Otitis media (synonym: middle ear infection; ICD-10-GM H66.-: Purulent and unspecified otitis media) is an inflammation of the middle ear (Latin: auris media).
It represents one of the most common diseases in childhood and rarely occurs in adults.
The disease is usually caused by a bacterial infection with Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pyogenes and Staphylococcus aureus. However, it can also be viral – respiratory syncytial viruses (74%), parainfluenza viruses (52%), influenza viruses (42%), and enteroviruses (11%).
Otitis media is not contagious.
Otitis media acuta (acute otitis media) occurs more frequently in the winter months, mostly in people who have previously had a cold.
Recurrent AOM occurs when there have been at least three episodes of AOM in the past six months or at least four episodes in the past twelve months. In such cases, allergies as well as immunodeficiencies should be excluded.
Otitis media can be divided into the following forms:
- Otitis media acuta (OMA; acute otitis media, AOM) – acute inflammation of the middle ear.
- Acute otitis media purulenta (acute purulent otitis media).
- Acute viral otitis media
- Otitis media catarrhalis – tubal middle ear catarrh with severe effusion, only slight swelling.
- Otitis media purulenta – purulent inflammation of the middle ear.
- Otitis media chronica (chronic otitis media) – chronic inflammation of the middle ear.
Frequency peak: the disease occurs predominantly between the 6th month of life and the 4th year of life.
The prevalence (disease incidence) is about 80% of under three-year-olds and drops to 2% in the 8th year of life (in Germany). The 12-month prevalence of AOM in children and adolescents between the day of birth and 17 years of age averages 11% (in Germany).
Course and prognosis: Otitis media can occur unilaterally or bilaterally. The disease begins with pulsatile ear pain accompanied by fever, throbbing ear noises, and hearing loss. The inflammatory phase lasts one to two days. In the days that follow, bacterial otitis media often results in spontaneous tympanic membrane perforation (eardrum rupture), which discharges pus. Subsequently, pain and fever subside. It takes two to four weeks for the middle ear infection to heal completely. Normally, antibiotics are not necessary if: the middle ear infection is uncomplicated, there are no complications and the patient is well controlled by the doctor within the first three days.
Spontaneous improvement of symptoms of acute otitis media occurs in about 60% of cases within the first 24 hours, in about 80-85% within the first 2-3 days and in about 90% after 4-7 days. After two weeks 60-70 % of the children still have a tympanic effusion, after four weeks 40 % and after three months up to 25 % (synonym: seromucotympanum; caution: danger of delay in speech development!).
Because the possible triggers of otitis media include pneumococci and Haemophilus influenzae, and vaccines are available against both pathogens, these vaccinations are recommended.
