• In a noninterventional, controlled, single-blinded trial, 251 children were examined in a university hospital emergency department setting to study the influence of acute otitis media on the relationship between rectal and auditory canal temperatures. Bilateral auditory canal temperatures were measured using an infrared detection probe and microprocessor by nursing staff blinded to the presence of acute otitis media. Correlation between rectal and auditory canal temperatures in children with (r =.81) and without (r=.75) acute otitis media were not significantly different. There was no significant difference between infected (38.1°C ± 1.0°C) and uninfected ears (38.0°C ± 1.0°C) with unilateral otitis (n = 75). Although significantly higher than in uninfected children, auditory canal temperatures of children with acute otitis media reflected elevated rectal temperatures and not differences in auditory canal temperatures between ears.