Our orders are delivered strictly on time without delay 
ZM is an 8-year-old male who is brought to the clinic by his mother for complaints of acute left ear pain. She has recently picked him up from a week-long stay at camp, and he stated his ear hurt so bad he was crying. When his mother looked at this ear, she noticed the outside canal was very swollen. He could not even touch his ear. His mother states: “He is never sick, and he never cries.”
Past Medical History
• All immunizations current
• No history of surgeries
• No history of allergies
• No history of significant illness
Medications
• Multivitamin, daily
• Occasional allergy medication with children’s loratadine
Physical Examination
• Pulse: 100; respiration rate: 22; temperature: 100.2 °F data scan
• Left ear canal swollen; unable to access with otoscope to observe tympanic membrane
• Swelling noted in lymph nodes below ear
• Ear is red and warm to touch
Diagnosis
• External otitis
Discussion Questions
1. What factors in ZM’s recent history should the clinician consider, and what additional questions should the clinician ask the mother?
2. What treatment options are indicated for ZM?
3. What patient teaching should the clinician provide?
