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A 3-year-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 temperature is 38.9 C (102 F). Examination shows downward and lateral displacement of the right auricle with tenderness to palpation of the posterior auricular area; his neck is supple. Which of the following is the most appropriate next step in diagnosis?

) Bone scan

) CT scan of the head

) Tympanometry

) Lumbar puncture

) Tympanocentesis

IS this mastoiditis as a complication of OM , so what do u think



) Tympanocentesis

Kaplan has a similar q, for mastoiditis complicated by otitis media, typanocentesis is diagnostic (culture) and therapeutic (drainage)


Diagnostic is clinical and first step in management is myringotomy+ antibiotics. Failure of treatment --- mastoidectomy.


i think we should do CT 1st (see the Q in world in ENT section )

Edited by dr_jojo on Mar 11, 2007 - 1:41 PM


I agree CT is the next step to confirm diagnosis.

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