Overview
What is acute otitis media (AOM)?
What are the signs and symptoms of acute otitis media (AOM)?
Which pneumatic otoscopy findings are characteristic of acute otitis media (AOM)?
Which tests are indicated for the diagnosis of acute otitis media (AOM)?
What is the role of imaging studies in the diagnosis of acute otitis media (AOM)?
What is the role of tympanocentesis in the diagnosis of acute otitis media (AOM)?
Which antibiotics are used in the treatment of acute otitis media (AOM)?
Which surgical procedures are used in the treatment of acute otitis media (AOM)?
How common is acute otitis media (AOM) in children younger than 5 years?
What is the definition of acute otitis media (AOM)?
What is the initial therapy of choice for acute otitis media (AOM)?
How does anatomy affect placement of ventilation tubes in the treatment of acute otitis media (AOM)?
What causes acute otitis media (AOM)?
How does otitis media (AOM) develop?
How do viruses and bacteria cause acute otitis media (AOM)?
Which viruses are typically found in the middle ear of patients with acute otitis media (AOM)?
What is the role of immunology in the pathogenesis of acute otitis media (AOM)?
What is the role immunoglobulins in the pathogenesis of acute otitis media (AOM)?
What is the role of respiratory syncytial virus (RSV) in the etiology of acute otitis media (AOM)?
Which bacteria are etiologic agents in acute otitis media (AOM)?
What is the role of S pneumoniae in the etiology of acute otitis media (AOM)?
What is the role of H influenzae in the etiology of acute otitis media (AOM)?
What is the role of M catarrhalis in the pathogenesis of acute otitis media (AOM)?
What is the role of S pyogenes in the pathogenesis of acute otitis media (AOM)?
Which bacteria are less common causes of acute otitis media (AOM)?
What is the role of anaerobic bacteria in the etiology of acute otitis media (AOM)?
Which bacteria are associated with acute otitis media (AOM) in neonates?
What are the risk factors for acute otitis media (AOM)?
What is the incidence and prevalence of acute otitis media (AOM) in the US?
In which age groups is acute otitis media (AOM) most prevalent?
How does the prevalence of acute otitis media (AOM) vary among races?
What is the prognosis of acute otitis media (AOM)?
Presentation
Which history findings suggest acute otitis media (AOM)?
How is acute otitis media (AOM) diagnosed?
What does a finding of tympanic membrane perforation indicate in acute otitis media (AOM)?
How is acute bullous myringitis differentiated from acute otitis media (AOM)?
Which comorbidities must be identified before treatment of acute otitis media (AOM) is initiated?
How should temperature be measured in children with suspected acute otitis media (AOM)?
What are the potential complications of acute otitis media (AOM)?
Which findings are signs of impending complications of acute otitis media (AOM)?
How often is mastoiditis a complication of acute otitis media (AOM)?
DDX
Which other conditions should be considered in the workup of acute otitis media (AOM)?
What are the differential diagnoses for Acute Otitis Media?
Workup
Which tests may be performed in the workup of acute otitis media (AOM)?
What is the role of tympanocentesis in the diagnosis of acute otitis media (AOM)?
When is tympanocentesis indicated in the workup of acute otitis media (AOM)?
Treatment
What are the treatment options for acute otitis media (AOM)?
When should antibiotic therapy be initiated for treatment of acute otitis media (AOM)?
How effective is antibiotic therapy for acute otitis media (AOM)?
Why are antibiotics the initial therapy for treatment of acute otitis media (AOM)?
What are the CDC guidelines for the use of antibiotics for treatment of acute otitis media (AOM)?
What is the basis of antibiotic selection in the treatment of acute otitis media (AOM)?
What is the duration of antibiotic therapy for the treatment of acute otitis media (AOM)?
What is the role of pulse-dosing antibiotics in the treatment of acute otitis media (AOM)?
What is the role of subminimal serum antibiotics in the treatment of acute otitis media (AOM)?
Which antibiotic is the initial treatment of choice for acute otitis media (AOM)?
What are the treatment options for antibiotic-resistant acute otitis media (AOM) infections?
Which surgical procedures are performed in the treatment of acute otitis media (AOM)?
What is the role of tympanocentesis in the management of acute otitis media (AOM)?
When is tympanocentesis indicated in the treatment of acute otitis media (AOM)?
How is tympanocentesis performed in acute otitis media (AOM)?
How is a tympanocentesis converted to a myringotomy during treatment for acute otitis media (AOM)?
How is a myringotomy performed in the treatment of acute otitis media (AOM)?
When are tympanostomy tubes indicated in the treatment of acute otitis media (AOM)?
What factors increase the risk of tympanostomy tube occlusion in acute otitis media (AOM)?
What is the role of mastoidectomy in the treatment of acute otitis media (AOM)?
When is surgery contraindicated for acute otitis media (AOM)?
What are possible surgical complications in the treatment of acute otitis media (AOM)?
What are the treatment options for recurrent acute otitis media (AOM)?
Which vaccines have reduced the incidence of acute otitis media (AOM) in children?
Which vaccines are being investigated for prevention of acute otitis media (AOM)?
When is antibiotic prophylaxis indicated in the management of acute otitis media (AOM)?
What is the role of xylitol in the prevention of acute otitis media (AOM)?
How effective is a tympanostomy tube in the management of acute otitis media (AOM)?
Does control of nasal inflammation affect recurrence of acute otitis media (AOM)?
Which risk factors for acute otitis media (AOM) can be mitigated?
What is the role of adenoidectomy in the treatment of acute otitis media (AOM)?
When should patients with acute otitis media (AOM) be reexamined after initiation of treatment?
What findings are expected at a follow up visit for acute otitis media (AOM)?
Does acute otitis media (AOM) affect a child’s quality of life?
Guidelines
Which organizations have released treatment guidelines for acute otitis media (AOM)?
What are the AAP diagnostic guidelines for acute otitis media (AOM)?
What are the UMHS diagnostic guidelines for acute otitis media (AOM)?
What are the AAP treatment guidelines for acute otitis media (AOM)?
What are the UMHS treatment guidelines for acute otitis media (AOM)?
Medications
Which medications are used in the treatment of acute otitis media (AOM)?
Which medications in the drug class Antibiotics are used in the treatment of Acute Otitis Media?
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Healthy tympanic membrane.
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Tympanic membrane of a person with 12 hours of ear pain, slight tympanic membrane bulge, and slight meniscus of purulent effusion at bottom of tympanic membrane. Reproduced with permission from Isaacson G: The natural history of a treated episode of acute otitis media. Pediatrics. 1996; 98(5): 968-7.
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Drawing of normal right tympanic membrane. Note outward curvature of pars tensa (*) of eardrum. Tympanic annulus is indicated anteriorly (a), inferiorly (i), and posteriorly (P). M = long process of malleus; I = incus; L = lateral (short) process of malleus.