A1 Refereed original research article in a scientific journal

Symptoms and otoscopic signs in bilateral and unilateral acute otitis media




AuthorsUitti J, Laine M, Tähtinen P, Ruuskanen O, Ruohola A

Publication year2013

JournalPediatrics

Journal name in sourcePediatrics

Number in series2

Volume131

Issue2

First page e398

Last pagee405

Number of pages8

ISSN0031-4005

DOIhttps://doi.org/10.1542/peds.2012-1188

Web address http://api.elsevier.com/content/abstract/scopus_id:84873477806


Abstract
OBJECTIVE: Bilateral acute otitis media (AOM) is considered more severe than unilateral AOM, and several guidelines recommend more active treatment and/or follow-up of bilateral AOM. We studied whether bilateral AOM is a clinically more severe illness than unilateral AOM by comparing symptoms and otoscopic signs between bilateral and unilateral AOM. METHODS: Two hundred thirty-two children aged 6 to 35 months diagnosed with AOM were eligible. We surveyed the symptoms with a structured questionnaire and recorded the otoscopic signs systematically. RESULTS: Ninety-eight children had bilateral and 134 children unilateral AOM. Children with bilateral AOM were more often ,24 months than children with unilateral AOM (87% vs 75%; P = .032). Fever (<38°C) occurred in 54% and 36% (P = .006) and severe conjunctivitis in 16% and 44% (P = .047) of children with bilateral and unilateral AOM, respectively. In 15 other symptoms, we found no overall differences even when adjusted with age. We observed the following severe otoscopic signs in the bilateral and unilateral AOM group, respectively: moderate/marked bulging of tympanic membrane (63% and 40%; P = .001), purulent effusion (89% and 71%; P = .001), bulla formation (11% and 10%; P = .707), and hemorrhagic redness of tympanic membrane (7% and 10%; P = .386). Copyright © 2013 by the American Academy of Pediatrics.



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