Suppurative middle-ear infection, commonest in children 6 m–3 y.
Clinical features
- • Ear pain
- • Fever
- • Reduced hearing
- • Otorrhoea if perforation
Examination
- • Bulging erythematous tympanic membrane
- • Loss of light reflex
- • Perforation with discharge
Investigations
- • Clinical
- • Audiometry if recurrent
Differential diagnosis
- • Otitis externa
- • Mastoiditis
- • Referred pain (teeth, TMJ)
Management
- • Most resolve in 72 h — analgesia & safety-net
- • Antibiotics if <2 y bilateral, perforation, systemically unwell
Drug therapy
- • Amoxicillin 500 mg PO tds × 5 days
- • Clarithromycin if penicillin allergy
Complications
- • Mastoiditis
- • Tympanic perforation
- • Hearing loss
- • Intracranial spread (rare)
Clinical pearls
- • Recurrent AOM ≥3 in 6 m → ENT for grommets
Related in WardRound
Educational — verify locally.
