Thirty children with clinical evidence of otitis media underwent tympanocentesis. Streptococcus pneumoniae was the predominant organism recovered (63%). Three cases of Hemophilus influenzae, alone or in combination with S pneumoniae, were identified. Other organisms found were Staphylococcus albus, Neiserria species. Group A B-hemolytic Streptococcus, and anaerobes. In four patients (13%) no organism was recovered. All isolates were ampicillin susceptible. No relationship was found between WBC, temperature, or age and the organism recovered. Tympanocentesis did not provide any information resulting in an alteration of therapy. Tympanocentesis may be indicated for relief of pain or for periodic surveillance of organism sensitivities, but is not justified in the emergency department for uncomplicated acute otitis media. [Friedman A, Fleisher GR, Henretig F, Handler S, Campos JM: Otitis media: Update on etiology and management. Ann Emerg Med 11:181-183, April 1982.]