An 8-year-old male arrives with his mother at the emergency department complaining of left ear pain. The pain started 4 days ago and has become worse. The child had ear infections as a toddler, but none recently. In addition to the ear pain, for the past several days he has also had seasonal allergy symptoms including watery eyes and a runny nose. Evaluation of the left ear reveals this image.
The child has acute otitis media (AOM) of the left ear.
There is a significant bulging of the pars flaccida, loss of the malleus bony landmark, and erythema (redness). Given the history of worsening pain, along with this imaging, the child was placed on a course of antibiotics.