student cases for discussion with faculty
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Student Case 3:

Child 13 months old

Developed AOM 4 days ago and
was started on azithromycin

2 days later returned  to office,
ear still bulging and red,
no structures identified
Switched to high dose amoxicillin

2 days later returned again,
 still spiking temperatures with
 red, bulging tympanic membrane

 tympanic membrane
  
Questions for discussion with faculty:
 1.  Name the microorganisms which might be causing this infection.
2.  Without doing a tympanocentesis, how might you identify the infecting agents?
3.  Name two acceptable alternatives to treating this child.