The 2-year child has complaints of the ear that have deprived him of sleep due to the associated pain. There are two possible diagnosis in this case; on one hand the patient could be having a swimmer’s ear condition also known as the acute otitis externa which usually a condition that causes, inflammation, irritation as well as infection on the ear canal that runs from the eardrum to the external region of the ear (Burns, Dunn, Brady, Starr & Blosser, 2013). The condition is characterized by the production of an odorless clear discharge from the ear which can advance to pus in the later stages if not managed early. The patient may develop a fever, redness of the outer parts of the ear, lymph nodes swelling, and a full blockage of the ear canal.
On the other hand, the patient could be diagnosed with acute otitis media which is a condition that affects the middle ear causing inflammation, irritation and an infection that leads to the formation of opaque pus in the region between behind the eardrum. Once this infection occurs, the child will suffer a fever with temperatures of up to 100.4ºF and above (Burns, Dunn, Brady, Starr & Blosser, 2013). In this patient, the likely condition is the acute otitis media as indicated by the presence of opaque pus since in case of acute otitis externa, there is a clear odorless discharge. On the other hand, the swelling in this patient is much concentrated in the internal region as indicated by the left tympanic membrane which is full probably due to inflammation (Burns, Dunn, Brady, Starr & Blosser, 2013).
This condition has been caused by a bacterial infection as indicated by the patient’s development of lymphadenitis which is a condition that causes the swelling of the lymph nodes. Lymphadenitis has accompanying symptoms such as a runny nose, a sore throat as well as congestion of the lungs with a mild cough (Jarvis, 2015). These signs are a manifestation of the infection within the ear that has advanced into the other systems and thus leaving the primary diagnosis as acute otitis media influenced by a bacterial infection. The development of Lymphadenitis is another unique characteristic of acute otitis media (Burns, Dunn, Brady, Starr & Blosser, 2013).
Treatment and management
The patient will be treated on a dose of an antibiotic and pain killers to relive the pain, provide comfort and help recover normal sleeping patterns disrupted by the irritation within the ear. Amoxillin dosage of about 25 mg/2.2 pounds body weight, with two daily doses of twelve hours apart and oral ibuprofen dosage of 5 mg/kg, three times in a day (8 hours apart) will be appropriate. The parent can also try to use a warm compressor on the ear region prior to sleeping to help relieve the pain. The condition will mostly subside within 72 hours and the child will regain normal activity (Lieberthal et al., 2013).
Patient education
The parent should ensure that the child’s immunization schedule is updated especially on the case of pneumococcal vaccinations. On the other hand, the parent should ensure that the child’s ear canal is free of moisture especially after a bath (Lieberthal et al., 2013). The vigorous scratching of the ear should also be avoided and the cleaning of the internal ear should only be done when necessary. It is also important to avoid the use of headphones or such earring aid for the young child (Burns, Dunn, Brady, Starr & Blosser, 2013).
References
Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., & Blosser, C. G. (2013). Pediatric primary care(5th ed.). Philadelphia, PA: Elsevier.
Jarvis, C. (2015). Physical examination & health assessment (7th ed.). St. Louis, MO: Saunders Elsevier.
Lieberthal, A. S., Carroll, A. E., Chonmaitree, T., Ganiats, T. G., Hoberman, A., Jackson, M. A., & Schwartz, R. H. (2013). The diagnosis and management of acute otitis media. Pediatrics, 131(3), e964-e999.
