Question

exam (50 points) johnnys history is significant for tympanostomy tubes placed bilaterally when he was 2 years old. one tube left a persistent perforation in the tympanic membrane, so he had tympanoplasty at 3 years of age. he has not had any episodes of otitis media in the past 2 years. objective physical exam rr: 24; hr: 88; temp: 99.9; bp: 98/68. gen: well - developed 4y/o in no acute distress. heent: normocephalic. perrla no conjunctival erythema; mild clear nasal discharge; right canal blocked with cerumen - after ceruminolytic placed and canal clear, the tympanic membrane was seen. it was erythematous and full. some mild tympanosclerosis of tm noted; the left ear was erythematous and full. mild mastoidalgia on the left, but the ear is not displaced forward. cv: rrr without murmur. resp: cta assessment johnny has chronic otitis media failing three courses of oral antibiotics. plan i have performed tympanocentesis in the office and sent the fluid for culture. while awaiting the result, we will treat him with an im antibiotic. i will also send a fungal culture to rule out otomycosis. while johnny has mild mastoidalgia, he is afebrile today and in no distress, and his ear is not displaced. thus, i do not think he has acute mastoiditis, but i told johnnys parents what to look for. given how long johnny has had this infection, he will need to see audiology for audiometry when he is better. - johanna long, md the patient was referred to this clinic for chronic otitis media, which is o inflammation of the middle ear that has been going on for a while. o inflammation of the middle ear that just started recently. o inflammation of the outer ear that has been going on for a while. o inflammation of the outer ear that just started recently.

Explanation:

Chronic otitis media refers to long - term inflammation of the middle ear. The patient Johnny has had this condition for some time and has failed three courses of oral antibiotics.

Answer:

Inflammation of the middle ear that has been going on for a while.