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1. A 30-year-old woman complained of drainage from her ear for the past three months. She admitted that her hearing was diminished in that ear. She had a history of recurrent ear infections since childhood.
Photo courtesy of Vladimir Zlinsky, MD, in Roy F. Sullivan, PhD. Audiology Forum: video otoscopy, www.rcsullivan.com. Reprinted from The Color Atlas of Family Medicine. 2nd ed.
Diagnosis: Cholesteatoma, similar to an epidermal inclusion cyst in the skin, produces keratinaceous material that fills the middle ear, causing hearing loss and otorrhea.
For more information, see “Diminished hearing.” J Fam Pract. 2013.
For the next photograph, proceed to the next page >>
2. A 2-year-old child was brought for a well-child exam two months after an episode of acute otitis media. He appeared healthy and was meeting all of his developmental milestones. An otoscopic examination revealed air-fluid levels in the right ear.
Photo courtesy of Frank Miller, MD. Reprinted from The Color Atlas of Family Medicine. 2nd ed.
Diagnosis: Otitis media with effusion, which is a characterized by fluid in the middle ear in a patient without signs or symptoms of an acute ear infection. The most common problem, present in more than half of patients, is mild hearing loss. This is usually identified when parents express concern regarding their child’s behavior, performance at school, or language development. The absence of signs and symptoms of acute illness assists in differentiating OME from AOM.
For more information, see “Air-fluid levels in ear.” J Fam Pract. 2013.
For the next photograph, proceed to the next page >>
3. A 15-month-old boy was brought in with a two-day history of fever, irritability, and frequent tugging on his left ear. The week before, he had nasal congestion, cough, and rhinorrhea. On otoscopy, his left tympanic membrane (TM) appeared erythematous, cloudy, and bulging. The TM failed to move on pneumatic otoscopy.
Photo courtesy of William Clark, MD. Reprinted from The Color Atlas of Family Medicine. 2nd ed.
Diagnosis: Acute otitis media, which is characterized by middle-ear effusion in a patient with signs and symptoms of acute illness (eg, fever, irritability, otalgia).
For more information, see “Ear pain in baby.” J Fam Pract. 2013.
For the next photograph, proceed to the next page >>
4. A 72-year-old man sought treatment for an earache in his left ear. He said that the pain began when he got a new “in the canal” hearing aid for his left ear a month earlier.
Photo courtesy of Dr. Roy F. Sullivan. Reprinted from The Color Atlas of Family Medicine. 2nd ed.
Diagnosis: Acute otitis externa, secondary to ear canal damage done by using the new hearing aid, caused the viscous purulent discharge and narrowing of the ear canal.
For more information, see “Earache.” J Fam Pract. 2013.
For the next photograph, proceed to the next page >>
5. Parents brought their 3-year-old daughter to an urgent care facility because she had been crying all day. The child was irritable, had scant otorrhea, and had been pulling on her right ear.
Photo courtesy of William Clark, MD. Reprinted from The Color Atlas of Family Medicine. 2nd ed.
Diagnosis: Otoscopy revealed an erythematous, swollen external auditory canal and a foreign object. The parents reported that their child had been playing with a toy beaded necklace when she started crying. The patient was referred to an otolaryngologist, who removed the bead using an operating microscope for visualization. She evaluated the child for a co-existing otitis externa and decided that the external canal was markedly inflamed and probably infected.
For more information, see “Object in ear.” J Fam Pract. 2013.
1. A 30-year-old woman complained of drainage from her ear for the past three months. She admitted that her hearing was diminished in that ear. She had a history of recurrent ear infections since childhood.
Photo courtesy of Vladimir Zlinsky, MD, in Roy F. Sullivan, PhD. Audiology Forum: video otoscopy, www.rcsullivan.com. Reprinted from The Color Atlas of Family Medicine. 2nd ed.
Diagnosis: Cholesteatoma, similar to an epidermal inclusion cyst in the skin, produces keratinaceous material that fills the middle ear, causing hearing loss and otorrhea.
For more information, see “Diminished hearing.” J Fam Pract. 2013.
For the next photograph, proceed to the next page >>
2. A 2-year-old child was brought for a well-child exam two months after an episode of acute otitis media. He appeared healthy and was meeting all of his developmental milestones. An otoscopic examination revealed air-fluid levels in the right ear.
Photo courtesy of Frank Miller, MD. Reprinted from The Color Atlas of Family Medicine. 2nd ed.
Diagnosis: Otitis media with effusion, which is a characterized by fluid in the middle ear in a patient without signs or symptoms of an acute ear infection. The most common problem, present in more than half of patients, is mild hearing loss. This is usually identified when parents express concern regarding their child’s behavior, performance at school, or language development. The absence of signs and symptoms of acute illness assists in differentiating OME from AOM.
For more information, see “Air-fluid levels in ear.” J Fam Pract. 2013.
For the next photograph, proceed to the next page >>
3. A 15-month-old boy was brought in with a two-day history of fever, irritability, and frequent tugging on his left ear. The week before, he had nasal congestion, cough, and rhinorrhea. On otoscopy, his left tympanic membrane (TM) appeared erythematous, cloudy, and bulging. The TM failed to move on pneumatic otoscopy.
