Clinical Pathway for Evaluation/Treatment of Acute Otitis Media in Children 2 Months to 12 Years Old

Diagnostic Considerations

AOM (all 3 required)
Onset Acute onset of signs and symptoms
Bulging membrane Best predictor of bacterial infection
Middle ear effusion Reduced TM mobility with pneumatic otoscopy
  • AOM should be diagnosed in children with new onset otorrhea without otitis externa
  • OME diagnosis is based on a middle ear effusion without middle ear inflammation
Mild Bulging Moderate Bulging Severe Bulging