Which combination of symptoms is most characteristic of acute otitis media?

• A. Cough and wheeze
• B. Sore throat only
• C. Dizziness and fatigue
• D. Pain, fever, and potential hearing loss

Answer: (D)

Acute otitis media classically presents with ear pain from inflammation and pressure in the middle ear, often accompanied by fever as the infection develops. The presence of fluid in the middle ear and an inflamed tympanic membrane can lead to a temporary conductive hearing loss, which is why hearing symptoms are included in the typical picture. This combination—ear pain plus fever and potential hearing change—best captures the characteristic presentation of AOM.

The other patterns don’t fit as well because they point to different issues. Cough and wheeze are more typical of a lower airway or viral URI pattern rather than the middle-ear infection itself. A sore throat alone suggests pharyngitis. Dizziness and fatigue can occur with many conditions and don’t specifically indicate middle-ear involvement.