The epidemiology of acute bullous myringitis and its relationship to recurrent acute otitis media in children less than 2 years of age.
OBJECTIVE
To evaluate the epidemiological characteristics of acute bullous myringitis (BM), i.e. inflammation of the tympanic membrane with blister(s) in children <2 years and study the relationship between bullous myringitis and recurrent acute otitis media.


METHODS
2028 children aged 7-24 months in a prospective longitudinal cohort study in the Finnish Otitis Media vaccine trial. The main outcome measures were the incidence of bullous myringitis and the incidence of acute otitis media (AOM) before and after the event of bullous myringitis.


RESULTS
82 children had a total of 86 events of acute bullous myringitis. The incidence of bullous myringitis was 5.7 per 100 person years (95% CI, 4.6-7.1 per 100 person years). The number of events with bullous myringitis was 4.6% of the number of all AOM events diagnosed during the follow-up. Recurrent AOM (> or =6 AOM events) occurred in 33% of children with bullous myringitis in comparison with 23% of control children with at least one event of AOM (RR 1.7; 95% CI, 1.01-2.7). The incidence of AOM in children with bullous myringitis was 1.8 per person year (95% CI, 1.4-2.2 per person year) before the event of bullous myringitis and 2.9 per person year (95% CI, 2.3-3.5 per person year) after the event of bullous myringitis. The higher incidence rate of AOM lasted for 2 months after the office visit of bullous myringitis.


CONCLUSIONS
Acute bullous myringitis is not a rare disease; it was diagnosed in 5.7% of children <2 years in a 1-year follow-up. It was present in almost 1 of every 20 AOM events. Acute bullous myringitis increases the subsequent risk of recurrent AOM.
Department of Otorhinolaryngology, Tampere University Hospital, P.O. Box 2000, 33521 Tampere, Finland. kotikoski@koti.tpo.it
Mikko J
MJ
Kotikoski
Arto A I
AA
Palmu
Heini
H
Huhtala
Heljä
H
Savolainen
Heikki J
HJ
Puhakka
D000208:Acute Disease; D001768:Blister / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D010033:Otitis Media / Q000453:epidemiology / Q000473:pathology*; D022242:Pneumococcal Vaccines; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D012621:Seasons; D014432:Tympanic Membrane / Q000473:pathology*
D022242:Pneumococcal Vaccines