ent - kallastro

[ArchivalUser]

A 3-year-old girl presents with a temperature of 100.2°F and severe ear pain. "She gets these all the time," the parents tell you, "and Dr Treetemall always gives us the pink medicine and sometimes the white fruity one." The child is alert, with some discomfort, nasal congestion, and slight cough. Her tympanic membranes are red, with positive movement on insufflation. The tympanogram does show a peaked curve. What would be the most appropriate treatment?

A. Myringotomy for positive identification and treatment
B. Antihistamines and decongestants
C. Acetaminophen
D. Azithromycin (Zithromax)
E. Amoxicillin/potassium clavulanate (Augmentin)

[ArchivalUser]

E. Amoxicillin/potassium clavulanate (Augmentin)

[ArchivalUser]

I like to know though if we would go for A w/ Recurrent OM or if we would only go for A if the Om did not resolve??

[ArchivalUser]

I meant to say go for A if the OM did not resolve after Rxment??

[ArchivalUser]

answer is C....

i am also wrong in this question ....ben don't worry.....

The clinical vignette described is typical of myringitis, or inflammation of the tympanic membrane, but not of otitis media (OM). Therefore, antibiotic treatment would not be indicated. In OM, there would be blunting of the curve on tympanogram, and insufflation would reveal decreased mobility. In addition, with OM we would expect a more toxic-looking child. Decongestants or antihistamines have no proven value in treating myringitis or OM. Acetaminophen will help alleviate the pain.

Reference

Siegel RM, Kiely M, Bien JP, et al. Treatment of otitis media with observation and a safety-net antibiotic prescription. Pediatrics. 2003;112:527-531.

[ArchivalUser]

in OM, there will be no/reduced mobility of TM

[ArchivalUser]

wow, good question

[ArchivalUser]

assume question kallastro! Good Review