Document Detail


Acute otitis media in infants less than three months of age: clinical presentation, etiology and concomitant diseases.
MedLine Citation:
PMID:  16154644     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Acute otitis media (AOM) in the neonatal period can be difficult to diagnose. This infection can be isolated and localized, or it may be associated with serious bacterial infections or other illnesses. The objectives of this study were to determine the clinical presentation, etiology, susceptibility pattern, and frequency of bacteremia, meningitis and other serious bacterial infections associated with the first episode of AOM in young infants. METHODS: From July 2002 to August 2004, infants less than 12 weeks of age with confirmed AOM underwent tympanocentesis with culture of the middle ear fluid. Sepsis work-up was performed in all infants, and they were admitted to the pediatric department. Parenteral antibiotic therapy with a combination of ampicillin and gentamicin was initiated. RESULTS: Sixty-eight infants were diagnosed with AOM. The median age was 43+/-17 days, 17 infants (25%) were less than 4 weeks of age. Fever was present in 45 (66%) of the patients. Meningitis or bacteremia was not diagnosed in any of the cases. Concomitant urinary tract infection was diagnosed in six (8.8%) cases and broncholitis in seven (10.4%). Forty-seven bacterial pathogens were isolated from the middle-ear fluid. Streptococcus pneumoniae was the leading pathogen with 18 isolates (38%), followed by non-typable Haemophilus influenzae with nine (19%). Fourteen of the S. pneumoniae (78%) isolates were susceptible to penicillin and the other four (22%) were intermediately resistant. Three (33%) of the nine H. influenzae isolates were beta-lactamase producers. CONCLUSIONS: In our study, AOM in infants less than 3 months of age is a localized infection and it is not associated with severe bacterial infections. S. pneumoniae and H. influenzae are the leading pathogens. In our region, most of S. pneumoniae strains are still susceptible to penicillin. Although only small number of patients were under 4 weeks of age, the results of the present study raise the question of whether the current policy of a full sepsis work-up in neonates with AOM is relevant.
Authors:
Waheeb Sakran; Hassan Makary; Raul Colodner; Dror Ashkenazi; Yoseph Rakover; Raphael Halevy; Ariel Koren
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Publication Detail:
Type:  Journal Article     Date:  2005-09-09
Journal Detail:
Title:  International journal of pediatric otorhinolaryngology     Volume:  70     ISSN:  0165-5876     ISO Abbreviation:  Int. J. Pediatr. Otorhinolaryngol.     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-02-28     Completed Date:  2006-09-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8003603     Medline TA:  Int J Pediatr Otorhinolaryngol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  613-7     Citation Subset:  IM    
Affiliation:
Pediatric Department B, Ha'Emek Medical Center, Afula 18101, Israel. sakran_w@clalit.org.il
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Anti-Bacterial Agents / therapeutic use*
Bronchiolitis / epidemiology*
Comorbidity
Haemophilus influenzae / isolation & purification
Humans
Infant
Infant, Newborn
Otitis Media / diagnosis*,  epidemiology*,  etiology*
Paracentesis*
Penicillins / therapeutic use*
Streptococcus pneumoniae / isolation & purification
Systemic Inflammatory Response Syndrome / epidemiology*
Urinary Tract Infections / epidemiology*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Penicillins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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