What is the common cause of acute otitis media?

• A. Pseudomonas aeruginosa
• B. Streptococcus pneumoniae or H. influenzae
• C. Virus only
• D. Fungi

Answer: (B)

Acute otitis media is most often a bacterial infection that follows a viral upper respiratory infection, which disrupts eustachian tube function and traps fluid in the middle ear, creating a setting where bacteria can proliferate. The leading culprits are Streptococcus pneumoniae and non-typeable Haemophilus influenzae, which together account for the majority of acute cases. Moraxella catarrhalis also contributes, but these two pathogens are the primary ones clinicians worry about. Pseudomonas aeruginosa is not a typical cause of uncomplicated acute otitis media (it’s more associated with chronic otitis externa or special settings), and fungi are rare players in this condition. Viral involvement can trigger the illness, but when it comes to the common bacterial etiologies, S. pneumoniae and H. influenzae are the best answer.