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A 3-year-old boy presents to the pediatrician crying with ear pain and his temperature has been 101°F (38.3°C) for several days. His mother states that other children at his daycare center have been having similar symptoms. She further describes that he was fed formula and was not breastfed. The mother admits that she smokes cigarettes daily. On exam, the boy is irritable and crying, and frequently tugs on his left ear. Both tympanic membranes appear erythematous, and the left appears opaque and bulging with decreased mobility on pneumatic otoscopy. Which of the following is the best next step in management?
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A 3-year-old previously healthy female is brought to your office by her mother. The mother reports the child has been crying and pulling at her right ear over the past 2 days, and reports the patient has been febrile the past 24 hours. The patient’s past medical history is unremarkable, although the mother reports the patient had a “common cold” a week ago which resolved without intervention. Her temperature is 101.6 deg F (38.7 deg C), blood pressure is 100/70 mmHg, pulse is 120/min, and respirations are 22/min. Otoscopic exam is seen in Figure A. What is the most likely diagnosis?
Malignant otitis externa
Acute otitis externa
Acute otitis media
Otitis media with effusion
A 6-year-old previously healthy boy is brought to the emergency department for right ear pain. His mother states he has been pulling at his ear for the past 2 days and has complained of discomfort. She states he felt warm but has not taken his temperature. His birth history is unremarkable and he has no significant medical history. His temperature is 100.4°F (38.0°C), blood pressure is 94/54 mmHg, pulse is 100/min, respirations are 17/min, and oxygen saturation is 98% on room air. Physical exam is notable for the finding in Figure A. Which of the following is the most likely etiology of this patient's symptoms?