A 3-year-old child presents with a 2-week history of what the parents describe as “not hearing well.” The child has had several upper respiratory infections over the past few months. On examination, the child is afebrile and the tympanic membranes are dull and retracted with poor mobility. What is the most common cause of hearing loss in a child of this age?
A 3-year-old presents with a 2-day history of right-sided purulent conjunctivitis and has now developed ear pain. On examination, the right tympanic membrane is bulging and erythematous. What is the most likely causative organism?
A 10-year-old competitive swimmer presents with a 2-day history of right ear pain, itching, and a feeling of fullness. Examination reveals diffuse erythema and edema of the ear canal with a small amount of thick, white, clumpy discharge. The tragus is tender to palpation. What is the most appropriate initial treatment?
A 2-year-old boy presents with a 3-month history of persistent, malodorous, bloody right ear drainage and progressive hearing loss. He has been treated with multiple courses of topical and oral antibiotics for presumed otitis media with perforation without improvement. Otoscopy reveals a polypoid mass filling the middle ear space. CT scan shows a soft tissue mass with extensive destruction of the temporal bone. What is the most likely diagnosis?
A 2-year-old presents with a fever of 39.0°C (102.2°F), severe ear pain, and postauricular tenderness and erythema. On examination, the right pinna is displaced outward and downward. The tympanic membrane is bulging and erythematous. These clinical findings are most characteristic of which complication of acute otitis media?
A 3-year-old with tympanostomy tubes, placed 6 months ago for recurrent acute otitis media, develops purulent drainage from his left ear canal. He is afebrile and does not appear systemically ill. What is the recommended first-line therapy for this child’s acute otitis media-associated tube otorrhea?
A newborn is noted to have a small, pit-like depression just anterior to the helix of the left ear. The infant is otherwise healthy, and the structure is not red, swollen, or draining. What is the most appropriate management for this finding?
A 5-year-old child is brought to the emergency department after falling from a playground structure and striking his head. During the physical examination, the physician notes a large, bruised area behind the left ear over the mastoid process. What is this clinical sign called and what does it suggest?
A 4-year-old child with no significant past medical history is diagnosed with uncomplicated, non-severe, unilateral acute otitis media. The parents are reliable, have good access to follow-up care, and express concerns about antibiotic overuse. What is the most appropriate initial management strategy?
An 8-year-old boy with type 1 diabetes presents with severe, deep right ear pain, purulent otorrhea, and fever. Examination reveals significant erythema and swelling of the external ear canal, granulation tissue on the floor of the canal, and tenderness with manipulation of the pinna. What is the most critical diagnosis to consider given his underlying condition and presentation?
