From the Guidelines
To diagnose an ear infection, pneumatic otoscopy should be used as the primary diagnostic method, as recommended by the American Academy of Pediatrics, American Academy of Family Physicians, and American Academy of Otolaryngology–Head and Neck Surgery 1. When diagnosing an ear infection, it is essential to distinguish otitis media with effusion (OME) from acute otitis media (AOM) 1. The diagnostic process typically involves:
- A physical examination of the ear using an otoscope to look for signs of inflammation, fluid buildup, or pus in the middle ear
- Assessing symptoms like ear pain, hearing difficulty, drainage from the ear, fever, and balance problems
- Using pneumatic otoscopy to check eardrum movement
- Possibly using tympanometry to measure eardrum response to pressure changes
- In some cases, taking a fluid sample for testing if the infection appears severe or recurrent It is crucial to document the laterality, duration of effusion, and presence and severity of associated symptoms at each assessment of the child with OME 1. Hearing testing should be conducted when OME persists for 3 months or longer, or at any time that language delay, learning problems, or a significant hearing loss is suspected in a child with OME 1. If you suspect an ear infection, seek medical attention promptly, especially if symptoms are severe or persist longer than a day, as proper diagnosis is essential for appropriate treatment.
From the Research
Diagnostic Methods for Ear Infections
- Ear infections can be diagnosed through various methods, including physical examination, medical history, and diagnostic tests 2.
- Tympanocentesis is a procedure that can be used to diagnose acute otitis media (AOM) by extracting fluid from the middle ear to identify the causative pathogen 3, 4.
- Otoscopy and tympanometry are also useful diagnostic tools for assessing the middle ear and eardrum 5.
Symptoms and Diagnostic Criteria
- Symptoms of ear infections may include ear pain, fever, irritability, otorrhea, anorexia, and vomiting or lethargy 5.
- Diagnostic criteria for AOM include moderate to severe bulging of the tympanic membrane or new-onset otorrhea not caused by acute otitis externa, and mild bulging with recent-onset ear pain or intense erythema of the tympanic membrane 5.
Specialized Diagnostic Tests
- Tympanocentesis can be used to identify the causative pathogen in AOM and guide antibiotic selection 3, 4.
- Imaging studies, such as CT or MRI scans, may be used to evaluate complications of ear infections, such as mastoiditis or meningitis 6.
- Mycologic culture and histologic examination are important for diagnosing fungal otitis externa, also known as otomycosis 6.