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Acute otitis media observation — USMLE Step 3 MCQ

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HardPediatrics (Well-child / Chronic Management)Acute otitis media observationUSMLE Step 3

A 3-year-old has unilateral ear pain for one day, temperature 37.8°C, mildly bulging erythematous tympanic membrane, and reliable follow-up. She is otherwise well. What is the best next step?

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Correct answer: D — Provide analgesia and observe with a clear safety-net follow-up plan

For selected children with nonsevere unilateral acute otitis media and reliable follow-up, observation with analgesia is appropriate. Escalated antibiotics, imaging, tubes, and steroids are not first steps here.

Reference: American Academy of Pediatrics, Acute Otitis Media Guideline: https://publications.aap.org/pediatrics/article/131/3/e964/30968/The-Diagnosis-and-Management-of-Acute-Otitis