This study aimed to review the literature regarding the mechanisms of transition from asymptomatic colonization to induction of otitis media and how the insight into the pathogenesis of otitis media has the potential to help design future otitis media-directed vaccines. Respiratory viruses have long been shown to predispose individuals to bacterial respiratory infections, such as otitis media. Furthermore, an understanding of the transcriptional and proteomic changes occurring in bacteria during transition to infection has led to identification of novel vaccine targets that are disease-specific and will not affect asymptomatic colonization. This approach will avoid major changes in the delicate balance of microorganisms in the respiratory tract microbiome due to elimination of S. Our recent findings are reviewed in the context of the current literature on the epidemiology and pathogenesis of otitis media. We also discuss how other otopathogens, such as Haemophilus influenzae and Moraxella catarrhalis , as well as the normal respiratory microbiome, can modulate the ability of pneumococci to cause infection. Furthermore, the unsatisfactory protection offered by the pneumococcal conjugate vaccines is highlighted and we review potential future strategies emerging to confer a more specific protection against otitis media.
Diagnosis and Treatment of Otitis Media
Otitis Media: Diagnosis and Treatment - American Family Physician
Streptococcus pneumoniae , or pneumococcus , is a Gram-positive , alpha-hemolytic under aerobic conditions or beta-hemolytic under anaerobic conditions , facultative anaerobic member of the genus Streptococcus. However, in susceptible individuals with weaker immune systems , such as the elderly and young children, the bacterium may become pathogenic and spread to other locations to cause disease. It spreads by direct person-to-person contact via respiratory droplets and by autoinoculation in persons carrying the bacteria in their upper respiratory tracts. The organism also causes many types of pneumococcal infections other than pneumonia. These invasive pneumococcal diseases include bronchitis , rhinitis , acute sinusitis , otitis media , conjunctivitis , meningitis , sepsis, osteomyelitis , septic arthritis , endocarditis , peritonitis , pericarditis , cellulitis , and brain abscess. The encapsulated , Gram-positive, coccoid bacteria have a distinctive morphology on Gram stain, lancet -shaped diplococci.
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Otitis Media: Diagnosis and Treatment
Penicillin-susceptible and intermediately resistant pneumococci are likely to respond better to this treatment than to any other. Because of the high rate of spontaneous resolution, the American Academy of Pediatrics has subsequently recommended watchful waiting for children aged greater than 2 years unless severe pain or high fever are present, and these recommendations seem appropriate for adults, as well. When adults are treated, amoxicillin should be given at mg four times daily.
See the CME Quiz. Acute otitis media is diagnosed in patients with acute onset, presence of middle ear effusion, physical evidence of middle ear inflammation, and symptoms such as pain, irritability, or fever. Acute otitis media is usually a complication of eustachian tube dysfunction that occurs during a viral upper respiratory tract infection.