Scenario
An 18-month-old boy presents with a 3-day history of yellow nasal discharge and left ear rubbing. He was kept home from daycare, and this morning, he developed pink, crusted eyes with yellow discharge. He is fussy, eating poorly, and has a low-grade fever of 100°F.
On exam, he is alert but fussy, with a normal throat and lungs. The left tympanic membrane is bulging, red, and has fluid behind it, while the ear canal is clear. Both eyes show yellow discharge and conjunctival redness.
Most Likely Cause, Pathogen, and Mode of Transmission
In the above case, otitis media (OM), a middle ear infection, is the most likely cause of this 18-month-old boy’s symptoms. Bacteria or viruses, such as Streptococcus pneumoniae, Haemophilus influenzae, or, less commonly, Moraxella catarrhalis, are most likely to be the cause of the pathogen. Otitis media is contagious and can be transmitted through contact with an infected individual, such as coughing, sneezing, or touching contaminated objects or surfaces.
Supporting Data for Diagnosis
The diagnosis of otitis media was made in this case because the condition is an infection of the middle ear that causes inflammation, fluid collection, and pressure abnormalities in the affected ear. Some of the symptoms of otitis media are earache, fever, irritability, difficulty sleeping, decreased appetite, and hearing loss (Danishyar & Ashurst, 2022). Additionally, otitis media can also be characterized by decreased hearing acuity, impaired speech, and persistent effusion in the ear (Danishyar & Ashurst, 2022). Environmental stresses, including allergies, tobacco smoke, air pollution, and some immunizations, can, in some situations, predispose a child to otitis media.
Treatment Strategies
Antibiotics such as gentamycin are frequently used in treatment regimens, both topical (ear drops) and systemic (given orally or intravenously). Children with otitis media frequently require their ears to be cleaned and fluid from the middle ear suctioned out (Danishyar & Ashurst, 2022). In some circumstances, surgery may be required to repair a perforated eardrum.
Pain medications such as ibuprofen or acetaminophen might be administered to alleviate the patient’s symptoms. Furthermore, nasal decongestants and humidifiers reduce inflammation and refill fluid in the middle ear. Finally, his parents should practice proper hygiene, including washing their hands and any shared items with soap and water, and avoiding contact with anyone infected.
References
Danishyar, A., & Ashurst, J. V. (2022). Acute otitis media. PubMed; StatPearls Publishing. Web.
Sooriyamoorthy, T., & De Jesus, O. (2023). Conductive hearing loss. PubMed; StatPearls Publishing. Web.