Photo courtesy of William Clark, MD. Reprinted from The Color Atlas of Family Medicine. 2nd ed.
Diagnosis: Acute otitis media, which is characterized by middle-ear effusion in a patient with signs and symptoms of acute illness (eg, fever, irritability, otalgia).
For more information, see “Ear pain in baby.” J Fam Pract. 2013.
For the next photograph, proceed to the next page >>
4. A 72-year-old man sought treatment for an earache in his left ear. He said that the pain began when he got a new “in the canal” hearing aid for his left ear a month earlier.
Photo courtesy of Dr. Roy F. Sullivan. Reprinted from The Color Atlas of Family Medicine. 2nd ed.
Diagnosis: Acute otitis externa, secondary to ear canal damage done by using the new hearing aid, caused the viscous purulent discharge and narrowing of the ear canal.
For more information, see “Earache.” J Fam Pract. 2013.
For the next photograph, proceed to the next page >>
5. Parents brought their 3-year-old daughter to an urgent care facility because she had been crying all day. The child was irritable, had scant otorrhea, and had been pulling on her right ear.
Photo courtesy of William Clark, MD. Reprinted from The Color Atlas of Family Medicine. 2nd ed.
Diagnosis: Otoscopy revealed an erythematous, swollen external auditory canal and a foreign object. The parents reported that their child had been playing with a toy beaded necklace when she started crying. The patient was referred to an otolaryngologist, who removed the bead using an operating microscope for visualization. She evaluated the child for a co-existing otitis externa and decided that the external canal was markedly inflamed and probably infected.
For more information, see “Object in ear.” J Fam Pract. 2013.
1. A 30-year-old woman complained of drainage from her ear for the past three months. She admitted that her hearing was diminished in that ear. She had a history of recurrent ear infections since childhood.
Photo courtesy of Vladimir Zlinsky, MD, in Roy F. Sullivan, PhD. Audiology Forum: video otoscopy, www.rcsullivan.com. Reprinted from The Color Atlas of Family Medicine. 2nd ed.
Diagnosis: Cholesteatoma, similar to an epidermal inclusion cyst in the skin, produces keratinaceous material that fills the middle ear, causing hearing loss and otorrhea.
For more information, see “Diminished hearing.” J Fam Pract. 2013.
For the next photograph, proceed to the next page >>
2. A 2-year-old child was brought for a well-child exam two months after an episode of acute otitis media. He appeared healthy and was meeting all of his developmental milestones. An otoscopic examination revealed air-fluid levels in the right ear.
Photo courtesy of Frank Miller, MD. Reprinted from The Color Atlas of Family Medicine. 2nd ed.
Diagnosis: Otitis media with effusion, which is a characterized by fluid in the middle ear in a patient without signs or symptoms of an acute ear infection. The most common problem, present in more than half of patients, is mild hearing loss. This is usually identified when parents express concern regarding their child’s behavior, performance at school, or language development. The absence of signs and symptoms of acute illness assists in differentiating OME from AOM.
For more information, see “Air-fluid levels in ear.” J Fam Pract. 2013.
For the next photograph, proceed to the next page >>
3. A 15-month-old boy was brought in with a two-day history of fever, irritability, and frequent tugging on his left ear. The week before, he had nasal congestion, cough, and rhinorrhea. On otoscopy, his left tympanic membrane (TM) appeared erythematous, cloudy, and bulging. The TM failed to move on pneumatic otoscopy.
Photo courtesy of William Clark, MD. Reprinted from The Color Atlas of Family Medicine. 2nd ed.
Diagnosis: Acute otitis media, which is characterized by middle-ear effusion in a patient with signs and symptoms of acute illness (eg, fever, irritability, otalgia).
For more information, see “Ear pain in baby.” J Fam Pract. 2013.
For the next photograph, proceed to the next page >>
4. A 72-year-old man sought treatment for an earache in his left ear. He said that the pain began when he got a new “in the canal” hearing aid for his left ear a month earlier.
Photo courtesy of Dr. Roy F. Sullivan. Reprinted from The Color Atlas of Family Medicine. 2nd ed.
Diagnosis: Acute otitis externa, secondary to ear canal damage done by using the new hearing aid, caused the viscous purulent discharge and narrowing of the ear canal.
For more information, see “Earache.” J Fam Pract. 2013.
For the next photograph, proceed to the next page >>
5. Parents brought their 3-year-old daughter to an urgent care facility because she had been crying all day. The child was irritable, had scant otorrhea, and had been pulling on her right ear.
Photo courtesy of William Clark, MD. Reprinted from The Color Atlas of Family Medicine. 2nd ed.
Diagnosis: Otoscopy revealed an erythematous, swollen external auditory canal and a foreign object. The parents reported that their child had been playing with a toy beaded necklace when she started crying. The patient was referred to an otolaryngologist, who removed the bead using an operating microscope for visualization. She evaluated the child for a co-existing otitis externa and decided that the external canal was markedly inflamed and probably infected.
For more information, see “Object in ear.” J Fam Pract. 2013.