Approach

The key factors in the history that support the diagnosis of AOM vary depending on the age of the patient. In an older, verbal child they include a preceding viral respiratory illness followed by the acute onset of otalgia. In a pre-verbal child, the key factors should include fever or systemic symptoms indicative of otalgia such as irritability, crying, sleep disturbance, vomiting, or poor appetite.

AOM occurs in less than 1% of adults. Adults typically present more quickly than children with complaints of ear pain, decreased hearing, sore throat, and otorrhoea. Nonetheless, adults have higher rates of persistent middle ear effusions or infections 2 months after initial diagnosis compared with children.[17] Bacteriology and treatment are similar to those for children.

BMJ Best Practice is an evidence-based point of care tool for healthcare practitioners.

To continue reading and access all of BMJ Best Practice's pages you'll need to log in or start a free trial.

You can access through your institution if your hospital, university, trust or other institution provides access to BMJ Best Practice through either OpenAthens or Shibboleth.

Use of this content is subject to our disclaimer