Otitis Media

Paul George, MD, MHPE Reviewed 06/2017
 


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 ...

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

Rettig  E, Tunkel  DE. Contemporary concepts in the management of acute otitis media in children. Otolaryngol Clin North Am.  2014;47(5):651–672.  [View Abstract]
Harmes  KN, Blackwoo...

ADDITIONAL READING

Lieberthal AS, Carroll AE, Chonmaitree T, et al. The diagnosis and management of acute otitis media. Pediatrics.  2013;131(3):e964–e999.  

SEE ALSO

Algorithm: Ear Pain 

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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