Three hundred and eighty-two children were hospitalized in Department of Pediatrics due to bronchitis, pneumonia, or fever of unknown origin from April 1999 to May 2000. Fifty of these children were found to have severe acute otitis media (AOM). Seventy-five children, including the above mentioned 50 children with severe AOM requiring hospitalization, were analyzed. Of these patients,66.7% were 0 or 1-year-old infants,68.0% were male,58.7% were cared for in day care centers, and 65.3% had the chief complaint of fever. Penicillin-resistant Streptococcus pneumoniae were identified in the nasophalynx of one case, but β-lactamase-negative ampicillin-resistant Haemophilus influenzae were not identified.