How can I differentiate between OME and acute otitis media in a child presenting with ear symptoms?

The primary way to differentiate between otitis media with effusion (OME) and acute otitis media (AOM) in a child presenting with ear symptoms is based on the presence of acute inflammation and the rapid onset of symptoms ³.

• Otitis Media with Effusion (OME): This condition is characterised by the presence of fluid (effusion) in the middle ear space, but it occurs without signs of acute inflammation or infection ³. Children with OME often present with symptoms such as hearing difficulties (e.g., mishearing, difficulty in groups, asking for repetitions), delayed speech and language development, ear discomfort, or tinnitus ³. It is typically not associated with rapid onset of symptoms, pain, or fever ²,³.
• Acute Otitis Media (AOM): AOM is defined by the presence of acute inflammation in the middle ear ³. It is accompanied by the rapid onset of symptoms and signs of an ear infection ³. AOM is typically associated with ear pain and/or fever ².