therapy for fetal lung maturation. 6797185 - The control of the adaptation of the human neonate to postnatal nutrition. |
Publication Detail:
|
Type: Evaluation Studies; Journal Article Date: 2008-03-12 |
Journal Detail:
|
Title: Archives of disease in childhood Volume: 93 ISSN: 1468-2044 ISO Abbreviation: Arch. Dis. Child. Publication Date: 2008 Aug |
Date Detail:
|
Created Date: 2008-07-22 Completed Date: 2008-08-12 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0372434 Medline TA: Arch Dis Child Country: England |
Other Details:
|
Languages: eng Pagination: 690-4 Citation Subset: AIM; IM |
Affiliation:
|
Department of Pediatrics, Bikur Cholim Hospital, Jerusalem, Israel. berkun@post.tau.ac.il |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Acute Disease Bacterial Infections / diagnosis* Clinical Competence / standards* Diagnosis, Differential Female Humans Infant Infant, Newborn Male Otitis Media / diagnosis*, microbiology Otolaryngology / standards Pediatrics / standards* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Physical long-term health problems and mental comorbidity: evidence from Vietnam.
Next Document: Absence of urinary opioid peptides in children with autism.