CLINICAL MANIFESTATIONS AND HOSPITAL TREATMENT OF COMPLICATED OTITIS MEDIA IN IMMUNOSUPPRESSED CHILDREN

Abstract

Otitis media, a middle ear infection, is a common childhood condition. In immunosuppressed children, due to underlying conditions such as leukemia, lymphoma or the use of immunosuppressants, otitis media can present a more severe course with a greater risk of complications, such as mastoiditis, meningitis and brain abscess. These complications can have serious consequences and, in some cases, lead to death. Given the severity of otitis media complications in immunosuppressed children, it is essential to understand the specific clinical manifestations of this condition and the best therapeutic approaches to ensure effective and early treatment, aiming to reduce morbidity and mortality. Objective: The objective of this systematic review was to identify and synthesize the available scientific evidence on the clinical manifestations and hospital treatment of complicated otitis media in immunosuppressed children. Methodology: A systematic review of the literature was carried out, following the recommendations of the PRISMA statement. The PubMed, Scielo and Web of Science databases were searched using the following descriptors: “otitis media”, “child”, “immunosuppression”, “complications” and “hospitalization”. Original articles published in the last 10 years were included, describing cases of complicated otitis media in immunosuppressed children, reporting the clinical manifestations and hospital treatment. Review articles, isolated case reports and studies with inadequate methodology were excluded. Results: The results of the 19 studies selected for the review demonstrated that complicated otitis media in immunosuppressed children may present atypical and more severe clinical manifestations compared to immunocompetent children. The most common complications include mastoiditis, bacterial meningitis and brain abscess. High fever, severe earache, purulent otorrhea and signs of meningeal irritation were the most frequently reported symptoms. Hospital treatment involved the administration of broad-spectrum antibiotics, surgical drainage of the middle ear and, in some cases, surgical treatment of complications. Conclusion: Complicated otitis media in immunosuppressed children is a serious condition that requires a high index of clinical suspicion and a rapid and effective therapeutic approach. Early recognition of warning signs and immediate initiation of antibiotic and surgical treatment are crucial to reduce morbidity and mortality. Future studies with a larger number of patients and a more robust design are necessary to deepen knowledge about this condition and establish more precise guidelines for clinical management.