Acute otitis media case study
Case Study 1:
HPI: A mother presents with her 2-year-old African American male child with complaints of ear pain and decreased sleep. Earlier this week, he had a runny nose and congestion with a mild cough that occurred mostly when lying down. His temperature is 100.7.
PE: Pt is walking around room, exploring in no acute distress.
HEENT: Mild nasal congestion, clear postnasal drainage, and lungs clear to auscultation. Ear exam reveals right tympanic membrane erythematous, translucent, in a neutral position, with no pus or fluid noted. Left tympanic membrane is full, reddish/orange in appearance, and opaque with pus. Acute otitis media case study.
Neck: Shotty anterior cervical adenopathy
Lungs: Clear to auscultation
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Although many pediatric patients present with common HEENT disorders such as ear infections, allergies, and strep throat, some patients present with rare disorders requiring specialist care. In your role, making this distinction between when to treat and when to refer is essential. For this Discussion, examine the following case studies and consider potential diagnoses and management strategies.
Diagnosis/Differential Diagnosis
Based on the signs and symptoms that the patient in this case scenario presented, it is likely that it is an infection of the middle ear called acute otitis media. (Peterson & Reintjes, 2016). These symptoms often occur during or after cold symptoms and are associated with the symptoms of headache, fever otorrhoea, irritability, vomiting, and diarrhea. Similarly, in this case, the child presented with complaints of nasal congestion, a running nose, and a cough before the ear pain Acute otitis media case study.
Besides, the clinician visualized a red, translucent, neutrally positioned and non-pus filled right tympanic membrane. The left tympanic membrane was reddish-orange, opaque, full and filled with pus. According to Peterson & Reintjes (2016), visual findings are consistent with acute otitis media. In the advanced form, acute otitis media can precede otitis media with effusion when patients present with vertigo, ringing in the ears or hearing loss. Potential differential diagnoses, in this case, include AOE and OME. In the former, patients present with a red, painful and itchy ear canal Acute otitis media case study.
Treatment and Management/Education
According to Hochman & Shapiro (2016), amoxicillin is the most recommended antibiotic for managing acute otitis media. However, not all cases of acute otitis media are managed using drugs. In other instances, patients are given supportive treatment since it is a self-limiting illness and this helps to prevent bacterial resistance. Otitis media is preventable using xylitol (Azarpazhooh, Lawrence & Shah, 2016). This substitute helps to reduce the proliferation and adherence of H influenzae and S. pneumonia in the oral and nasal cavities. Caregivers should be informed of the need to receive influenza and pneumococcal immunizations, avoiding exposure to tobacco and breastfeeding to boost a child’s immunity. Acute otitis media case study.
References
Azarpazhooh, A., Lawrence, H. P., & Shah, P. S. (2016). Xylitol for preventing acute otitis media in children up to 12 years of age. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.cd007095.pub3
Hochman, M., & Shapiro, N. (2016). Treatment of Acute Otitis Media in Children. 50 Studies Every Pediatrician Should Know, 87-92. doi:10.1093/med/9780190204037.003.0013
Peterson, S., & Reintjes, S. (2016). Otitis Externa, Otitis Media, and Mastoiditis. Oxford Medicine Online. doi:10.1093/med/9780199976805.003.0011 Acute otitis media case study