Author: Thomas Brougham / Editor: Jason Kendall / Reviewer: Phil Delbridge / Codes: EC8, EP5, NeuP1, NeuP2, RP6, RP8, SLO3 / Published: 15/01/2021
A 34-year-old female presented to the emergency department with a 3-day history of left ear pain, without discharge or tinnitus.
Over the last 24 hours this had progressed to a severe generalised headache with a high fever. On examination, she appeared unwell, septic and drowsy. She was tachycardic and febrile.
Observations were as follows:
HR 110, BP 98/50, RR 24, Sats 98% on air, GCS 14 (E3, V5, M6), Temp 39.3 degrees centigrade
Heart sounds were normal and the chest was clear to auscultation. Abdomen was soft.
She had no mastoid tenderness or meninigism. Neurological examination was normal.
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Question 1 of 3
1. Question
Which one of the following will be least helpful in the initial clinical assessment of this patient?
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3. Question
CT demonstrates an otitis media that has eroded through the superior aspect of the middle ear leading to pneumocephalus. Which of the following interventions would you initiate (more than one option can be selected)?
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18 responses
Good case
Interesting case, may face similar cases in A&E
good interesting and learning case. teaches us to be vigilant to signs and symptoms of the patient even though may seem just otitis media…
Informative
very informative
good case, thanks
Eye opener
Educative.
very interesting and informative case..
Interesting case and useful
Very interesting and informative case.Thankyou
Intresting
Interesting and informative
Nice review, Thanks
Imperative to look for other sources of sepsis when none of the routine ones found
Been looking for another case on pneumonia. thanks
Excellent Case
excellant case