Otitis media and externa (pediatrics) Quiz: Ace Your Exams

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A 1-year-old boy is brought to his pediatrician’s office for evaluation of ear pain. The parent reports that the patient has been increasingly fussy over the past two days and has been holding the left ear in discomfort. They report that these symptoms were preceded by cough and nasal congestion. The patient was born full term and has otherwise been healthy since birth. Temperature is 39°C (102°F), blood pressure is 100/60 mmHg, pulse is 115/min, respiratory rate is 30/min, and oxygen saturation is 99% on room air.  On physical examination, there is no erythema of the pinna, no pain with manipulation of the pinna, and there is no otorrhea or visible swelling of the ear. There is no mastoid tenderness to palpation bilaterally. Which of the following is the best next step in management?

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