Otitis media and externa (pediatrics) Quiz: Ace Your Exams
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A 3-year-old boy is brought to his primary pediatrics PA’s office for evaluation of ear pain. The parent reports that the patient has been holding the right ear in discomfort for the past 24 hours. They report an associated cough and nasal congestion. The patient was born full term and has otherwise been healthy since birth. Temperature is 39.4°C (103°F), blood pressure is 107/55 mmHg, pulse is 102/min, respiratory rate is 32/min, and oxygen saturation is 99% on room air. Physical examination demonstrates an erythematous, bulging tympanic membrane with a purulent effusion and impaired mobility following insufflation. There is no otorrhea present. The patient is started on high-dose amoxicillin and acetaminophen for analgesia. Forty-eight hours later, the patient returns for reassessment with persistent ear discomfort. Repeat otoscopic examination demonstrates persistent erythema, bulging, and purulent effusion of the tympanic membrane. Which of the following is the best next step in management?
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