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1

Maxson, Suzanne, and Terry Yamauchi. "Acute Otitis Media." Pediatrics In Review 17, no. 6 (June 1, 1996): 191–95. http://dx.doi.org/10.1542/pir.17.6.191.

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Definitions Acute otitis media with effusion (AOME) is a clinically identifiable, suppurative infection of the middle ear. The infection has a relatively sudden onset and short duration. It denotes inflammation of the mucoperiosteal lining of the middle ear. The inflamed tympanic membrane (TM) is bulging, opacified, or both. The condition chronic otitis media is poorly defined, but it may be categorized into two clinical entities for simplification: chronic otitis media with effusion (COME) and chronic suppurative otitis media (CSOM). COME, also known as serous or non-suppurative otitis media, is characterized by the presence of a middle ear effusion (MEE) behind an intact TM that persists for more than 2 to 3 months. It may be asymptomatic except for hearing loss. There generally are no acute clinical signs or symptoms, and the TM is not red or bulging. CSOM is characterized by chronic perforation of the TM, with purulent discharge, for a prolonged period of time, usually more than 6 weeks. There generally is an insidious clinical onset. Either COME or CSOM may follow AOME. Epidemiology Otitis media is one of the most frequent causes for physician visits by children. Approximately 25% of such visits during the first year of life are for middle ear disease; this increases to 40% for children 4 to 5 years of age.
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2

&NA;. "Acute otitis media." Inpharma Weekly &NA;, no. 1175 (February 1999): 3. http://dx.doi.org/10.2165/00128413-199911750-00003.

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3

Maxson, S., and T. Yamauchi. "Acute Otitis Media." Pediatrics in Review 17, no. 6 (June 1, 1996): 191–95. http://dx.doi.org/10.1542/pir.17-6-191.

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4

Curran, John F., Hannah L. Cornwall, Miklos Perenyei, and Tobias Moorhouse. "Acute otitis media." InnovAiT: Education and inspiration for general practice 11, no. 6 (April 26, 2018): 305–12. http://dx.doi.org/10.1177/1755738018766193.

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Middle ear infection, or acute otitis media (AOM), is a common condition encountered in primary care. Unfortunately, the diagnosis and sequelae of AOM can be overlooked, leading to significant patient morbidity. This article aims to raise awareness of AOM and highlights the relevant anatomy, epidemiology and aetiology. We discuss prevention, diagnosis and management of AOM in primary care, the recognition of complications and when to refer to secondary care.
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5

Branefors-Helander, P., O. Nylén, and P. H. Jeppsson. "ACUTE OTITIS MEDIA." Acta Pathologica Microbiologica Scandinavica Section B Microbiology and Immunology 81B, no. 5 (August 15, 2009): 508–18. http://dx.doi.org/10.1111/j.1699-0463.1973.tb02236.x.

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6

Van Buchen, F. L. "ACUTE OTITIS MEDIA." Pediatric Infectious Disease Journal 4, no. 5 (September 1985): 566. http://dx.doi.org/10.1097/00006454-198509000-00043.

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7

Atkinson, Helen, Sebastian Wallis, and Andrew P. Coatesworth. "Acute otitis media." Postgraduate Medicine 127, no. 4 (April 27, 2015): 386–90. http://dx.doi.org/10.1080/00325481.2015.1028872.

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8

Dickson, Gretchen. "Acute Otitis Media." Primary Care: Clinics in Office Practice 41, no. 1 (March 2014): 11–18. http://dx.doi.org/10.1016/j.pop.2013.10.002.

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9

Pirozzo, S. "Acute otitis media." Western Journal of Medicine 175, no. 6 (December 1, 2001): 402–7. http://dx.doi.org/10.1136/ewjm.175.6.402.

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10

Lindbaek, M. "Acute otitis media." BMJ 320, no. 7228 (January 15, 2000): 182. http://dx.doi.org/10.1136/bmj.320.7228.182.

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11

Matz, Paul S. "Acute Otitis Media." Pediatric Case Reviews 2, no. 4 (October 2002): 209–19. http://dx.doi.org/10.1097/00132584-200210000-00003.

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12

Aylett, M. J. "Acute otitis media." BMJ 300, no. 6735 (May 19, 1990): 1341–42. http://dx.doi.org/10.1136/bmj.300.6735.1341-d.

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13

Skinner, D. W., A. J. Prichard, and A. Narula. "Acute otitis media." BMJ 300, no. 6738 (June 9, 1990): 1524. http://dx.doi.org/10.1136/bmj.300.6738.1524-a.

