An 18 months old toddler presents with 1 week of rhinorrhea, cough and congestion. Her parents report she has been irritable, sleeping restlessly, and not eating well. On examination, the toddler appears irritable and apprehensive. She is febrile and has signs of a viral respiratory infection, including rhinorrhea and congestion. Otoscopy reveals a bulging, erythematous landmarks. History reveals that she has had all her vaccination, attends day care and both parents smoke. What potential sequelae do you need to be concerned about?

Tympanic membrane perforation, chronic suppurative otitis media, ossicular necrosis, cholesteatoma, mastoiditis, labyrinthitis, meningitis and CN VII paralysis

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This post was written by Omar Rifai