Otitis media in infants aged 0-8 weeks

Otologic Examination Findings In Afebrile Young Infants Clinically Diagnosed With Acute Otitis Media

“…9 Multiple examination findings consistent with AOM were more frequently documented in older infants, suggesting that clinicians may be using fewer or less stringent examination criteria to diagnose AOM in the youngest infants, despite the impact this diagnosis may have on additional testing and treatment in this age group. 2,4,5 This is likely related to challenges inherent in visualizing the TM through smaller ear canals. It is unclear why the youngest infants in the study had a higher prevalence of tympanic membrane perforation documented, although a small case series suggests that it may be related to differences in otopathogens causing AOM in neonates.…”

“…1 RSV imposes a high disease burden on a global level and can cause life-threatening infections in young children and the elderly. 2 RSV infections in children under the age of 5 years were estimated to lead to 3 million hospitalizations and 150,000 deaths worldwide in 2015. 3 To prevent RSV infections and reduce the global burden of disease, pharmaceutical companies are in the process of developing a vaccine that protects against RSV.…”

“…Accurately diagnosing AOM in infants ≤90 days is essential, as clinicians are more concerned about concomitant serious bacterial infections in this age group. 2,4,5 It is unclear what examination findings clinicians use to diagnose AOM in young infants, if they vary from criteria established for older infants and children, and how these differences may impact their care. In our previously published study of afebrile infants ≤90 days with clinically diagnosed AOM, 6 we briefly summarized the documented ear examination findings without assessing combinations of findings or whether examination findings differed across age subgroups.…”

“…The current American Academy of Pediatrics (AAP) guideline on acute otitis media (AOM) recommends the following diagnostic criteria for AOM: (1) moderate to severe bulging of the tympanic membrane (TM), (2) acute otorrhea not due to acute otitis externa or (3) mild bulging of the TM with either recent ear pain or intense erythema of the TM. 1 However, this guideline excludes infants <6 months of age.…”

“…There are no widely agreed-upon diagnostic criteria for the diagnosis of AOM in young infants. Prior studies of AOM in young infants have utilized tympanocentesis for diagnosis, 2,3 but this is impractical in most clinical settings and does not represent the standard of care in the management of uncomplicated AOM.…”