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February 19, 1982

Otitis Media and Fever

JAMA. 1982;247(7):978. doi:10.1001/jama.1982.03320320018013

To the Editor.—  Schwartz and his colleagues reported that 23% of their patients with acute otitis media were febrile and that this contrasts to the much higher incidence of fever reported in other studies. They speculate that their population of white middle-class patients visits private physicians much more promptly than might patients from lower socioeconomic groups attending hospital outpatient departments. They thus imply that fever develops as a later feature of acute otitis media. This would account for the higher incidence of 64% of patients with fever in Mortimer and Watterson's report1 and the 67% in the series of Halstead et al2 for example. We think this conclusion is intriguing but unsupported by any data.During the period March 10 to May 27, 1981, there were 1,641 children seen in the emergency room of the Children's Mercy Hospital whose conditions were diagnosed as an acute episode of otitis