Commonest causative organism for ASOM in 2 years child is
ACUTE SUPPURATIVE OTITIS MEDIA It is an acute inflammation of middle ear by pyogenic organ isms. Here, middle ear implies middle ear cleft, i.e. eustachian tube, middle ear, attic, aditus, antrum and mastoid air cells. ROUTES OF INFECTION 1. Via eustachian tube: It is the most common route. Infection travels the lumen of the tube or along subepithelial peritubal lymphatics. Eustachian tube in infants and young children is shoer, wider and more horizontal and thus may account for higher incidence of infections in this age group. Breast or bottle feeding in a young infant in horizontal position may force fluids through the tube into the middle ear and hence the need to keep the infant propped up with head a little higher. Swimming and diving can also force water through the tube into the middle ear. 2. Via external ear: Traumatic perforations of tympanic membrane due to any cause open a route to middle ear infection. 3. Blood-borne: This is an uncommon route. AETIOLOGY : It is more common especially in infants and children of lower socioeconomic group. Bacteriology: Most common organisms in infants and young children are Streptococcus pneumoniae (30%), Haemophilus influenzae (20%) and Moraxella catarrhalis (12%). Other organisms include Streptococcus pyogenes, Staphylococcus aureus and sometimes Pseudomonas aeruginosa. Ref:- Dhingra; pg num:-62
Pneumococcus
Streptococcus
Staphylococcus
H. influenzae
Ear