Diagnosis and Treatment of Otitis Media (Middle Ear Infection)

Diagnosis and Treatment of Otitis Media (Middle Ear Infection)
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Otitis media, earache or middle ear infection is a painful complication of common cold, or of any infection of the throat or nose. The pathogens cause the production of pus, which builds up pressure against the eardrum and causes it to become painful and inflamed. The disease is usually observed in children because their auditory tubes connecting their throats to their middle ears are short and more easily blocked by infection (Wheelis 2007).

Otitis media is caused by several pathogenic bacteria (Ryan et al. 2003). About 35% of otitis media cases are caused by the bacterium Streptococcus pneumonia. 20-30% are caused by Haemophilus influenza, 10-15% by Moraxella catarrhalis, 8-19% by Streptococcus pyogenes, and 1-2% by Streptococcus aureus. There are cases (Wheelis 2007) in which no bacteria are detected (3-5%), but instead viruses are found; the typical virus isolate belongs to the family of respiratory syncytial viruses.

About 85% of children under the age of three are affected by otitis media, and it accounts for nearly half of office visits to American pediatricians – approximately 8 million cases annually in the US (Konopka et al. 2003). In treating the disease, it is always assumed that bacteria are the causative agents so antibiotics are the prescribed drugs in treating the disease. In fact, ear infections account for about 25% of the prescriptions for antibiotics. The usual antibiotics prescribed for children are penicillins such as amoxicillin (Ryan et al. 2003). Recently, many doctors are questioning the value of antibiotics, doubtful whether these drugs shorten the source of the infection.

A conjugate vaccine exists which is intended to avert pneumonia caused by Steptococcus pneumonia. Because this bacterium is also a cause of otitis media, even though different serological types are often responsible, there was an interest in seeing whether this conjugate vaccine has any effect on the prevalence of otitis media. It was observed by experience, that the vaccine effectively reduced the incidence of otitis media by 6-7%. This reduction may not look like much, but it amounts to over a million cases annually. Hence, the S. pneumonia vaccine has now been added to the suggested vaccine schedule for children (Ryan et al. 2003; Wheelis 2007).

References

Wheelis M. 2007. Prnciples of Modern Microbiology. Jones and Bartlett Publishers.

Ryan KJ, George Ray C, and JC Sherris. 2003. Sherris Medical Microbiology: An Introduction of Infectious Diseases. McGraw-Hill Professional.

Konopka A, Furbacher P, and C Gedney. 2003. Introduction to Microbiology. Pearson Education, Limited.

Photo Credit: https://en.wikipedia.org/wiki/File:Otitis_chron_mesotymp_7.jpg