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Acute Otitis Media

Last updated April 3, 2018

Approved by: Maulik P. Purohit MD, MPH

Watch this great video DoveMed found on otitis media. Otitis media is a group of inflammatory diseases of the middle ear.The two main types are acute otitis media (AOM) and otitis media with effusion (OME).

What are the other Names for this Condition? (Also known as/Synonyms)

  • Acute Ear Infection
  • AOM (Acute Otitis Media)
  • Middle Ear Infection - Acute

What is Acute Otitis Media? (Definition/Background Information)

  • Acute Otitis Media (AOM) is an infection of the middle ear commonly caused by bacteria and viruses. It is also known as Acute Ear Infection and affects children more than adults
  • The condition is marked by inflammation and accumulation of fluid in the middle ear. The middle ear is an air-filled space behind the eardrum that contains the tiny vibrating bones of the ear
  • The common signs and symptoms of Acute Otitis Media include ear pain, fever, irritability, trouble sleeping, and hearing loss
  • Some ear infections clear up on their own without the use of antibiotics; some home measures may be sufficient to treat the infection. Children less than 6 months of age are treated with antibiotics
  • Acute Otitis Media can be treated easily, but the condition may recur. With appropriate treatment Acute Ear Infection has excellent prognosis

Ear infections are classified into the following types:

  • Acute Otitis Media (AOM): An ear infection accompanied by pain that lasts only for a short duration of time
  • Chronic Otitis Media (COM): An ear infection that lasts for a longer time or occurs on and off, is called as a chronic ear infection

Who gets Acute Otitis Media? (Age and Sex Distribution)

  • Acute Otitis Media may affect any individual irrespective of age and gender; but, children and infants are more likely to be affected than adults
  • The condition is seen worldwide; no racial or ethnic preference is observed

What are the Risk Factors for Acute Otitis Media? (Predisposing Factors)

The risk factors associated with Acute Otitis Media are:

  • Attending daycare centers: Studies have shown that children who attend daycare centers have a higher incidence of ear infections than kids who do not attend such centers. However, other studies have also shown that such infections acquired from a daycare may help children build their immune system
  • Changes in altitude and changes in climate; cold climate
  • Exposure to smoke: Both firsthand and secondhand smoke can increase the incidence of Acute Ear Infection
  • Genetic factors
  • Not being breastfed: Breast milk has high quality proteins that boost the immune system of the child
  • Use of a pacifier
  • Recent or past ear infection
  • Recent illness of any type that reduces immunity level

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one's chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Acute Otitis Media? (Etiology)

Acute Otitis Media is commonly caused by microorganisms such as bacteria and viruses.

  • Common bacteria responsible for causing the condition include:
    • Streptococcus pneumoniae
    • Hemphilus influenzae
    • Moraxella catarrhalis
    • Streptococcus pyogenes
  • Common virus responsible for causing the condition include:
    • Respiratory syncytial virus (RSV)
    • Influenza virus
    • Human parainfluenza virus (HPIV)

The Eustachian tube, which runs from the middle of each ear to the back of the throat, helps in draining the fluids made in the middle ear. When this tube gets blocked, infection occurs. There are conditions that cause the Eustachian tube to become swollen or blocked; this leads to more fluid being built-up in the middle ear and behind the eardrum.

Such conditions may include:

  • Common cold
  • Sinus infections
  • Allergies
  • Excess saliva and mucus production during teething
  • Infected or overgrown adenoids (glands behind the nose and throat)
  • Tobacco smoke or other similar irritants
  • Children spending lot of time drinking from a ‘sippy cup’ or bottle, while lying flat on their back

What are the Signs and Symptoms of Acute Otitis Media?

The signs and symptoms associated with Acute Otitis Media are:

In infants:

  • Irritability, inconsolable crying
  • Fever
  • Trouble sleeping

In older children and adults:

  • Earache
  • Fullness in the ear, hearing loss
  • Drainage of green or yellow fluid from the ear
  • General illness
  • Vomiting
  • Diarrhea

How is Acute Otitis Media Diagnosed?

The diagnosis of Acute Otitis Media may include:

  • Physical examination and medical history evaluation (history of recent illnesses)
  • The medical practitioner will check the inside of the ears using an instrument called the otoscope, which will reveal:
    • Area of dullness and redness
    • Air bubbles or fluid behind the eardrum
    • Presence of fluid in the middle ear
    • A hole in the eardrum (eardrum perforation)
  • A hearing test will be recommended for those having a history of repeated ear infections

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Acute Otitis Media?

Complications associated with acute otitis media are:

  • Minor or short term hearing loss occurs because of the presence of excess fluid
  • Mastoiditis: Infection of the skull bones
  • Meningitis: Infection of the brain
  • Ruptured or perforated eardrum
  • Chronic and recurrent ear infections
  • Enlarged adenoids or tonsils
  • Formation of an abscess or a cyst
  • Speech or language delay for a child with recurrent ear infections

How is Acute Otitis Media Treated?

Some Acute Ear Infections resolve on their own without the use of antibiotics. A few home remedies may be sufficient to clear the infection. These include:

  • Applying warm cloth or warm water bottle to the affected ear
  • Applying pain-relief drops to relieve pain
  • Taking medications for fever and ear pain such as ibuprofen or acetaminophen

If the condition does not improve with these simple home care methods, then an appointment may be scheduled with the healthcare provider.

All children, who are less than 6 months old and affected by an ear infection, may be treated with antibiotics. Some of the antibiotics used include:

  • Amoxicillin
  • Amoxicillin clavulanate
  • Azithromycin
  • Cefdinir
  • Cefpodoxime
  • Ceftriaxone
  • Cefuroxime
  • Clarithromycin
  • Clindamycin

Children, who have frequent and recurrent episodes of ear infection, are advised to have daily dose of antibiotics to prevent infections.

Tympanostomy tube insertion:

  • This treatment is carried out when the ear infection cannot be controlled by medications alone
  • A tiny tube is inserted into the eardrum  that allows air to enter, so that the fluid may be drained more easily

Adenoidectomy surgery: When the adenoids become enlarged, a surgical removal is recommended.

How can Acute Otitis Media be Prevented?

Following preventive methods may be followed to reduce the risk of Acute Otitis Media. These include:

  • Washing hands frequently
  • Children’s toys should be washed and cleaned at regular intervals
  • Choose a daycare center with lesser number of children enrolled
  • Avoid the use of pacifiers
  • Breastfeeding is encouraged for infants
  • While bottle feeding, the infant must be held upright, in a seating position
  • Exposure to smoke must be avoided
  • Ensure that the child is properly immunized. Pneumococcal vaccines prevent infection from bacteria that causes Acute Ear Infection
  • Complete the course of prescribed medications (antibiotics)
  • Acclimatize slowly to higher altitudes

What is the Prognosis of Acute Otitis Media? (Outcomes/Resolutions)

  • Acute Otitis Media may be treated easily, but it is known to recur
  • With appropriate treatment, ear infections generally have an excellent prognosis

Additional and Relevant Useful Information for Acute Otitis Media:

All children should have an updated vaccination status, meaning that all children shall be current on their vaccinations.

What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: May 27, 2015
Last updated: April 3, 2018