Acute Otitis Media: The Daily PANCE Blueprint
A 3-year-old presents with ear pain, fever, and a bulging, erythematous, immobile tympanic membrane on pneumatic otoscopy. What is the most likely causative organism?
A. Pseudomonas aeruginosa
B. Streptococcus pneumoniae
C. Staphylococcus aureus
D. Respiratory syncytial virus
E. Candida albicans
Answer and topic summary
The answer is B. Streptococcus pneumoniae.
Acute otitis media follows a viral upper respiratory infection that lets nasopharyngeal bacteria ascend the eustachian tube; the leading bacterial causes are Streptococcus pneumoniae (most common), nontypeable Haemophilus influenzae, and Moraxella catarrhalis. Pseudomonas causes otitis externa (swimmer’s ear); Staphylococcus aureus is uncommon here; RSV is a viral co-traveler rather than the treated bacterial pathogen; and Candida does not cause typical AOM. When treatment is indicated, first-line therapy is high-dose amoxicillin.
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