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Otitis Media

Sarah Renna, MD and Sahil Mullick, MD Reviewed 06/2019
 


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

    • Otalgia

    • Preceding or accompanying URI symptoms

    • Decreased hearing

  • In adults, otalgia without fever or hearin...

TREATMENT

  • Significant disagreement exists about the usefulness of antibiotic treatment for this often self-resolving condition. Studies suggest number needed to treat for an additional beneficial outc...

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
Kaur R, Morris M, Pichichero ME. Epidemiology of acute otitis media in the postpneumococcal conjugate vaccine era. Pediatrics.  2017;140(3):e20170181. [View Abstract on OvidMedline]
2
L...

ADDITIONAL READING

  • Marchisio P, Consonni D, Baggi E, et al. Vitamin D supplementation reduces the risk of acute otitis media in otitis-prone children. Pediatr Infect Dis J.  2013;32(10):1055–1060...

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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