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14

Paul, Caroline R., and Megan A. Moreno. "Acute Otitis Media." JAMA Pediatrics 174, no. 3 (March 1, 2020): 308. http://dx.doi.org/10.1001/jamapediatrics.2019.5664.

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15

Parmet, S. "Acute Otitis Media." JAMA: The Journal of the American Medical Association 290, no. 12 (September 24, 2003): 1666. http://dx.doi.org/10.1001/jama.290.12.1666.

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16

Torpy, Janet M., Cassio Lynm, and Richard M. Glass. "Acute Otitis Media." JAMA 304, no. 19 (November 17, 2010): 2194. http://dx.doi.org/10.1001/jama.304.19.2194.

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17

Leskinen, Kimmo, Panu Hendolin, Anni Virolainen-Julkunen, Jukka Ylikoski, and Jussi Jero. "Alloiococcus otitidis in acute otitis media." International Journal of Pediatric Otorhinolaryngology 68, no. 1 (January 2004): 51–56. http://dx.doi.org/10.1016/j.ijporl.2003.09.005.

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18

Malipatil, Sharanabasappa Rudragouda, Ciju Kunjumon George, Jathin Sam Thekkethil, and Betsy Mathew. "A RARE CASE OF ACUTE NECROTISING OTITIS MEDIA." ORISSA JOURNAL OF OTOLARYNGOLOGY AND HEAD AND NECK SURGERY XI, no. II (December 5, 2017): 62–64. http://dx.doi.org/10.21176/ojolhns.2017.11.2.14.

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19

Isaacson, Glenn, and Sharon Griswold. "Differentiating acute otitis media from otitis media with effusion." Visual Journal of Emergency Medicine 21 (October 2020): 100891. http://dx.doi.org/10.1016/j.visj.2020.100891.

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20

Block, Stan L. "Diagnosing acute otitis media." Postgraduate Medicine 122, no. 6 (November 15, 2010): 5–12. http://dx.doi.org/10.3810/pgm.2005.12.suppl42.215.

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21

Stiernberg, Charles M., Cam Stiernberg, Byron J. Bailey, and Francis B. Quinn. "Acute Necrotizing Otitis Media." Otolaryngology–Head and Neck Surgery 94, no. 5 (June 1986): 648–51. http://dx.doi.org/10.1177/019459988609400522.

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22

Stiernberg, Charles M., Cam Stiernberg, Byron J. Bailey, and Francis B. Quinn. "Acute Necrotizing Otitis Media." Otolaryngology–Head and Neck Surgery 94, no. 6 (June 1986): 648–51. http://dx.doi.org/10.1177/019459988609400622.

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23

Shaikh, Nader, and Alejandro Hoberman. "Update: Acute Otitis Media." Pediatric Annals 39, no. 1 (January 1, 2010): 28–33. http://dx.doi.org/10.3928/00904481-20091222-03.

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24

Wilkinson, Eric P., and Rick A. Friedman. "Acute Suppurative Otitis Media." Ear, Nose & Throat Journal 87, no. 5 (May 2008): 250. http://dx.doi.org/10.1177/014556130808700502.

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25

Marsten, G. "RECURRENT ACUTE OTITIS MEDIA." Pediatric Infectious Disease Journal 9, no. 5 (May 1990): 377. http://dx.doi.org/10.1097/00006454-199005000-00023.

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26

Pelton, Stephen I. "Modifying Acute Otitis Media." Pediatric Infectious Disease Journal 23, no. 9 (September 2004): 839–41. http://dx.doi.org/10.1097/01.inf.0000138453.32886.a6.

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27

PICHICHERO, MICHAEL E., and CHRISTY L. PICHICHERO. "Persistent acute otitis media." Pediatric Infectious Disease Journal 14, no. 3 (March 1995): 178–82. http://dx.doi.org/10.1097/00006454-199503000-00002.

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28

PICHICHERO, MICHAEL E., and CHRISTY L. PICHICHERO. "Persistent acute otitis media." Pediatric Infectious Disease Journal 14, no. 3 (March 1995): 183–88. http://dx.doi.org/10.1097/00006454-199503000-00003.

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29

Deguine, Christian, and Jack L. Pulec. "Acute Suppurative Otitis Media." Ear, Nose & Throat Journal 72, no. 6 (June 1993): 387. http://dx.doi.org/10.1177/014556139307200602.

