Pediatrics

7 year old boy with ear pain

Shilpa Gulati on May 26, 2013

A 7 year old boy presents to your office on a cold March day with his mother, who reports that he has had a cough and runny nose for the last several days, and recently started tugging on his ears. He has been somewhat cranky and tired, and vomited once. His past medical history is significant for ear infections in the past, with his last otitis media being 5 months ago. His immunizations are up to date, including pneumococcal vaccine. No current medications other than tylenol, and no known allergies.

  • Temp  99 C
  • HR  95
  • BP  105/65
  • RR  24

General: Patient is alert and responsive

HEENT: Right tympanic membrane is erythematous and bulging with poor mobility on pneumatic otoscopy. Left TM is clear with good mobility. Throat non-erythematous. Cervical lymphadenopathy.

Pulm: Lungs are clear to auscultation.

Rest of exam wnl.

Q What is the most likely bug causing this patient’s otitis media?

Expand all answers
Pseudomonas
Haemophilus influenzae
Streptococcus Pneumoniae
Moraxella catarrhalis

A 7 year old boy presents to your office on a cold March day with his mother, who reports that he has had a cough and runny nose for the last several days, and recently started tugging on his ears. He has been somewhat cranky and tired, and vomited once. His past medical history is significant for ear infections in the past, with his last otitis media being 5 months ago. His immunizations are up to date, including pneumococcal vaccine. No current medications other than tylenol, and no known allergies.

  • Temp  99 C
  • HR  95
  • BP  105/65
  • RR  24

General: Patient is alert and responsive

HEENT: Right tympanic membrane is erythematous and bulging with poor mobility on pneumatic otoscopy. Left TM is clear with good mobility. Throat non-erythematous. Cervical lymphadenopathy.

Pulm: Lungs are clear to auscultation.

Rest of exam wnl.

Q What is the most likely bug causing this patient’s otitis media?

Expand all answers
Pseudomonas
Haemophilus influenzae
Streptococcus Pneumoniae
Moraxella catarrhalis

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