USMLE Forum Archives - USMLE Step 3 - ID
ID
conym5 - 07-03-09 13:17
A 70-year-old patient with long-standing Type 2 diabetes mellitus
presents with complaints of
pain in the left ear with purulent drainage. On physical exam, the
patient is afebrile. The pinna of the left ear is tender, and the external
auditory canal is swollen and edematous. The peripheral white blood
cell count is normal. The organism most likely to grow from the purulent
drainage is
conym5 - 07-03-09 13:17
A 70-year-old patient with long-standing Type 2 diabetes mellitus
presents with complaints of
pain in the left ear with purulent drainage. On physical exam, the
patient is afebrile. The pinna of the left ear is tender, and the external
auditory canal is swollen and edematous. The peripheral white blood
cell count is normal. The organism most likely to grow from the purulent
drainage is
The correct answer and explanation will be available after you answer.
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#2
Re: ID
conym5 - 07-04-09 08:49 ans:A
Ear pain and drainage in an
elderly diabetic patient must raise concern about malignant external otitis.
The swelling and inflammation of the external auditory meatus strongly
suggests this diagnosis. This infection usually occurs in older diabetics
and is almost always caused by Pseudomonas aeruginosa. Haemophilus
influenzae and Moraxella catarrhalis frequently cause otitis media but not
external otitis.
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