Clinical features and outcome of acute otitis media in early infancy

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Acute otitis media (AOM) is common in childhood, but little is known on its course very early in infancy. In this study we investigated predisposing factors, clinical characteristics, and long-term outcomes of AOM in very young infants. One hundred sixty infants aged less than 12 months with AOM hospitalized in two general hospitals during 2005-2006 were included in the study and followed-up for 3 years. Demographics, history, clinical manifestations, and further AOM episodes were studied in two infant groups defined by age at the first AOM episode: the very young infants, aged less than 60 days, and the older infants aged 61-365 days. Of the 147/160 infants successfully followed-up, 48 (32.7%) were aged less than 60 days and 99 (67.3%) were aged 61-365 days. The very young infants with AOM had more siblings (1.25 vs. 0.87; p=0.047) and used pacifiers less often (45.8% vs. 75.8%; RR 0.61, 95% CI 0.44-0.84; p=0.0007). Purulent otorrhea and irritability were more common in the early AOM onset group (52.1% vs. 32.3%; risk ratio (RR) 1.61, 95% confidence interval (CI) 1.09-2.39; p=0.03, and 60.4% vs. 38.4%; RR 1.57, 95% CI 1.12-2.21; p=0.01, respectively). AOM was complicated with meningitis in two infants, both in the very young group, and with mastoiditis in a further two infants, one in each group. No difference in further AOM episodes, use of ventilation tubes, or hearing impairment was observed between the two infant groups. AOM in the first 2 months of life may have different predisposing factors and clinical presentations, but not different recurrence rates or long-term outcomes.