A 3-year-old boy presents with a fever, ear pain, and a draining ear. His mother reports that he was diagnosed with acute otitis media two days ago and was started on antibiotics. What could be happening, and what is the next step?
This child likely has acute otitis media with tympanic membrane perforation, given his history of AOM and new-onset otorrhea (ear drainage). This condition occurs when the pressure from the infected fluid in the middle ear causes the tympanic membrane to rupture. The perforation often relieves pain and can allow the infection to drain. Most perforations will heal on their own once the infection is treated. The child should continue on antibiotics, and the ear should be kept clean and dry.