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The pathological inflammatory process in the Eustachian tube, as well as the catarrhal stage of acute otitis media, are the most common conditions in the practice of a pediatric otolaryngologist. The article presents literature data on acute pathology of the middle ear, epidemiology, etiology and standard conservative therapy. The fact of the influence of persistence of herpes virus infection on the development of hyperplastic processes in the lymphoid ring of the pharynx in children is described. It was noted that there are few data on the conduct of etiotropic and pathogenetic therapy in patients with acute middle ear pathology infected with pathogens of latent infections in the literature. The article presents a clinical case of successful treatment of the patient with acute otitis media and timely identified markers of an active infection process. Also the determination of clear indications and the timing of the specific conservative treatment of acute otitis media in children, based on an analysis of the etiological aspects of the development of this disease, the duration and somatic condition of the patient allowed to reduce the percentage of complications and relapses in the development of acute otitis media. When selecting adequate therapy for acute otitis media in children, it is necessary to consider the etiology of the disease in each individual patient. In the presence of acute lymphoproliferative syndrome in combination with middle ear inflammation, it is necessary to verify the causative factor with a laboratory examination (diagnosis by polymerase chain reaction and enzyme-linked immunosorbent assay with antibody detection) for herpes virus infection (Epstein-Barr virus, cytomegalavirus, herpes simplex virus 6 type), with further selection of specific therapy and observation of an otolaryngologist and infectious disease specialist.

The foundation of treatment of otitis media in children on the modern stage