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30

Kochhar, Suneeta. "Managing acute otitis media." Independent Nurse 2015, no. 15 (September 21, 2015): 27. http://dx.doi.org/10.12968/indn.2015.15.27.

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31

Leibovitz, Eugene, Elad Asher, Lolita Piglansky, Noga Givon-Lavi, Robert Satran, Simon Raiz, Yuval Slovik, Alberto Leiberman, and Ron Dagan. "Is Bilateral Acute Otitis Media Clinically Different Than Unilateral Acute Otitis Media?" Pediatric Infectious Disease Journal 26, no. 7 (July 2007): 589–92. http://dx.doi.org/10.1097/inf.0b013e318060cc19.

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32

Howie, Virgil M. "Otitis Media." Pediatrics In Review 14, no. 8 (August 1, 1993): 320–23. http://dx.doi.org/10.1542/pir.14.8.320.

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Definitions When the diagnosis of otitis media has been made on the basis of skilled clinical observation and the tympanic membrane is intact, it is practical to assume that an effusion is present. However, this can be confirmed only by recovery of fluid from the middle ear on tympanocentesis or myringotomy. Several methods will confirm the diagnosis of effusion with the indicated accuracy, as generally reported in the literature (Table 1). Acute Otitis Media A common error in the diagnosis of otitis media with effusion (OME) is equating an "injected" or "red" eardrum with OME. Acute otitis media may present with an injected drum, but the critical factor is not drum color but the presence of fluid in the middle ear cavity. The drum frequently is suffused and red when an infant or toddler is crying from either fear or pain during the otoscopic examination. A bulging eardrum, on the other hand, usually is regarded as defining acute otitis media (also called suppurative or purulent otitis media) with or without symptoms (pain, sleeplessness, fever, irritability) of systemic illness. Experienced clinicians try to avoid the "red ear" error with either tympanometry or acoustic reflectivity (Table 1) or by careful removal of all external ear contents to visualize fully the landmarks (eg, both ends of the malleolus) and their mobility with the pneumatic otoscope.
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33

Suzuki, Chiaki, and Noboru Yamanaka. "Is Bilateral Acute Otitis Media Clinically more Refractory than Unilateral Acute Otitis Media?" Practica Oto-Rhino-Laryngologica 107, no. 6 (2014): 447–51. http://dx.doi.org/10.5631/jibirin.107.447.

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34

Suzuki, Chiaki, and Noboru Yamanaka. "Is Bilateral Acute Otitis Media Clinically more Refractory than Unilateral Acute Otitis Media?" Practica oto-rhino-laryngologica. Suppl. 140 (2014): 40–41. http://dx.doi.org/10.5631/jibirinsuppl.140.40.

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35

Canafax, Daniel M., and G. Scott Giebink. "Antimicrobial Treatment of Acute Otitis Media." Annals of Otology, Rhinology & Laryngology 103, no. 5_suppl (May 1994): 11–14. http://dx.doi.org/10.1177/00034894941030s504.

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Episodes of acute otitis media frequently occur in childhood and are attended by significant morbidity, such as hearing loss and possible speech delay. Bacteria play an important etiologic role in the pathogenesis of otitis media; therefore, antimicrobial agents are the cornerstone in the treatment of this disease. Many antimicrobial choices are available for treating children with acute otitis media. To choose an antimicrobial for each patient, consideration must be given to the patient's age, history of otitis media episodes, and responses to previously used antimicrobial drugs, and the regional antimicrobial susceptibility of the otitis media pathogens.
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36

Nitsche, María Pía, and Monica Carreño. "Antibiotics for acute otitis media in children." Medwave 15, Suppl2 (October 30, 2015): e6295-e6295. http://dx.doi.org/10.5867/medwave.2015.6295.

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37

Bajaj, Anubha. "The Aural Defilement-Otitis Media." Journal of Virology and Viral Diseases 2, no. 1 (February 9, 2022): 1–7. http://dx.doi.org/10.54289/jvvd2200103.

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Otitis media is an infectious disease arising within the middle ear. Otitis media emerges as an acute or chronic inflammation or infection of middle ear cavity or middle ear space. The condition is preponderantly constituted of acute otitis media, chronic suppurative otitis media and otitis media with effusion. A globally discerned infection, otitis media appears due to diverse bacterial or viral agents although fungal or pneumocystis infection can exceptionally appear in immunocompromised or human immunodeficiency virus (HIV) infected subjects.
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38

Tachibana, Fumitoshi, Takaaki Shimada, Yohji Hori, Yoshizumi Wada, Yasuo Ishitani, and Yasuo Koike. "Platelet-Activating Factor and Leukotrienes in Acute Otitis Media, Secretory Otitis Media, and Chronic Otitis Media on the Acute Excerbation." Auris Nasus Larynx 23, no. 1 (January 1996): 20–25. http://dx.doi.org/10.1016/s0385-8146(96)80004-6.

