Acute otitis media in childhood: a review

Abstract

Acute otitis media (AOM) refers to an acute infection of the middle ear. Despite its lack of propensity for causing mortality, the morbidity burden in ambulatory paediatric practice remains huge, not only in tropical communities, but indeed on the global terrain. The current communication has emanated from a review of the current literature, and our experience in a tropical tertiary paediatric practice.

The aim is to highlight the local and global epidemiological import of AOM in infants and young children, the pathogenesis and the corresponding anatomical peculiarities accounting for the vulnerability of this age-group. This review also focuses on the clinical presentation, possible complications, as well as the investigative and treatment options, indicating as required those that are of practical values in resource-poor tropical practice.

The overall objective is to heighten the overall index of diagnostic suspicion of the clinician for a valid recognition of AOM as a common cause of a febrile illness in the tropical child, hence the prompt initiation of the appropriate treatment measures. This will reduce the overall prevalence of complications, some of which are serious complications and give rise to long term sequelae. We emphasise the need for a prompt otoscopy as an indispensable diagnostic tool of AOM in the child, presenting with fever and/or the symptoms of common cold.

Keywords: otitis media; epidemiology; management; tropics