What is the most common cause of acute otitis media in children?

Streptococcus pneumoniae is recognized as the most common bacterial pathogen responsible for acute otitis media in children. This bacterium can colonize the nasopharynx and, under certain circumstances, ascend to the middle ear, leading to infection. It's notable that the anatomy of the pediatric Eustachian tube, which is shorter and more horizontal in infants and young children, makes them more susceptible to ear infections. When this bacterium proliferates in the middle ear, it can cause pain, fever, and irritability in the affected child, which prompts parents to seek medical attention.

Other microorganisms can also cause acute otitis media, but they are less prevalent. The influenza virus and respiratory syncytial virus, while they can lead to upper respiratory infections that may predispose children to developing otitis media, are not the primary causative agents. Haemophilus influenzae was once a significant contributor before the widespread use of the Haemophilus influenzae type b vaccine, which has greatly reduced its incidence. Hence, Streptococcus pneumoniae stands out as the leading cause of acute otitis media in children today.