What factors in ZM’s recent history should the clinician consider, and what additional questions should the clinician ask the mother? What treatment options are indicated for ZM?

Patient with Otitis Externa
ZM is an 8-year-old male who is brought to the clinic by his mother for complaints of acute left ear pain. She has recently picked him up from a week-long stay at camp, and he stated his ear hurt so bad he was crying. When his mother looked at this ear, she noticed the outside canal was very swollen. He could not even touch his ear. His mother states: “He is never sick, and he never cries.”
Past Medical History
All immunizations current
No history of surgeries
No history of allergies
No history of significant illness

Medications
Multivitamin, daily
Occasional allergy medication with children’s loratadine

Physical Examination
Pulse: 100; respiration rate: 22; temperature: 100.2 °F data scan
Left ear canal swollen; unable to access with otoscope to observe tympanic membrane
Swelling noted in lymph nodes below ear
Ear is red and warm to touch

Diagnosis
External otitis

Discussion Questions
What factors in ZM’s recent history should the clinician consider, and what additional questions should the clinician ask the mother?
What treatment options are indicated for ZM?
What patient teaching should the clinician provide?

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