What factors in ZM’s recent history should the clinician consider, and what additional questions should the clinician ask the mother? 

Patient with Otitis Externa

ZM is an 8-year-old male who is brought to the clinic by his mother for complaints of acute left ear pain. She has recently picked him up from a week-long stay at camp, and he stated his ear hurt so bad he was crying.

When his mother looked at this ear, she noticed the outside canal was very swollen. He could not even touch his ear. His mother states: “He is never sick, and he never cries.”

Past Medical History

All immunizations current

No history of surgeries

No history of allergies

No history of significant illness

Medications

Multivitamin, daily

Occasional allergy medication with children’s loratadine

Physical Examination

Pulse: 100; respiration rate: 22; temperature: 100.2 °F data scan

Left ear canal swollen; unable to access with otoscope to observe tympanic membrane

Swelling noted in lymph nodes below ear

Ear is red and warm to touch

Diagnosis

External otitis

Discussion Questions

What factors in ZM’s recent history should the clinician consider, and what additional questions should the clinician ask the mother?

What treatment options are indicated for ZM?

What patient teaching should the clinician provide?