What are the AAP diagnostic guidelines for 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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Diagnostic action statements from the AAP guidelines include the following [38, 39] :

  • AOM should be diagnosed when there is moderate to severe tympanic membrane bulging or new-onset otorrhea not caused by acute otitis externa

  • AOM may be diagnosed from mild tympanic membrane bulging and ear pain for less than 48 hours or from intense tympanic membrane erythema; in a nonverbal child, ear holding, tugging, or rubbing suggests ear pain

  • AOM should not be diagnosed when pneumatic otoscopy and/or tympanometry do not show middle ear effusion

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