Myringitis is a form of acute otitis media in which vesicles develop on the tympanic membrane.
Myringitis can develop with viral, bacterial (particularly Streptococcus pneumoniae), or mycoplasmal otitis media. Pain occurs suddenly and persists for 24 to 48 h. Hearing loss and fever suggest a bacterial origin. Diagnosis is based on otoscopic visualization of vesicles on the tympanic membrane.
Because differentiation among a viral, bacterial, and mycoplasmal cause is difficult, antibiotics effective against organisms causing otitis media are prescribed (see Table: Guidelines for Using Antibiotics in Children With Acute Otitis Media*). Severe, continued pain may be relieved by rupturing the vesicles with a myringotomy knife or by oral analgesics (eg, oxycodone with acetaminophen). Topical analgesics (eg, benzocaine, antipyrine) may also be beneficial.