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Lack of specific symptomatology in children with acute otitis media
M Niemela1, M Uhari, K Jounio-Ervasti
1Department of Pediatrics, University of Oulu, Finland.
Insights
Ear-related symptoms like earache significantly increase acute otitis media (AOM) likelihood. However, not all young children with AOM exhibit ear symptoms, highlighting the need for comprehensive diagnostic approaches.
Area of Science:
- Pediatrics
- Otolaryngology
- Infectious Diseases
Background:
- Limited data exists on symptoms associated with acute otitis media (AOM) in children.
- Understanding these symptoms is crucial for accurate diagnosis and patient follow-up.
Purpose of the Study:
- To compare symptoms in children diagnosed with AOM versus those with other acute infectious diseases.
- To identify key symptoms indicative of AOM in pediatric patients.
Main Methods:
- Prospective survey of 354 children presenting with acute symptoms to healthcare providers.
- Parental recording of home-observed symptoms and physician recording of physical examination findings.
Main Results:
- Acute otitis media (AOM) was diagnosed in 54.0% of the surveyed children.
- Key indicators for AOM included earache (RR 5.4), rubbing the ear (RR 5.0), and blocked ear sensation (RR 4.5).
- Rhinitis (RR 2.3) and excessive crying in children over 2 (RR 3.0) also increased AOM likelihood, though not all children had ear-specific symptoms.
Conclusions:
- While ear-related symptoms are strong indicators of AOM, their absence in some young children necessitates considering other signs.
- Co-occurring conditions like rhinitis and behaviors such as excessive crying are associated with AOM in children.
- Fever, earache, or crying were common in both AOM and other infections, underscoring diagnostic challenges.
Abstract:
Although the symptoms of the acutely ill child are important both in the diagnosis and follow-up of acute otitis media (AOM), data about them are quite limited. We carried out a prospective survey by collecting information on 354 consecutive children visiting a pediatrician, otolaryngologist or general practitioner because of any kind of acute symptoms to compare symptoms of children with acute otitis media with those of children with other acute infectious diseases. The symptoms and signs observed at home were recorded by the parents before the visit and the findings in the physical examination were recorded later by the physician. AOM was diagnosed in 191 patients (54.0%). The most important symptoms increasing the likelihood of AOM significantly were ear-related symptoms, such as earache (relative risk (RR) 5.4; P < 0.001), rubbing of the ear (RR 5.0; P < 0.001) and feeling of blocked ear (RR 4.5; P < 0.05). However, only 67.7% of children younger than 2 years of age with AOM had any ear-related symptoms. The children with tympanostomy tubes had earache (47.8%) and rubbing of the ear (58.8%) of the same magnitude as did children without tubes. Rhinitis increased the likelihood of AOM (RR 2.3; P < 0.001) as did excessive crying in children older than 2 years of age (RR 3.0; P < 0.001). Fever, earache or excessive crying was present in 90.1% of patients with AOM but also in 72.4% of patients without AOM.(ABSTRACT TRUNCATED AT 250 WORDS)