How often does otitis media cause fever?

I read with interest “Otitis media? Not likely” in your “What’s the Verdict” column (J Fam Pract. 2014;63:47). I agree with Dr. Hickner’s assessment that a 3-month-old child who has a fever of 103°F should raise concern for other serious illnesses, yet I disagree that otitis media rarely causes fever.

Fever is relatively common in children with acute otitis media. Schwartz et al,¹ presented a case series of 671 children with otitis media. They could identify no cause of fever other than the ear infection in 23% of patients.

Thomas Bielanski, MD, FAAFP
Oak Park, Ill