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Pathology 20

A 55-year-old man presents to the emergency department with worsening left ear pain for the past week. The ear pain originally began two weeks ago with redness and pain, and he developed discharge from the ear two days ago. He has been using over-the-counter eardrops intermittently with minimal relief. He has a history of type 2 diabetes mellitus, and his last hemoglobin A1C one month ago was 11%. Vital signs are temperature is 39°C (102.2°F), pulse 110 beats/min, and blood pressure is 140/95 mm Hg. On physical examination, his left ear shows an erythematous, swollen pinna that is tender to touch with purulent discharge noted. Posterior auricular lymphadenopathy is also present. CT scan of the head confirms the diagnosis.

Which of the following is the most likely cause of the patient's symptoms?

  • A) Acute suppurative otitis media
  • B) Brain abscess
  • C) Brain tumor
  • D) Malignant otitis externa
  • E) Meningitis


Neal Deot


Dr. Ted O'Connell


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