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Acute Otitis Media — MRCGP AKT MCQ

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HardENTAcute Otitis MediaMRCGP AKTUKMLAPARA

A child treated for acute otitis media develops swelling and erythema behind the ear with the pinna pushed forwards. What is the best action?

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Correct answer: E — Arrange urgent hospital assessment

The best answer is “Arrange urgent hospital assessment”. Post-auricular inflammation with displacement of the pinna suggests acute mastoiditis, a serious suppurative complication requiring urgent hospital assessment and intravenous treatment with ENT input. It is not an expected stage of uncomplicated otitis media, and community topical or delayed therapy is inadequate.

Reference: NICE NG91: Acute otitis media antimicrobial prescribing: https://www.nice.org.uk/guidance/ng91/chapter/Recommendations