For Sarah
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Bloomfield College *
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Medicine
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Jan 9, 2024
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docx
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Uploaded by SargentSnow3799
For Sarah, we will want to start by assessing the ear canal with an otoscope. An otoscope can be utilized
to help us visualize the ear canal, help identify abnormal findings, and hopefully help us reach a
diagnosis for our patient (Wu et al., 2021). For young Sarah, I expect to find erythema either at the
outside of the ear canal or inside, closer to the tympanic membrane. Otitis media is one of the most
common ailments in pediatric patient but can be quite difficult to accurately diagnose (Wu et al, 2021).
Sarah has been tugging at her ears, which leads me to believe they are causing her discomfort and could
be the source of her symptoms, including her elevated temperature.
I would diagnose this patient with bilateral otitis media. Otitis media can be defined as a middle
ear infection or inflammation, that can present with ear pain and fever (Johns Hopkins, 2023). These
common symptoms match the symptoms reported by Sarah’s mother, as well as the symptoms observed
from Sarah. Otitis media can be diagnosed with an otoscope, pneumatic otoscope, or tympanometry—
although this method can be difficult on small children due to difficulties remaining still (Johns Hopkins,
2023). Treatment for this condition will be dependent on symptom management and duration of illness.
Education will be helpful for the mom to help her predict ear infections in the future and manage them a
bit better. This education can include abstaining from tobacco smoke, staying updated with vaccinations,
and protecting from foreign pathogens (Danishyar, 2023).
We will also utilize pharmacological interventions to help Sarah battle her ear infection. Amoxicillin is a
great antibiotic choice for pediatric otitis media due to its higher concentration at the middle ear of the
patient (Danishyar, 2023). Carefully considering the patients allergies, it has been reported that Sarah
has an allergy to penicillin, meaning she will have an allergic reaction to the amoxicillin. When a penicillin
allergy exists, one single dose of azithromycin at 10 milligrams per kilograms can be utilized, or two
doses of clarithromycin at 15 milligrams per kilogram (Danishyar, 2023). Sarah weighs 18 kilograms, so I
would prescribe her 270 milligrams of azithromycin to help treat her otitis media, and encourage her
mom to continue to administer Tylenol to manage her pain and fever.
Danishyar A, Ashurst JV. Acute Otitis Media. [Updated 2023 Apr 15]. In: StatPearls [Internet]. Treasure
Island (FL): StatPearls Publishing; 2023 Jan-. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK470332/
Johns Hopkins (2023). Ear Infection (Otitis Media). Johns Hopkins Medicine.
Wu Z, Lin Z, Li L, Pan H, Chen G, Fu Y, & Qiu Q. (2021). Deep Learning for Classification of Pediatric Otitis
Media. The Laryngoscope, 131(7), E2344–E2351. https://doi.org/10.1002/lary.29302
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