What distinguishes acute otitis media from otitis media with effusion?

Acute otitis media is characterized by the presence of middle ear inflammation, typically accompanied by fluid accumulation and often associated with symptoms such as pain, fever, and irritability in children. This inflammation is usually a direct result of an upper respiratory infection leading to blockage of the Eustachian tube, resulting in infection.

In contrast, otitis media with effusion occurs when fluid remains in the middle ear space without the signs of acute infection. This condition can follow an episode of acute otitis media or can develop without any acute infection. The primary distinguishing factor is the presence of inflammation, which denotes an active infection in acute otitis media as opposed to the fluid that might be present in the absence of an inflammatory process in otitis media with effusion.

Other options do not effectively capture the pivotal difference. Hearing loss can occur in both conditions, and fever is common in acute otitis media but not necessarily present in otitis media with effusion. The duration of symptoms can vary, but it is primarily the evidence of inflammation within the middle ear that serves as the key distinguishing feature between these two conditions.