Case 2

A 10-month old black male develops fever to 1020F, vomiting, cough, and irritability. Physical examination showed mild rhinorrhea, normal conjunctiva and pharynx, clear breath sounds bilaterally, and a normal abdominal exam. The left tympanic membrane was normal, but the right tympanic membrane was bulging, dull and opaque, with purulent material visible behind the drum.

Questions

1. Which bacteria are the most likely etiologic agents of this infection?  Answer

2. How are these organisms acquired by the host?  Answer

3. What is known about the pathogenesis of the infection? Which structure is most important for normal drainage of the middle.ear?  Answer

4. How could the physician determine which bacterial agent is present in the middle ear?  Answer

5. Is prevention possible?  Answer

6. What antimicrobial agents are effective for the treatment of acute otitis media? Is there a drug of choice?  Answer

7. What are the complications and long-term consequences of the infection?  Answer