A 5-year-old patient with a history of chronic otitis media complains of severe unilateral ear pain that worsens at night. The pain has progressively worsened over the past 3 days
Your examination reveals tenderness, erythema, and swelling below the right ear, and diminished hearing on the right. Which of the following is a likely diagnosis?
A. Sinus infection
B. Skull fracture
C. Mastoiditis
D. Foreign body
ANS: C
Mastoiditis refers to infection of the mastoid bone, which is almost always a complication of acute otitis media (AOM). The patient complains of radiating ear pain and fever. The pain is persistent (for days to weeks), severe, deep, and often worst at night. The hearing on the affected site is usually significantly diminished. As the condition progresses, there is swelling, erythema, and tenderness over the mastoid bone.
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