A school-age child has a history of chronic otitis media and is seen in the clinic with vertigo. The primary care pediatric nurse practitioner notes profuse purulent otorrhea from both pressure-equalizing tubes and a pearly-white lesion on one tympanic membrane ™. Which condition is most likely?

Question

Quizplus · Accepted Answer

The profuse purulent otorrhea from both pressure-equalizing tubes and the pearly-white lesion on one tympanic membrane are suggestive of cholesteatoma, which is a condition characterized by the accumulation of keratin debris within the middle ear. Cholesteatomas can develop as a complication of chronic otitis media, especially if pressure-equalizing tubes have been inserted. Mastoiditis is an inflammation of the mastoid bone, which can occur as a complication of untreated or inadequately treated acute otitis media. Otitis externa is an infection of the external ear canal, which typically causes pain and itching. Otitis media with effusion is a collection of fluid within the middle ear cavity, which can occur as a result of Eustachian tube dysfunction. None of these conditions are consistent with the findings described in this scenario.

A School-Age Child Has a History of Chronic Otitis Media