Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- otalgia
- sintomas antecedentes do trato respiratório superior
- abaulamento da membrana timpânica
- miringite
Other diagnostic factors
- irritabilidade
- perturbação do sono
- febre
- diminuição do apetite
Risk factors
- frequentar creches
- irmãos mais velhos
- pouca idade
- história familiar
- povos nativos da América ou do Alasca
- sexo masculino
- ausência de aleitamento materno
- alimentação em posição supina (escorar a mamadeira)
- uso de chupeta
- fumaça de cigarro no ambiente
- situação socioeconômica baixa
- anomalia craniofacial
- deficiência imunológica
Diagnostic tests
1st tests to order
- nenhum exame inicial
Tests to consider
- otoscopia pneumática
- timpanometria
- reflectometria acústica
- cultura bacteriana do conteúdo da orelha média
Treatment algorithm
suspeita de otite média aguda (OMA)
otite média aguda (OMA) confirmada
Contributors
Authors
Carlos E. Armengol, MD
Pediatric Associates of Charlottesville PLC
Charlottesville
VA
Disclosures
CEA is an author of a reference cited in this topic.
Acknowledgements
Dr Carlos E. Armengol would like to gratefully acknowledge the late Professor J. Owen Hendley, a previous contributor to this topic.
Disclosures
JOH declared that he had no competing interests.
Peer reviewers
Ozgur Yigit, MD
Chief
ENT Department
Istanbul Training and Research Hospital
Istanbul
Turkey
Disclosures
OY declares that he has no competing interests.
Peter Bull, MB FRCS
Retired Consultant Paediatric Otolaryngologist
Formerly at Sheffield Children's Hospital
Sheffield
UK
Disclosures
PB declares that he has no competing interests.
Richard Schwartz, MD
Clinical Professor of Pediatrics
Georgetown University and George Washington University School of Medicine
Professor of Pediatrics
Medical College of Virginia
Clinical Professor
University of Virginia Medical College
Charlottesville
VA
Disclosures
At the time of the peer review, RS declared no competing interests. We have been informed that Dr Schwartz is now deceased.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Lieberthal AS, Carroll AE, Chonmaitree T, et al. The diagnosis and management of acute otitis media. Pediatrics. 2013 Mar;131(3):e964-99. [Erratum in: Pediatrics. 2014 Feb;133(2):346.]Full text Abstract
Sjoukes A, Venekamp RP, van de Pol AC, et al. Paracetamol (acetaminophen) or non-steroidal anti-inflammatory drugs, alone or combined, for pain relief in acute otitis media in children. Cochrane Database Syst Rev. 2016 Dec 15;(12):CD011534.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Otite média com efusão
- Miringite
- Mastoidite
More DifferentialsGuidelines
- Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2024 update by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM)
- Otitis media (acute): antimicrobial prescribing
More GuidelinesPatient information
Infecção da orelha média
Infecções otológicas em crianças: perguntas a fazer ao seu médico
More Patient information
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