David P McCormick1, Kristofer Jennings2, Linda C Ede3, Pedro Alvarez-Fernandez4, Janak Patel5, Tasnee Chonmaitree6. 1. Department of Pediatrics, University of Texas Medical Branch at Galveston, TX, USA. Electronic address: dpmccorm@utmb.edu. 2. Department of Preventive Medicine and Community Health, University of Texas Medical Branch at Galveston, TX, USA. Electronic address: krjennin@utmb.edu. 3. Department of Pediatrics, University of Texas Medical Branch at Galveston, TX, USA. Electronic address: lcede@utmb.edu. 4. Department of Pediatrics, University of Texas Medical Branch at Galveston, TX, USA. Electronic address: pedroenrique1971@gmail.com. 5. Department of Pediatrics, University of Texas Medical Branch at Galveston, TX, USA. Electronic address: jpatel@utmb.edu. 6. Department of Pediatrics, University of Texas Medical Branch at Galveston, TX, USA; Department of Pathology, University of Texas Medical Branch at Galveston, TX, USA. Electronic address: tchonmai@utmb.edu.
Abstract
OBJECTIVES: Infants and children with upper respiratory tract infection (URI) often have concurrent acute otitis media (AOM). Young infants have fewer specific symptoms than older children. The purpose of this study was to evaluate the usefulness of symptoms and other risk factors in predicting the presence of AOM in infants. METHODS: Healthy infants, age less than four weeks, were enrolled and followed prospectively for up to age one year. Infants were scheduled for a research visit when their parents noted the onset of symptoms. At each URI visit, parents first reported the severity of symptoms. An investigator then diagnosed the presence or absence of concurrent AOM. Risk factors and symptom scores for infants with and without AOM were studied. RESULTS: Infants (N=193, mean age at first URI 3.9±2.5 months) experienced 360 URI episodes and 63 AOM events. Symptoms consisting of fever, earache, poor feeding, restless sleep, and irritability together (ETG-5) were statistically associated with the prediction of AOM (P=0.006). A multiple variable statistical model (J-Score) that included day care attendance, age, severity of cough and earache best predicted AOM (P<0.001), with 95% specificity. Both ETG-5 and J-score yielded relatively low sensitivity for AOM prediction. CONCLUSIONS: In infants with URI in the first year of life, severity of symptoms was significantly associated with concurrent AOM. Daycare attendance, presence and severity of earache and cough added to better correlation. These observations may have clinical application in identification of infants at risk for AOM.
OBJECTIVES:Infants and children with upper respiratory tract infection (URI) often have concurrent acute otitis media (AOM). Young infants have fewer specific symptoms than older children. The purpose of this study was to evaluate the usefulness of symptoms and other risk factors in predicting the presence of AOM in infants. METHODS: Healthy infants, age less than four weeks, were enrolled and followed prospectively for up to age one year. Infants were scheduled for a research visit when their parents noted the onset of symptoms. At each URI visit, parents first reported the severity of symptoms. An investigator then diagnosed the presence or absence of concurrent AOM. Risk factors and symptom scores for infants with and without AOM were studied. RESULTS:Infants (N=193, mean age at first URI 3.9±2.5 months) experienced 360 URI episodes and 63 AOM events. Symptoms consisting of fever, earache, poor feeding, restless sleep, and irritability together (ETG-5) were statistically associated with the prediction of AOM (P=0.006). A multiple variable statistical model (J-Score) that included day care attendance, age, severity of cough and earache best predicted AOM (P<0.001), with 95% specificity. Both ETG-5 and J-score yielded relatively low sensitivity for AOM prediction. CONCLUSIONS: In infants with URI in the first year of life, severity of symptoms was significantly associated with concurrent AOM. Daycare attendance, presence and severity of earache and cough added to better correlation. These observations may have clinical application in identification of infants at risk for AOM.
Authors: David P McCormick; Tasnee Chonmaitree; Carmen Pittman; Kokab Saeed; Norman R Friedman; Tatsuo Uchida; Constance D Baldwin Journal: Pediatrics Date: 2005-06 Impact factor: 7.124
Authors: Paula A Tähtinen; Miia K Laine; Pentti Huovinen; Jari Jalava; Olli Ruuskanen; Aino Ruohola Journal: N Engl J Med Date: 2011-01-13 Impact factor: 91.245
Authors: Nader Shaikh; Alejandro Hoberman; Jack L Paradise; Ellen R Wald; Galen E Switze; Marcia Kurs-Lasky; D Kathleen Colborn; Diana H Kearney; Lisa M Zoffel Journal: Pediatr Infect Dis J Date: 2009-01 Impact factor: 2.129
Authors: Norman R Friedman; David P McCormick; Carmen Pittman; Tasnee Chonmaitree; Davis C Teichgraeber; Tatsuo Uchida; Constance D Baldwin; Kokab A Saeed Journal: Pediatr Infect Dis J Date: 2006-02 Impact factor: 2.129
Authors: David P McCormick; Kokab A Saeed; Carmen Pittman; Constance D Baldwin; Norman Friedman; Davis C Teichgraeber; Tasnee Chonmaitree Journal: Pediatrics Date: 2003-10 Impact factor: 7.124