Spontaneous Tympanic Membrane Perforation in Infants Aged <3 Months with Acute Otitis Media

Abstract

Objective: Acute otitis media (AOM) is among the most common infectious childhood diseases, and during its course, spontaneous tympanic membrane perforation (STMP) can occur. Babies aged <3 months are more vulnerable to complications of AOM than those aged >3 months. This study aimed to determine the clinical course in babies aged <3 months with AOM and STMP. Material and Methods: The study included babies aged <3 months that were hospitalized for AOM and STMP. Patient medical records, including patient characteristics, clinical and laboratory findings, antibiotic treatment, and organisms isolated from clinical specimens, were retrospectively reviewed. Results: There were 31 patients with a mean age of 59 ± 19.6 days (d). Mean duration of complaint before hospital admission was 3.7 ± 3.6 d. The most common complaint was ear discharge [n= 16 (51.6%)]. The most common pathogen isolated from pus cultures was Streptococcus pyogenes [n= 3 (27%)]. Among the patients, one had Moraxella catarrhalis bacteremia, one developed mastoiditis as a complication of AOM. Conclusion: During the course of AOM and STMP in patients aged <3 months, bacteremia, and mastoiditis can complicate the prognosis. Antibiotics that target the bacteria which cause AOM should be preferred. Clinicians should be aware that S. pyogenes can cause STMP in young babies with AOM.