A 3-year-old previously healthy female is brought to your of…

Questions

A 3-yeаr-оld previоusly heаlthy femаle is brоught to your office by her mother. The mother reports the child has been crying and pulling at her right ear over the past 2 days, and reports the patient has been febrile the past 24 hours. The patient’s past medical history is unremarkable, although the mother reports the patient had a “common cold” a week ago which resolved without intervention. Her temperature is 101.6 deg F (38.7 deg C), blood pressure is 100/70 mmHg, pulse is 120/min, and respirations are 22/min. Otoscopic exam is performed (see image). What is the most likely diagnosis?

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