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JAMA Patient Page
September 24, 2003

Acute Otitis Media

JAMA. 2003;290(12):1666. doi:10.1001/jama.290.12.1666

Acute otitis media is an infection of the middle ear, the area of the ear directly behind the tympanic membrane (ear drum). Acute otitis media is one of the most commonly diagnosed childhood illnesses and is responsible for more than 30 million clinic visits a year in the United States.

The September 24, 2003, issue of JAMA includes an article on diagnosing acute otitis media in children.


Acute otitis media usually starts when germs that cause colds or sore throats (either bacterial or viral infections) spread to the middle ear. Once in the ear, the infection can cause a buildup of pus or fluid behind the eardrum. The pressure on the eardrum can lead to significant pain in some children.

Physicians diagnose acute otitis media using an otoscope, an instrument placed in the opening of the ear that allows the doctor to look at the eardrum. Inflammation of the eardrum can indicate an infection. Lack of movement of the eardrum can also indicate infection. If there is fluid or pus behind the eardrum, it usually does not move easily.


  • Fever

  • Ear pain or pulling at one or both ears

  • Irritability

  • Decreased appetite

  • Fluid coming from one or both ears

These symptoms can occur for other reasons, so it is important for children with these symptoms to be evaluated by a physician.


Acute otitis media may be treated with antibiotics if there is a bacterial infection. When children have recurrent or chronic (persisting long-term) otitis media, it may be necessary to have a tympanostomy tube placed in the eardrum. The tube falls out naturally after several months and the hole heals naturally. Treatment depends on the characteristics of each child, so it is important for your child to have an evaluation if these symptoms develop.



To find this and other Patient Pages, go to the Patient Page Index on JAMA's Web site at http://www.jama.com. A Patient Page on childhood ear infections was published in the December 8, 1999, issue.

Sources: National Institute on Deafness and Other Communication Disorders, American Academy of Pediatrics

The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424.