Otitis Media

Paul George, MD, MHPE Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Inflammation of the middle ear; usually accompanied by fluid collection

  • Acute otitis media (AOM): inflammation of the middle ear. Rapid onset; cause may be infectious, either viral (A...

DIAGNOSIS

HISTORY

  • AOM: acute history, signs, and symptoms of middle ear inflammation and effusion

    • Earache

    • Preceding or accompanying URI symptoms

    • Decreased hearing

  • In adults, earache without fever or hear...

TREATMENT

  • Significant disagreement exists about the usefulness of antibiotic treatment for this often self-resolving condition. Studies suggest that ~15 children need to be treated with antibiotics to...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patients with otitis media who do not respond within 48 to 72 hours should be reevaluated: 
  • If therapy was delayed and diagnosis is confirmed, start therapy with h...

REFERENCES

1 Coleman C, Moore M. Decongestants and antihistamines for acute otitis media in children. Cochrane Database Syst Rev.  2008;(3):CD001727.  [View Abstract]
2 Venekamp RP, Burton MJ, ...

ADDITIONAL READING

  • Harmes KM, Blackwood RA, Burrows HL, et al. Otitis media: diagnosis and treatment. Am Fam Physician.  2013;88(7):435–440.  [View Abstract]

  • Lieberthal AS, Carroll AE, Chonmaitre...

SEE ALSO

Algorithm: Ear Pain/Otalgia 

CODES

ICD10

  • H66.90 Otitis media, unspecified, unspecified ear

  • H66.40 Suppurative otitis media, unspecified, unspecified ear

  • H65.199 Other acute nonsuppurative otitis media, unspecified ear

  • H66.3X9 Other c...

CLINICAL PEARLS

  • Pneumatic otoscopy is the single most specific and clinically useful test for diagnosis.

  • Consider a delay of antibiotics for 24 to 48 hours in uncomplicated presentations (>6 months ...

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