Purulent Otitis Media in Adults

Abstract

While the bacterial origin of otitis media has been studied extensively in children, there are few data regarding adults with this disease. We undertook this study to identify the incidence, prevalence, and bacteriologic origin of purulent otitis media in adults. This was accomplished through a review of the English-language literature on adult otitis media and a retrospective review of adult patients with this disease who were hospitalized at our institution. Results of literature review indicate that Streptococcus pneumoniae and Haemophilus influenzae are the most common causes of otitis media in ambulatory adults, but this illness is uncommon, with an incidence of only 0.25%. Hospitalized patients in whom this diagnosis was established suffered a variety of serious suppurative complications such as mastoiditis, meningitis, or brain abscess. Otalgia and fever were the most common symptoms noted in this patient population. Further studies of adult otitis media need to be performed to determine bacteriologic, symptomatic, and high-risk patient groups.

Behavioral Economics Interventions to Improve Outpatient Antibiotic Prescribing for Acute Respiratory Infections: a Cost-Effectiveness Analysis

“…Within each group, the individual could contract either a viral ARI, susceptible bacterial ARI (sinusitis, otitis media, pharyngitis), or resistant bacterial ARI, due to the most common pathogens associated with these diseases in adults including S. pyogenes (pharyngitis), S. pneumoniae, H. influenzae, and M. catarrhalis (otitis media, sinusitis) and S. aureus in some cases of sinusitis. 20,21 In all three clinical conditions, individuals who received antibiotics were at risk for experiencing drug-associated adverse reactions that either self-resolved or resulted in an emergency department visit and very rarely, death. Severe bacterial ARI was assumed to be one requiring hospitalization regardless of organism susceptibility, with complications such as mastoiditis and brain abscess (acute otitis media), orbital infection (sinusitis), or rheumatic heart disease, tonsillar/retropharyngeal abscess, and glomerulonephritis (pharyngitis).…”

Streptococcus pneumoniae meningitis in Alberta pre‐ and postintroduction of the 7‐valent pneumococcal conjugate vaccine

“…Sinusitis, which in our study had to be confirmed by imaging, was surprisingly high in children five to 17 years of age, occurring 75% of the time. Concurrent otitis media occurred in 22% of adults with S pneumoniae meningitis, despite the fact that otitis media is uncommon in adults (28). Thus, a recent history of sinusitis or otitis media, particularly in teenagers or adults, may raise the index of suspicion of S pneumoniae meningitis in persons presenting with signs/symptoms suggestive of meningitis.…”

Group-A streptococcal meningitis in an adult, secondary to purulent otitis media

“…3 Meningitis is the most common intracranial complication of otitis media with Streptococcus pneumoniae being the most prevalent pathogen. 4 mostly due to introduction of Haemophilus in uenzae type-B vaccine.…”