Otitis Media with Effusion

A healthy 3-year-old male with one day of rhinorrhea and cough is in for COVID testing after a school exposure. The child apparently had similar symptoms several weeks prior that resolved spontaneously. The child’s COVID test was negative. The child has otitis media with effusion. You can see fluid layering inferiorly behind the tympanic membrane. There is also evidence of mild bulging, but the malleus is still discernable. The family was asked to return the next day in follow up to make sure of resolution. At the second visit, this image was obtained: In this image, the bulging appears to be mildly improved. The inferior layering of fluid is resolving into air-fluid levels. This suggests that the eustachian tube is properly venting and that the middle ear effusion will resolve without intervention. WiscMed thanks Dr. Caroline Rowlands of Optum Care Colorado Springs for this interesting image. WiscMed thanks Dr. Michael Poole of Savannah Pediatric Ear, Nose and Throat for his consultation on this case. His book, Acute Otitis Media, is available on Apple books and is highly recommended.