Acute Otitis Media

Acute otitis media (AOM) is an ear infection where parts of the middle ear become infected and inflamed and fluid gets trapped behind the tympanic membrane. AOM is one of the most common problems seen in children, with higher incidence during the first two years of life. AOM can occur in suppurative (with pus), nonsuppurative (no purulence), and recurrent forms. Recurrent AOM is defined as 3 or more episodes of suppurative infection in a month period or 4 or more episodes in a 12 month period.

Risk Factors:

  • Exposure to cigarette smoking
  • Child care attendance
  • Breast fed vs formula fed. Breast feeding has a protective benefit against AOM
  • Genetics
  • Males have a higher incidence than females

How Do I Know if My Child Has an Ear Infection?

Most ear infections occur before a child can talk. Look for the following signs per age group:

  • Neonates: Irritability or difficulty feeding child
  • Toddlers: The children may complain of ear pain with or without fever and tug at their ears
  • Older children and adults: Hearing loss is common. Fever, ear pain, and ear discharge may also be present


Audiologic testing often includes a hearing test and a tympanogram. Hearing can be assessed with testing in the hearing booth, in which the individual responds affirmatively when they hear the sound. This type of testing is not possible in neonates, toddlers that have difficulty following instructions, or any individual that cannot respond in an affirmative fashion when sound is presented. When booth testing is not possible, various other hearing tests may be performed that do not require a response from the individual.

In addition to hearing testing, a tympanogram is often performed to assess the ability of the eardrum to vibrate and whether middle ear disease is present. When there is fluid in the middle ear, the eardrum mobility is impacted and hearing may be affected. The presence of middle ear fluid and eardrum pathology may be checked with the use of a tympanogram, in addition to a full otologic examination.