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Otitis Media

Sahil Mullick, MD and Paul J Sliskovich, MD Reviewed 06/2022
 


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 and if present, recommend treatment to decrease otalgia.

  • Minimize any risk factors.

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

  • AOM: Observ...

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
Ben-Shimol S, Givon-Lavi N, Leibovitz E, et al. Impact of widespread introduction of pneumococcal conjugate vaccines on pneumococcal and nonpneumococcal otitis media. Clin Infect Dis. 2016...

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

  • H65.01 Acute serous otitis media, right ear

  • H65.02 Acute serous otitis media, l...

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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