In a 4 year old child with ASOM the infecting of organism is likely to be –
Pneumococcus
H.influenza
Streptococcus
Staphylococcus
Three most common organisms causing ASOM -4 S. pneumoniae (40%), H. influenzae (25-30%), Moraxella, catarrhalis (10-15%)
Note - H.influenzae causing ASOM is nontypable. The incidence of H.influenzae type 'b' has decreased because of widespread use of Hib vaccine.