Am J Perinatol 2010; 27(8): 663-665
DOI: 10.1055/s-0030-1249763
© Thieme Medical Publishers

Spontaneous Perforation of the Tympanic Membrane in the First 10 Days of Life

Nicoletta Iacovidou1 , Vasiliki Falaena1 , Augustina Alexaki1 , Angeliki Nika1
  • 1NICU, 2nd Department of Paediatrics, University of Athens, Aglaia Kyriakou Children's Hospital, Athens, Greece
Further Information

Publication History

Publication Date:
11 March 2010 (online)

ABSTRACT

Twelve cases of neonates admitted to the neonatal unit of our hospital, between January 1, 2000, and December 31, 2005, because of otorrhea due to spontaneous perforation of the tympanic membrane within the first 10 days of life are presented. Data were collected retrospectively from medical records. Cultures of the middle ear exudate grew Pseudomonas aeruginosa in 10, Serratia marcenscens in 1, and Staphylococcus aureus in 1 neonate. Cultures of nasopharyngeal secretions grew P. aeruginosa in nine, S. marcenscens in one, S. aureus in one, and Streptococcus viridans in one neonate. Middle ear versus nasopharyngeal secretions cultures grew the same organism in 11 neonates. A 10-day course of parenteral antibiotics was administered (ampicillin-ceftazidime for all neonates except for the one neonate with the S. aureus otitis who received netilmicin-cloxacillin). All neonates had uneventful course and were discharged home in good clinical condition. Our findings suggest that neonates with eardrum perforation should receive antibiotics parenterally, as the most common pathogens is P. aeruginosa, for which there are no satisfactory antibiotics for oral use.

REFERENCES

  • 1 Rennie J M, Roberton N R. Textbook of Neonatology. 3rd ed. Edinburgh; Churchill Livingstone 1999
  • 2 Palva T, Ramsay H. Epitympanic diaphragm in the new-born.  Int J Pediatr Otorhinolaryngol. 1998;  43 261-269
  • 3 Paradise J L, Smith C G, Bluestone C D. Tympanometric detection of middle ear effusion in infants and young children.  Pediatrics. 1976;  58 198-210
  • 4 Engel J, Anteunis L, Chenault M, Marres E. Otoscopic findings in relation to tympanometry during infancy.  Eur Arch Otorhinolaryngol. 2000;  257 366-371
  • 5 Berman S A, Balkany T J, Simmons M A. Otitis media in the neonatal intensive care unit.  Pediatrics. 1978;  62 198-201
  • 6 Grant H R, Quiney R E, Mercer D M, Lodge S. Cleft palate and glue ear.  Arch Dis Child. 1988;  63 176-179
  • 7 Bland R D. Otitis media in the first six weeks of life: diagnosis, bacteriology, and management.  Pediatrics. 1972;  49 187-197
  • 8 Nozicka C A, Hanly J G, Beste D J, Conley S F, Hennes H M. Otitis media in infants aged 0–8 weeks: frequency of associated serious bacterial disease.  Pediatr Emerg Care. 1999;  15 252-254
  • 9 Burton D M, Seid A B, Kearns D B, Pransky S M. Neonatal otitis media. An update.  Arch Otolaryngol Head Neck Surg. 1993;  119 672-675
  • 10 Tetzlaff T R, Ashworth C, Nelson J D. Otitis media in children less than 12 weeks of age.  Pediatrics. 1977;  59 827-832
  • 11 Shurin P A, Howie V M, Pelton S I, Ploussard J H, Klein J O. Bacterial etiology of otitis media during the first six weeks of life.  J Pediatr. 1978;  92 893-896
  • 12 Parker P C, Boles R G. Pseudomonas otitis media and bacteremia following a water birth.  Pediatrics. 1997;  99 653
  • 13 Berkun Y, Nir-Paz R, Ami A B, Klar A, Deutsch E, Hurvitz H. Acute otitis media in the first two months of life: characteristics and diagnostic difficulties.  Arch Dis Child. 2008;  93 690-694
  • 14 Brook I, Gober A E. Reliability of the microbiology of spontaneously draining acute otitis media in children.  Pediatr Infect Dis J. 2000;  19 571-573
  • 15 Pichichero M E, Casey J R, Hoberman A, Schwartz R. Pathogens causing recurrent and difficult-to-treat acute otitis media, 2003–2006.  Clin Pediatr (Phila). 2008;  47 901-906

Nicoletta IacovidouM.D. 

3, Pavlou Mela Str.

16233 Athens, Greece

Email: niciac@otenet.gr

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