Which history findings suggest acute otitis media (AOM)?

Updated: Sep 25, 2019
  • Author: John D Donaldson, MD, FRCSC, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

The history of acute otitis media (AOM) varies with age, but a number of constant features manifest during the otitis-prone years.

In the neonate, irritability or feeding difficulties may be the only indication of a septic focus. Older children begin to demonstrate a consistent presence of fever (with or without a coexistent upper respiratory tract infection [URTI]) and otalgia or ear tugging. These latter symptoms are not entirely exclusive to AOM; teething pain or pharyngitis (particularly coxsackievirus infection) can mimic these symptoms.

In older children and adults, hearing loss becomes a constant feature of AOM and otitis media with effusion (OME), with reports of ear stuffiness noted even before the detection of middle ear fluid. Otalgia without hearing loss or fever is observed in adults with external otitis, dental abscess, or pain referred from the temporomandibular joint. Orthodontic appliances often elicit referred pain as the dental occlusion is altered.


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