Skip to Main Content

++

Chapter 72. Upper Respiratory Tract Infections

++
++
++

ML is a 14-month-old girl diagnosed with acute otitis media. She presented to the pediatric clinic today with a fever of 102.4°F (39.1°C) and tugging of her right ear for the past 24 hours. She developed rhinorrhea, nasal congestion, and sneezing approximately 3 days ago, but those symptoms have improved. She attends daycare 3 days a week and has a 4-year-old brother who attends preschool. This is her first episode of acute otitis media. She had a urinary tract infection when she was 10 months old, which was treated with amoxicillin successfully. What risk factor(s) for otitis media is/are present in ML?

++
++
++

A. Female sex

++
++

B. Daycare attendance

++
++

C. Young sibling

++
++

D. Antibiotic therapy 4 months ago

++
++

E. B and C are both risk factors

++
++
++

ML has been vaccinated appropriately according to recommended childhood immunization schedules. The most likely bacterial pathogen causing her infection is:

++
++
++

A. Streptococcus pneumoniae

++
++

B. Streptococcus pyogenes

++
++

C. Moraxella catarrhalis

++
++

D. Staphylococcus aureus

++
++

E. Influenza

++
++
++

Acute otitis media should be diagnosed in a child with which of the following signs/symptoms?

++
++
++

A. Middle ear effusion only

++
++

B. Middle ear effusion and mild erythema of the tympanic membrane

++
++

C. Moderate bulging of the tympanic membrane and otalgia

++
++

D. Mild erythema of the tympanic membrane, middle ear effusion, and hearing impairment for at least 72 hours

++
++

E. None of these signs/symptoms are consistent with acute otitis media

++
++
++

JJ is a 13-month-old boy with bilateral acute otitis media that is not severe. He was treated for a similar episode 4 months ago with amoxicillin and developed a nonurticarial rash. Which of the following is the most appropriate treatment approach for JJ?

++
++
++

A. Amoxicillin-clavulanate

++
++

B. Azithromycin

++
++

C. Cefdinir

++
++

D. Clindamycin

++
++

E. Observation option

++
++
++

Adjunctive therapies for acute otitis media that are effective for reducing symptoms include:

++
++
++

A. Analgesics

++
++

B....

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.