Algorithm for Distinguishing Between Acute Otitis Media and Otitis Media with Effusion - Flowchart
Algorithm for Distinguishing Between Acute Otitis Media and Otitis Media with Effusion - Flowchart Otitis Media Otitis Media
«Flowchart»

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Yes

Yes

Yes

Yes

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Yes

Yes

Otitis media with effusion (OME)

Otitis media with effusion (OME)

Otitis media with effusion (OME)

At least one of:


    Substantial ear pain, including unaccustomed tugging or rubbing of the ear
    Marked redness of the TM
    Distinct fullness or bulging of the TM

At least one of:


    Substantial ear pain, including unaccustomed tugging or rubbing of the ear
    Marked redness of the TM
    Distinct fullness or bulging of the TM

At least one of:


    Substantial ear pain, including unaccustomed tugging or rubbing of the ear
    Marked redness of the TM
    Distinct fullness or bulging of the TM

Substantial ear pain, including unaccustomed tugging or rubbing of the ear
Marked redness of the TM
Distinct fullness or bulging of the TM

Middle-ear effusion (MEE)

Middle-ear effusion (MEE)

Middle-ear effusion (MEE)

No acute inflammation

No acute inflammation

No acute

Acute inflammation

Acute inflammation

Acute

End

End

End

Yes

Yes

Yes

Acute otitis media (AOM)

Acute otitis media (AOM)

Acute otitis media (AOM)

At least two of:


    Abnormal TM color: white, yellow, amber, or blue
    Opacification not due to scarring
    Decreased or absent mobility

At least two of:


    Abnormal TM color: white, yellow, amber, or blue
    Opacification not due to scarring
    Decreased or absent mobility

Abnormal TM color: white, yellow, amber, or blue
Opacification not due to scarring
Decreased or absent mobility At least two of

Or

Bubbles or air–fluid interfaces behind the TM

Or

Bubbles or air–fluid interfaces behind the TM

Bubbles

Acute purulent otorrhea not due to otitis externa

Acute purulent otorrhea not due to otitis externa

Acute purulent otorrhea