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39

Lamb, Harriet M., and Caroline M. Spencer. "Management of Acute Otitis Media." Disease Management and Health Outcomes 8, no. 6 (December 2000): 337–53. http://dx.doi.org/10.2165/00115677-200008060-00004.

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40

Greenberg, David, Sigalit Hoffman, Eugene Leibovitz, and Ron Dagan. "Acute Otitis Media in Children." Pediatric Drugs 10, no. 2 (2008): 75–83. http://dx.doi.org/10.2165/00148581-200810020-00002.

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41

Georgescu, Mădălina. "Acute otitis media in children." Pediatru.ro 4, no. 48 (2018): 18. http://dx.doi.org/10.26416/pedi.48.4.2017.1369.

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42

Lundgren, K., and L. Ingvarsson. "Acute Otitis Media in Sweden." Drugs 31, Supplement 3 (1986): 125–31. http://dx.doi.org/10.2165/00003495-198600313-00028.

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43

Eppes, S. C., J. D. Klein, L. L. Lewis;, E. I. Cantekin;, E. D. Barnett, D. W. Teele, J. O. Klein, and S. J. Kharasch. "Ceftriaxone for Acute Otitis Media." PEDIATRICS 100, no. 1 (July 1, 1997): 157. http://dx.doi.org/10.1542/peds.100.1.157.

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44

Kown, Junghun, and Juyong Chung. "Therapeutics for acute otitis media." Journal of the Korean Medical Association 64, no. 9 (September 10, 2021): 624–30. http://dx.doi.org/10.5124/jkma.2021.64.9.624.

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Background: Acute otitis media (AOM) is diagnosed in patients with acute onset of signs and symptoms of inflammation in the middle ear, accompanied by middle ear effusion. AOM is a common infectious disease in children, and its diagnosis and treatment can have significant impacts on the health of children.Current Concepts: The evidence-based clinical practice guidelines in Korea and other countries provide recommendations to primary care clinicians regarding the management of children with AOM. The treatment strategy for AOM depends on the patient’s age, severity of symptoms, the presence of otorrhea, and the laterality.Discussion and Conclusion: For children aged from 6-months to 2-years with unilateral non-severe AOM and children aged 2 years or older with unilateral or bilateral non-severe AOM, the published guidelines provide the option of observation rather than immediate treatment with antibiotics. High-dose amoxicillin (80 to 90 mg a day) is the firstline antibiotic for treating AOM in patients without penicillin allergies. Children in whom symptoms persist after 48 to 72 hours of antibiotic treatment should be re-examined and amoxicillin/clavulanate should be used as second-line antibiotics. Careful follow-up is required to identify the complications and sequelae of AOM, and to determine the optimum treatment.
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45

Sagraves, Rosalie, and William Maish. "Therapy of Acute Otitis Media." PharmacoEconomics 6, no. 3 (September 1994): 202–14. http://dx.doi.org/10.2165/00019053-199406030-00004.

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46

Pereira, Maria Beatriz Rotta, and Berenice D. Ramos. "Acute and secretory otitis media." Jornal de Pediatria 74, no. 7 (November 15, 1998): 21–30. http://dx.doi.org/10.2223/jped.483.

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47

Bergus, George R. "Staving off acute otitis media." Postgraduate Medicine 90, no. 3 (September 1991): 99–106. http://dx.doi.org/10.1080/00325481.1991.11701036.

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48

Bezshapochny, S. B., and N. B. Sonnik. "ACUTE OTITIS MEDIA IN CHILDHOOD." Bulletin of Problems Biology and Medicine 4, no. 1 (2020): 9. http://dx.doi.org/10.29254/2077-4214-2020-4-158-9-12.

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49

S. HANSON, MARY JANE. "Acute Otitis Media in Children." Nurse Practitioner 21, no. 5 (May 1996): 72???81. http://dx.doi.org/10.1097/00006205-199605000-00006.

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50

Balter, Sharon E., and Scott F. Dowell. "Update on acute otitis media." Current Opinion in Infectious Diseases 13, no. 2 (April 2000): 165–70. http://dx.doi.org/10.1097/00001432-200004000-00012.

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