With AOM, what additional condition may warrant a referral?

In the context of acute otitis media (AOM), a referral is typically warranted when there are complications or associated significant conditions that may require further evaluation or intervention. Periorbital sinusitis represents a concerning condition that can arise from the sinus cavities and can potentially lead to serious complications, such as orbital cellulitis or abscess, which could compromise vision or lead to further systemic issues.

In cases of AOM accompanied by periorbital sinusitis, there is a risk that the infection may spread to the surrounding tissues, therefore necessitating a more specialized approach and possibly imaging studies or more aggressive treatment strategies that might be beyond the scope of primary care.

Fever, nasal congestion, and rhinorrhea, while they can be associated symptoms in patients with AOM, are generally not indications for referral on their own. Fever is a common symptom in many infections, and nasal congestion and rhinorrhea are typical respiratory symptoms that do not usually indicate a complication that involves the need for specialized care.