Otitis media

A 6-year-old boy is brought to the pediatrician for evaluation of left ear pain. The patient's mother states, “He has been tugging on his left ear for the past three days; he just cannot seem to get any relief.” The patient has been taking tylenol at home for symptomatic relief. Temperature is 38.0°C (100.4°F), pulse is 99/min, respirations are 16/min, and blood pressure is 100/65 mmHg. Physical examination is notable for the following finding:

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Which of the following pathogens is the most likely cause of this patient’s clinical presentation?

Key Takeaways

Otitis media is an infection of the middle ear, which is the space behind the eardrum. It is most common in young children though it can occur at any age. Otitis media is often caused by a bacterial infection, such as Streptococcus pneumoniae, and Haemophilus influenzae, and it is usually a complication of cold or upper respiratory infection.

Symptoms may include abrupt onset ear pain in young children, increased crying, and poor sleep. Decreased eating and fever may also be present. Treatment may involve pain management, anti-inflammatories, and antibiotics.

Otitis media

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Otitis media

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Otitis media

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