A 5-year-old girl with a history of autism presented to an outside emergency department with a 10-day history of otitis media and recent fevers. She was eventually transferred to our hospital after a computerized tomographic (CT) scan was performed showing potential clinically significant ear abnormalities. On evaluation, the patient had a bulging, hyperemic left tympanic membrane, along with fullness of the postauricular, upper cervical region. Facial nerve function was intact. No focal neurologic deficits or meningeal signs were observed. A CT scan of the temporal bones with contrast was performed at our facility (Figure).
Barry R, Reddy A, Jeyakumar A. A Child With a Bulging Hyperemic Tympanic Membrane. JAMA Otolaryngol Head Neck Surg. 2016;142(1):95-96. doi:10.1001/jamaoto.2015.2718