title: Children hospitalized due to acute otitis media: how does this condition differ from acute mastoiditis?
abstract: OBJECTIVE
  To evaluate the clinical picture and microbiological findings of children hospitalized due to acute otitis media and to analyze how it differs from acute mastoiditis.
  
  
  METHODS
  A retrospective review of the medical records of all children (0-16 years) hospitalized due to acute otitis media in the Department of Otorhinolaryngology at the Helsinki University Hospital, between 2003 and 2012. Comparison with previously published data of children with acute mastoiditis (n=56) from the same institute and period of time.
  
  
  RESULTS
  The most common pathogens in the children hospitalized due to acute otitis media (n=44) were Streptococcus pneumoniae (18%), Pseudomonas aeruginosa (16%), Streptococcus pyogenes (14%), and Staphylococcus aureus (14%). One of the most common pathogens of out-patient acute otitis media, Haemophilus influenzae, was absent. Otorrhea was common in infections caused by S. pyogenes and otorrhea via tympanostomy tube in infections caused by P. aeruginosa. In children under 2 years-of-age, the most common pathogens were S. pneumoniae (43%), Moraxella catarrhalis (14%), and S. aureus (7%). S. pyogenes and P. aeruginosa were only found in children over 2 years-of-age. Previous health problems, bilateral infections, and facial nerve paresis were more common in children hospitalized due to acute otitis media, compared with acute mastoiditis, but they also demonstrated lower CRP values and shorter duration of hospital stay. The number of performed tympanostomies and mastoidectomies was also comparatively smaller in the children hospitalized due to acute otitis media. S. aureus was more common and S. pneumoniae, especially its resistant strains, was less common in the children hospitalized due to acute otitis media than acute mastoiditis.
  
  
  CONCLUSIONS
  Acute otitis media requiring hospitalization and acute mastoiditis compose a continuum of complicated acute otitis media that differs from common out-patient acute otitis media. The bacteriology of children hospitalized due to acute otitis media resembled more the bacteriology of acute mastoiditis than that of out-patient acute otitis media. The children hospitalized due to acute otitis media needed less surgical treatment and a shorter hospitalization than those hospitalized due to acute mastoiditis.
authors.affiliation: Department of Otorhinolaryngology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4E, PO Box 220, Helsinki FI-00029 HUS, Finland; Department of Allergy, University of Helsinki and Helsinki University Hospital, PO Box 160, Helsinki FI-00029 HUS, Finland. Electronic address: anu.laulajainen-hongisto@hus.fi.
authors.forename: Anu
authors.initials: A
authors.lastname: Laulajainen-Hongisto
authors.affiliation: Department of Radiology, University of Helsinki and HUS Medical Imaging Centre, Helsinki University Hospital, Haartmaninkatu 4, PO Box 340, Helsinki FI-00029 HUS, Finland.
authors.forename: Riste
authors.initials: R
authors.lastname: Saat
authors.affiliation: Department of Otorhinolaryngology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4E, PO Box 220, Helsinki FI-00029 HUS, Finland.
authors.forename: Laura
authors.initials: L
authors.lastname: Lempinen
authors.affiliation: Department of Otorhinolaryngology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4E, PO Box 220, Helsinki FI-00029 HUS, Finland.
authors.forename: Antti A
authors.initials: AA
authors.lastname: Aarnisalo
authors.affiliation: Department of Otorhinolaryngology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4E, PO Box 220, Helsinki FI-00029 HUS, Finland.
authors.forename: Jussi
authors.initials: J
authors.lastname: Jero
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D000553:Ambulatory Care; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005155:Facial Nerve Diseases / Q000382:microbiology; D005158:Facial Paralysis / Q000382:microbiology; D005260:Female; D006193:Haemophilus influenzae; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D008416:Mastoid / Q000601:surgery; D008417:Mastoiditis / Q000097:blood / Q000382:microbiology* / Q000601:surgery; D008876:Middle Ear Ventilation; D001936:Moraxella catarrhalis; D045828:Moraxellaceae Infections; D010033:Otitis Media / Q000097:blood / Q000382:microbiology* / Q000601:surgery; D011552:Pseudomonas Infections; D011550:Pseudomonas aeruginosa; D012189:Retrospective Studies; D013203:Staphylococcal Infections; D013211:Staphylococcus aureus; D013290:Streptococcal Infections; D013296:Streptococcus pneumoniae; D013297:Streptococcus pyogenes
chemical_list: D002097:C-Reactive Protein
keywords: Acute otitis media; Bacteriology; Facial nerve paresis; Mastoiditis; Pediatric