clinical features

Last reviewed 01/2018

Acute otitis media is more common in children. Its symptoms and signs include:

  • symptoms
    • earache, usually throbbing and severe
    • young children unable to express their earache might be noted to frequently rub their ear
    • excessive crying (1)
    • pyrexia up to 40 degrees - child may be flushed
    • otorrhoea will often be blood-stained - profuse and mucoid at first, later becomes thick and yellow
    • mucoid discharge: signifies tympanic membrane perforation, after which pain subsides
  • signs
    • conductive deafness is always present, and may be accompanied by tinnitus
    • tympanic membrane signs depend on the stage of infection
      • loss of lustre
      • break-up of the light reflex
      • redness
      • impaired mobility of tympanic membrane (1)
      • fullness of the ear drum - malleus handle becomes more vertical
      • progression to a bulging ear drum - purple colour
      • the final stage is perforation
    • tenderness: possibly to pressure on the mastoid antrum
  • diagnostic tests include; (1)
    • acoustic reflectometry
    • pneumatic otoscopy (2)
    • portable tympanometry
    • professional tympanometry

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