PITFALLS IN DIAGNOSING ACUTE OTITIS-MEDIA

The diagnosis of AOM in the infant and child requires an accurate history with special reference to fever, pain, and respiratory symptoms and a careful examination with particular attention to the appearance and movement of the TM. The practitioner must be wary of relying too heavily on any single physical finding, but instead consider all the variables that influence and alter the history and physical examination as summarized in Table 4. These variables include the reliability of the history, the history of previous infections, the age of the child, the appearance of the EAC, and the appearance and mobility of the TM. The importance of a correct diagnosis is crucial because of the immediate treatment and follow-up dictated by the diagnosis and because of the potential long-term effects on the child's health and development, which are described in the remaining articles in this issue of Pediatric Annals.