Mad-about-pediatriccardiology

Based on GISP data, CDC recommends combination therapy with ceftriaxone 250 mg intramuscularly and either azithromycin 1 g orally as a single dose or doxycycline 100 mg orally twice daily for 7 days as the most reliably effective treatment for uncomplicated gonorrhea. CDC no longer recommends cefixime at any dose as a first-line regimen for treatment of gonococcal infections. If cefixime is used as an alternative agent, then the patient should return in 1 week for a test-of-cure at the site of infection Link to website with the above recommendations

A 2 yo presents to the clinic with R sided ear pain, discharge and fever for the last 2-3days. When she woke up this morning her mother noticed that the skin around the R ear had turned red , with swelling behind the R ear as though the ear had been pushed forward .  She frequently gets ear infection and her last ear infection was last month when she was placed on amoxicillin for 10days. Mom denies a ny changes in her mental status , she has a poor appetite but had been drinking well and has had a good urine output. On taking a social history mom mentions that dad smokes inside the house and sometimes she puts her to sleep with a bottle of milk in her mouth. 1. What is your diagnosis? 2. Is imaging warranted in this scenario? 3. Why is the social history important in this case? 4. What is your choice of antibiotics ? Definition : - infection of the mastoid air cells - clinically characterized by a) protrusion of the pinna b) erythema/ tenderness over the mastoid p