Question 333 · LEK · Ear diseases
A 3-year-old child has had a fever of 39.5°C for two days, which has been causing the child to wake up screaming at night and have a poor appetite. The child has had a watery runny nose for five days. Also, a purulent discharge from the right ear has been observed. What is the optimal course of action?
- A. discharge culture should be performed and, once the results have been obtained, a targeted antibiotic therapy should be instituted.
- B. pneumonia should be diagnosed and empirical antibiotic therapy should be instituted.
- C. in all likelihood, it is an acute uncomplicated inflammation of the upper airways. Symptomatic treatment of the runny nose should be instituted.
- D. acute purulent otitis media should be diagnosed and empirical antibiotic therapy should be instituted.
- E. acute non-purulent otitis media should be diagnosed and no action should be taken - the child should remain under careful observation for 48 hours.
Hint
A cold followed by high fever, night-time screaming and purulent ear discharge suggests a specific complication with tympanic perforation.
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