A 4-year-old child with a history of recurrent acute otitis media presents with fever, postauricular erythema, tenderness, and anterior displacement of the auricle. CT scan with contrast shows coalescence of mastoid air cells. What is the most appropriate management?

• A Oral amoxicillin for 7 days
• B Intravenous antibiotics alone
• C Topical antibiotic ear drops
• D Intravenous antibiotics with myringotomy and possible mastoidectomy ✓

Explanation

Acute coalescent mastoiditis requires intravenous antibiotics and surgical drainage via myringotomy with or without mastoidectomy. Oral antibiotics or topical drops are insufficient. Intravenous antibiotics alone are inadequate once bony coalescence and abscess formation occur, as surgical drainage is necessary to prevent complications like intracranial extension.

Reference: Scott-Brown's Otolaryngology: Head and Neck Surgery, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.