A 15-month-old boy is brought by both parents to his family physician with a 2-day history of fever, irritability, and frequent tugging of his left ear. This was preceded by a 1-week history of nasal congestion, cough, and rhinorrhea. On otoscopy, his left tympanic membrane (TM) appears erythematous, cloudy, bulging, and exudative (Figure 26-1). His left TM fails to move on pneumatic otoscopy. The physician diagnoses acute otitis media and decides with the parents to prescribe a 10-day course of amoxicillin; the child recovers uneventfully.
In follow-up 2 months later, the child appears healthy and is meeting all his developmental milestones. On otoscopic examination, air-fluid levels are seen in the right ear (Figure 26-2). The physician explains the diagnosis of otitis media with effusion to the parents and arranges follow-up. Three months later the effusion is completely resolved.