Is the cause of otitis media whether the child's bath water enters the ear?

Patient's question:

Patient: Female, 2 years old, pediatric otitis media with fever without cold symptoms

Doctor's answer:

Otitis media, especially acute purulent otitis media, is more common in children. Clinically, it is often characterized by ear area fullness and pain, hearing loss, as well as systemic symptoms such as fever, headache, fatigue, and reduced appetite. Once the tympanic membrane perforates, pus can be seen flowing from the ear, and at this time, the swelling symptoms may actually subside. Some parents are greatly puzzled by the presence of pus flowing from the ear and often mistake it for water entering the ear. However, this view is not correct.