Otitis media secretions from the nasopharynx into the normally sterile middle-ear space, the fluid may then become infected — usually with bacteria. The virus that caused the initial URI (upper respiratory infection) can itself be identified as the pathogen causing the infection. As its typical symptoms overlap with other conditions, such as acute external otitis, clinical history alone is not sufficient to predict whether acute otitis media is present; it has to be complemented by visualization of the tympanic membrane. Examiners use a pneumatic otoscope with a rubber bulb attached to assess the mobility of the tympanic membrane. In more severe cases,
Common name not always English. For example, "Dikkop" is the centuries-old South African vernacular name for their two local species: "Burhinus capensis" is the Cape dikkop (or "gewone dikkop", not to mention the presumably much older Zulu name "umBangaqhwa"); "Burhinus vermiculatus" is the "water dikkop". The thick joints in question are not even, in fact, the birds’ knees, but the intertarsal joints—in lay terms the ankles. Furthermore, not all species in the genus have “thick knees”, so the thickness of the "knees" of some species is not of clearly descriptive significance. The family Burhinidae has members that have various common names even