Abstract In acute suppurative otitis media, Streptococcus pneumoniae, Haemophilus influenzae, and Streptococcus pyogenes are the most commonly isolated pathogens.1.2 These bacteria are susceptible to many antibiotic agents used in general practice and thus empirical therapy with antibiotics directed against these pathogens is usually successful. Since 1971 we have seen eight pediatric patients with acute otitis media and mastoiditis from whom the initial microbiological isolates were Pseudomonas aeruginosa and indole-positive Proteus strains. These Gram-negative bacilli, while frequently present in chronic otitis media3 and external malignant otitis, generally have not been considered to be etiologically important in acute otitis media.4.5 We present these patients to emphasize that failure to appreciate the pathogenic role of P aeruginosa in acute suppurative otitis media leads to irreparable delay in initiating adequate therapy and an unusually high rate of mastoiditis. Patients and Methods.—During the period of 1971 to 1976, eight pediatric patients References 1. Branfors-Helander P, Dahlberg T, Nylen O: Acute otitis media . Acta Otolaryngol 80:399-409, 1975.Crossref 2. Howie VM, Ploussard JH, Lester RL: Otitis media: A clinical and bacteriological correlation . Pediatrics 45:29-35, 1970. 3. Sade J Halevy A: The natural history of chronic otitis media . J Laryngol Otol 90:743-751, 1976.Crossref 4. Bland RD: Otitis media in the first six weeks of life . Pediatrics 49:187-197, 1972. 5. Howard JE, Nelson JD, Clahsen J, et al: Otitis media of infancy and early childhood . Am J Dis Child 130:965-970, 1976.Crossref 6. Edwards PR, Ewing WH: Identification of Enterobacteriacae , ed 3. Minneapolis, Burgess Publishing Co, 1972, p 362. 7. Wright I: The bacteriology of ear, nose and throat disease . J Laryngol Otol 84:283-308, 1970.Crossref 8. Diamant M, Diamant B: Abuse and timing of use of antibiotics in acute otitis media . Arch Otolaryngol 100:226-232, 1974.Crossref 9. O'Brien TF, Kent RL, Medeiros AA: Computer surveillance of shifts in the gross patient flora during hospitalization . J Infect Dis 131:88-96, 1975.Crossref 10. Ostfeld E, Rubinstein E, Gazit E, et al: The effect of systemic antibiotics on the microbial flora of the external ear canal in hospitalized children . Pediatrics 60:364-366, 1977.
American Journal of Diseases of Children – American Medical Association
Published: Jul 1, 1978