The Daily PANCE and PANRE Question 39

A 6-year-old female presents complaining of right ear pain. The tympanic membrane cannot be well visualized. She complains of pain when the tragus is manipulated. Several periauricular lymph nodes are easily palpable. Which of the following is the most likely diagnosis?

  1. acute otitis media
  2. acute otitis externa
  3. eustachian tube dysfunction
  4. Ramsay-Hunt syndrome
  5. perforated tympanic membrane

Answer: B

Acute otitis externa

OE is described here. OM would not cause preauricular nodes and tragal tenderness. Eustachian tube dysfunction would cause middle ear pain (like when you're up in a plane). Ramsay-Hunt is herpes zoster of the ear canal and would be visible. A perforated TM would cause middle ear, not external ear pain (typically).

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