Acute gram-negative bacillary infections of middle ear and mastoid.

Thirty-three patients with acute purulent otitis media and mastoiditis caused by Gram-negative bacilli are presented. The main features of the disease include: predilection for young male infants, a high rate of complications that include sepsis, mastoiditis and osteomyelitis of the base of the skull. Patients that are diagnosed early respond well to drainage and ventilation of the infected middle ear combined with in vitro effective antibacterial therapy. Patients that receive prior inappropriate antibacterial therapy tend to have prolonged courses and require mastoid surgery. It is suggested that early myringotomy and bacterial cultures be performed in all patients with acute middle ear infections.