LACK OF SPECIFIC SYMPTOMATOLOGY IN CHILDREN WITH ACUTE OTITIS-MEDIA

Although the symptoms of the acutely ill child are important both in t he diagnosis and follow-up of acute otitis media (AOM), data about the m are quite limited. We carried out a prospective survey by collecting information on 354 consecutive children visiting a pediatrician, otol aryngologist or general practitioner because of any kind of acute symp toms to compare symptoms of children with acute otitis media with thos e of children with other acute infectious diseases. The symptoms and s igns observed at home were recorded by the parents before the visit an d the findings in the physical examination were recorded later by the physician. AOM was diagnosed in 191 patients (54.0%). The most importa nt symptoms increasing the likelihood of AOM significantly were ear-re lated symptoms, such as earache (relative risk (RR) 5.4; P < 0.001), r ubbing of the ear (RR 5.0: P < 0.001) and feeling of blocked ear (RR 4 .5; P < 0.05). However, only 67.7% of children younger than 2 years of age with AOM had any ear-related symptoms. The children with tympanos tomy tubes had earache (47.8%) and rubbing of the ear (58.8%) of the s ame magnitude as did children without tubes. Rhinitis increased the li kelihood of AOM (RR 2.3; P < 0.001) as did excessive crying in childre n older than 2 years of age (RR 3.0; P < 0.001). Fever, earache or exc essive crying was present in 90.1% of patients with AOM but also in 72 .4% of patients without AOM. Many symptoms previously thought to be re lated to AOM, such as fever, cough, poor appetite, diarrhea and vomiti ng, were not more common in children with AOM than in children with ot her acute illnesses. The duration of any of the symptoms was not marke dly different in children with AOM than in children with other acute d iagnoses. We conclude that AOM does not cause any specific symptoms th at parents could use in their decision to seek medical advice for thei r child.