TABLE 2.

Definition of AOM

A diagnosis of AOM requires 1) a history of acute onset of signs and symptoms, 2) the presence of MEE, and 3) signs and symptoms of middle-ear inflammation.
Elements of the definition of AOM are all of the following:
  1. Recent, usually abrupt, onset of signs and symptoms of middle-ear inflammation and MEE

  2. The presence of MEE that is indicated by any of the following:

    1. Bulging of the tympanic membrane

    2. Limited or absent mobility of the tympanic membrane

    3. Air-fluid level behind the tympanic membrane

    4. Otorrhea

  3. Signs or symptoms of middle-ear inflammation as indicated by either

    1. Distinct erythema of the tympanic membrane or

    2. Distinct otalgia (discomfort clearly referable to the ear[s] that results in interference with or precludes normal activity or sleep)