Author Question: A 5-year-old patient with a history of chronic otitis media complains of severe unilateral ear pain ... (Read 93 times)

mwit1967 · **on:** Jun 25, 2018

A 5-year-old patient with a history of chronic otitis media complains of severe unilateral ear pain that worsens at night. The pain has progressively worsened over the past 3 days.

Your examination reveals tenderness, erythema, and swelling below the right ear, and diminished hearing on the right. Which of the following is a likely diagnosis?
A. Sinus infection
B. Skull fracture
C. Mastoiditis
D. Foreign body

Question 2

Ear pain related to tenderness over the auricle and ear canal is most commonly related to:

A. Excessive exposure to noise
B. Cerumen impaction
C. Otitis externa
D. Mnire's disease

Joc · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: C
Mastoiditis refers to infection of the mastoid bone, which is almost always a complication of acute otitis media (AOM). The patient complains of radiating ear pain and fever. The pain is persistent (for days to weeks), severe, deep, and often worst at night. The hearing on the affected site is usually significantly diminished. As the condition progresses, there is swelling, erythema, and tenderness over the mastoid bone.

Answer to Question 2

ANS: C
Ear pain is most often seen in children and is usually associated with bacterial or viral upper respiratory infection. Complaints of ear pain in the summer are often associated with otitis externa (OE), owing to swimmer's ear. Complaints of primary ear pain decline with age and, in adults, are more likely associated with secondary conditions, such as sinus infection; dental disease; malignancy; other disorders of the head, face, and neck; and nervous and vascular symptoms.