Otitis%20media%20-%20acute Diagnosis

Diagnosis

Diagnosis of acute otitis media (AOM) requires a history of acute onset of signs & symptoms, signs & symptoms of middle ear inflammation, & confirmation of middle ear effusion (MEE)

History

History alone is a poor predictor of the presence of acute otitis media (AOM)
Signs & symptoms are usually nonspecific
Viral upper respiratory tract infection (URTI) symptoms may be present before or during AOM

Physical Examination

Presence of middle ear effusion (MEE)

MEE can be confirmed by direct visualization of the tympanic membrane by otoscopy or pneumatic otoscopy
Presence of MEE is indicated by any of the following:
- Bulging tympanic membrane w/ loss of normal landmarks
- Opacification or cloudiness of tympanic membrane
- Absent or limited mobility of tympanic membrane w/ pneumatic pressure
- Otorrhea (positive purulence is associated w/ rupture of tympanic membrane)
- Air-fluid level behind the tympanic membrane

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