TY - CHAP M1 - Book, Section TI - Chapter 12. Ear, Nose, and Throat A1 - Lowry, Adam W. A1 - Bhakta, Kushal Y. A1 - Nag, Pratip K. PY - 2011 T2 - Texas Children's Hospital Handbook of Pediatrics and Neonatology AB - Epidemiology: 33% of all pediatric office visits; by 3 yo, 80% have ≥ 1 AOMPathophysiology: URI or inflammation → Eustachian tube dysfunction or occlusion → effusion → infectionEtiologic agents: Respiratory viruses >> Haemophilus influenzae (Post PCV7 52%, Pre PCV7 15-30%) > Pneumococcus spp. (Post PCV7 34%, Pre PCV7 25-50%) > Moraxella spp. (Pre PCV7 3%–20%) > GABHS > other (Pediatrics 2004;113:1451)DiagnosisHistory: Fever (especially increasing fever curve), URI, ear pain or fullness, hearing loss, vomiting, ear drainage or diarrhea.Physical exam: Bulging tympanic membrane (TM), purulent material, air-fluid level, ↓ or no movement of TM, otorrhea, ± redness, ± bullae.Best predictors are position (ie, bulging), mobility of TM (↓ or no movement of TM), and color (PIDJ 1998;17(6):540). Consider tympanocentesis and bacterial culture for children with recurrent or chronic disease.TreatmentPain and fever control are the most important interventions.Within 24 hours, 61% of patients have resolution of symptoms without antibiotics.Antibiotics (see table below) often do not change the duration of illness of AOM. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/29 UR - accesspediatrics.mhmedical.com/content.aspx?aid=7436216 ER -