GP - Telling the difference between acute otitis media and otitis media with effusion

Question 1

How do you differentiate AOM from OME clinically?

Answer 1

• Pain and fever before reduced hearing can point towards AOM that develops into glue ear. Loss of hearing before pain and fever point towards glue ear that develops into AOM
• Ear pain is more severe in AOM compared to OME
• Fever (infectious picture) is present in AOM but not in OME
• Bulging tympanic membrane –> AOM; Retracted tympanic membrane –> OME
• Acute onset in AOM vs chronic onset in OME
• Not much hearing loss in AOM vs hearing loss like underwater in OME
• URTI symptoms present in AOM, but not in OME
• Exudate in AOM vs Transudate in OME if eardrum perforated