“She has a fever.” The case of JuJu F. JuJu had a classic case of AOM––an acute middle ear infection that occurred in a young child after an otherwise unremarkable upper respiratory viral infection....

“She has a fever.” The case of JuJu F.

JuJu had a classic case of AOM––an acute middle ear infection that occurred in a young child after an otherwise unremarkable upper respiratory viral infection. Her pharyngeal and adenoidal edema blocked drainage from the Eustachian tube, which caused accumulation of fluid in the middle ear. This fluid became a culture medium for local bacteria, which proliferated to cause purulent infection. She exhibited classic signs and symptoms of purulent otitis media: fever, ear pain (tugging at the ear), irritability, and vomiting. The pediatrician’s examination documented the signs of AOM: a bulging, dull, red tympanic membrane. The pediatrician also was appropriately careful to ensure, to the extent reasonable in an office examination, that she did not also have a related condition such as pneumonia or meningitis. Her chest was clear, indicating no concomitant pneumonia; her neck was supple, and her anterior fontanel was soft and not bulging, indicating that meningitis was not present. Like most children, she responded well to oral antibiotics, but, as many do, she developed bilateral SOM in the aftermath of the acute infection. In addition, as most cases do, the SOM resolved without further therapy. Please review our Chapter 1 case, “My daughter has a fever and an earache.” The Case of Anne M., and compare it with this case.