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Most episodes of acute otitis media (AOM) in children are caused by bacteria, but viruses also play an important etiologic role. This study from Texas illuminates the relation between viral infection of the respiratory tract and AOM. Over a five-year period, middle-ear fluid and nasal specimens were collected from 456 children (age, two months to seven years) for viral and bacterial studies at diagnosis and two to five days after the start of antibiotic therapy.
A viral cause of infection (defined as a positive test from any specimen or at least a fourfold increase in viral titers) was found in 186 children (41%); some children were infected with more than one virus. Respiratory syncytial virus (RSV) was responsible for 65 infections and was…