Examination revealed normal vital signs and the painful swelling and erythema of the right ... center of the area of swelling. The ear canal and tympanic membrane were normal.

AOM may be diagnosed for mild TM bulging and ear pain for less than 48 hours or for intense TM erythema. In a nonverbal child, ear holding, tugging, or rubbing suggests ear pain. AOM should not be ...

b. Mild tympanic membrane bulging with injection but without intense erythema. Clinicians should not diagnose AOM in children who do not have middle-ear effusion (Figure 6). Figure 6. Retracted ...

“As clinicians use [these criteria], they should be aware that children with AOM may also present with recent onset of ear pain and intense erythema of the TM as the only otoscopic finding.

Figure 4: Hypothesized scenario of the TM and middle ear evolution in amniotes. Skeletal staining of embryos with alizarin red/alcian blue staining was performed according to previously described ...