In one large Canadian series acute otitis media was caused by pneumococcus in about 50% of cases and in the remainder the causes included Haemophilus influenzae and β-haemolytic streptococci.1 It may also be caused by Staph. pyogenes. It is commonest in childhood. In the series of Canadian children under 14 years of age about half were under 3 years of age.1 In a British series about 90% of patients were children between 2 and 8 years of age.2
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