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A 3 yr old boy is brought for a follow-up examination. He just completed a 10 day course of amoxicillin that has not resolved his right ear pain. He appears irritable. His temperatur is 38.9. Examination shows downward and lateral displacement of his right auricle with tenderness to palpation of the posterior auricular area; his neck is supple. Which of the following is most appropriate next step in diagnosis?
1. Bone scan
2. CT of head
3. Tympanometry
4. lumbar puncture
5.Tympanocentesis
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2. ct scan.........as pt might have developed mastoiditis (or may be cholestetoma )
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2. CT of head
tenderness to palpation of the posterior auricular area
he has Cx of otitis media: Mastoiditis.
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YES CT HE IS IRRITABLE AND THAT IS A SIGN OF MENINGITIS -CANNOT TAKE A CHANCE --DO CT.
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Yes that's what I guessed. Thx.
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i am a little bit confused in this q
because the syptoms goes with osteomylitis
so i would prefere to go with bone scan.
.second option is brain abcess if suspected due to mastoditis
CT scan is good here (but should be done with contrast)
lumbar puncture is not an option for 10 days disaese: so exclude miningitis.
this pt does not have Otitis media nor had (the pain is outside the earcanal)
actually i dont know the meaning of subble????
