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5 yr old girl with h/o recurrent otitis media and myringostomy tubes comes with b/l ear pain and discharge for the past one week.her temp is 38.1c.physical ex. shows both ear canals are filled with thick yellow drainage .she is uncomfortable and finds it difficult to let you look in her ears.
The next step in her management is
a) refer her for evaluation by her otolaryngologist,as her tubes do not seem to be working well
b)rx with antibiotic eardrops alone
c)rx with iv antibiotics
d)rx with oral antibiotics
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a) refer her for evaluation by her otolaryngologist,as her tubes do not seem to be working well
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b)rx with antibiotic eardrops alone
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the tube should habe been draining
if not ther is a problem
the girl should be refered
aaa
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) refer her for evaluation by her otolaryngologist,as her tubes do not seem to be working well
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ans is rx with antibiotic ear drops alone.
myringotomy tubes allow infected material to exit the middle ear and drain thru the ear canal.
therefore the tubes appear to be working well,and reevaluation is not necessary.
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Dear dr_ma,
could you pls tell me the source of your q & A? My understanding is that antibiotic drops is not going to help in thick profuse discharge as it is like adding a drop of water in the ocean. Im personally in favour of oral ABX & believe me Im doing research in middle ear inflmn. Casanova, they are asking the next step* in Mx...which should be starting ABX. Eventually you will refer her to the ENT no doubt.
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well gigolo these are from kaplan q book, explanation is, the best way of rx is delivery of antibiotics to the area of infection in the simplest manner ,your reasoning is also good but i think we can clear the discharge and instill the drops ,and coming to oral antibiotics these are not indicated unless the infection does not respond to eardrops.
