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Otitis Media

Sahil Mullick, MD and Andrew Slusarek, BMSc, MBBS Reviewed 06/2020
 


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:

    • Otalgia

    • Preceding or accompanying URI symptoms

    • Decreased hearing

  • AOM in adults can present with only otalgia without fever, or unilateral hearing loss.

  • AOM in infants and toddlers may...

TREATMENT

GENERAL MEASURES

  • Assess pain.

  • Avoid risk factors.

  • Two-thirds of children will recover without any antibiotic treatment.

  • AOM: American Academy of Pediatrics/American Academy of Family Physicians ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patients with otitis media who do not respond within 48 to 72 hours should be reevaluated: 
  • If therapy was initiated, consider changing the antibiotic; options are...

REFERENCES

1
Kaur R, Morris M, Pichichero ME. Epidemiology of acute otitis media in the postpneumococcal conjugate vaccine era. Pediatrics.  2017;140(3):e20170181.
2
Lieberthal A, Carroll A, Chonmai...

ADDITIONAL READING

Rettig E, Tunkel DE. Contemporary concepts in management of acute otitis media in children. Otolaryngol Clin North Am.  2014;47(5):651–672. 

SEE ALSO

Algorithm: Ear Pain/Otalgia 

CODES

ICD10

  • H65 Nonsuppurative otitis media

  • H65.0 Acute serous otitis media

  • H65.00 Acute serous otitis media, unspecified ear

  • H65.02 Acute serous otitis media, left ear

  • H65.03 Acute serous otitis media, bi...

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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