Etiology of acute otitis media in infants and children.

Seventy-one children were studied intensively in an attempt to identify both bacterial and viral agents responsible for acute otitis media. Studies included processing of nasopharyngeal secretions and of fluid obtained by needle aspiration of the middle ear. Ear fluid was consistently sterile for viruses but grew bacterial pathogens in 10 of 20 specimens. Nose and throat cultures yielded bacterial pathogens in less than 40% and were of little value in predicting middle-ear flora. Influenza C was isolated from one of 48 throat washings. Viral serology was compatible with influenza A2 and adenovirus infection in two cases. Bacterial and viral agents could not be incriminated in nearly 50% of the children studied.