Infective organisms

• bacterial causes include:
  • Strep pneumonia - 30%
  • H. influenzae - 20%
  • Moraxella catarrhalis - 20%
  • Group A Strep and Staph aureus - 5%
• viral causes (less than 10%) (1):
  • polymerase chain reaction (PCR) has shown detectable virus in the middle ear space
  • respiratory viral infection predisposes to bacterial infection
  • coinfection with bacteria is present in more than 40 percent viral-induced acute otitis media
  • associated viruses include:
    • RSV
    • parainfluenzae
    • influenza virus
    • rhinovirus
    • enterovirus
• Mycoplasma pneumoniae, Chlamydia pneumoniae, Chlamydia trachomatis are rare causes

Reference:

1. Mittal R, Lisi CV, Gerring R, et al; Current concepts in the pathogenesis and treatment of chronic suppurative otitis media. J Med Microbiol. 2015 Oct;64(10):1103-16.