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A 2 years old boy presents with sudden onset of a cough, accompanied by clear nasal discharge. He has had mild symptoms of an upper respiratory infection for the last 2 days, but his parents became alarmed when his breathing became labored. On examination, he has a seal-like barky cough and inspiratory stridor when at rest, which worsens twitch agitation. Persistent sternal indrawing is also evident at rest. What potential sequelae do you need to be concerned about?

January 2, 2021 8:10 am Published by

Bacterial tracheitis, airway obstruction and hypoxemia

A 2 years old boy presents with sudden onset of a cough, accompanied by clear nasal discharge. He has had mild symptoms of an upper respiratory infection for the last 2 days, but his parents became alarmed when his breathing became labored. On examination, he has a seal-like barky cough and inspiratory stridor when at rest, which worsens twitch agitation. Persistent sternal indrawing is also evident at rest. What are the most important differential diagnoses?

January 2, 2021 8:09 am Published by

Of the relevant differential diagnoses, it is important to rule out neoplasm, epiglottitis, diphtheriae and retropharyngeal or peritonsillar abscess.

A 2 years old boy presents with sudden onset of a cough, accompanied by clear nasal discharge. He has had mild symptoms of an upper respiratory infection for the last 2 days, but his parents became alarmed when his breathing became labored. On examination, he has a seal-like barky cough and inspiratory stridor when at rest, which worsens twitch agitation. Persistent sternal indrawing is also evident at rest. What is the most likely diagnosis?

January 2, 2021 8:08 am Published by

Laryngotracheobronchitis

A 40 years old woman presents with a 1-year history of recurrent episodes of vertigo. The vertigo spells are described as a sensation of the room spinning that lasts from 20 minutes to a few hours and may be associated with nausea and vomiting. The spells are incapacitating and are accompanied by dizziness, vertigo and disequilibrium, which may last for days. No loss of consciousness is reported. The patient also reports aural fullness, tinnitus, and hearing loss in the right ear that is more pronounced around the time of her vertigo spells. Physical exam reveals a horizontal nystagmus, and she is unable to maintain her position during Romberg testing or tandem stepping test. She turns toward the right side and she is unable to walk tandem. Her cerebellar function tests are normal. What potential sequelae do you need to be concerned about?

January 2, 2021 8:08 am Published by

Increased likelihood of accidents

A 40 years old woman presents with a 1-year history of recurrent episodes of vertigo. The vertigo spells are described as a sensation of the room spinning that lasts from 20 minutes to a few hours and may be associated with nausea and vomiting. The spells are incapacitating and are accompanied by dizziness, vertigo and disequilibrium, which may last for days. No loss of consciousness is reported. The patient also reports aural fullness, tinnitus, and hearing loss in the right ear that is more pronounced around the time of her vertigo spells. Physical exam reveals a horizontal nystagmus, and she is unable to maintain her position during Romberg testing or tandem stepping test. She turns toward the right side and she is unable to walk tandem. Her cerebellar function tests are normal. What are the most important differential diagnoses?

January 2, 2021 8:07 am Published by

Of the relevant differential diagnoses, it is important to rule out acoustic neuroma, labyrinthitis, vestibular neuronitis, vertebrobasilar insufficiency and cholesteatoma.

A 40 years old woman presents with a 1-year history of recurrent episodes of vertigo. The vertigo spells are described as a sensation of the room spinning that lasts from 20 minutes to a few hours and may be associated with nausea and vomiting. The spells are incapacitating and are accompanied by dizziness, vertigo and disequilibrium, which may last for days. No loss of consciousness is reported. The patient also reports aural fullness, tinnitus, and hearing loss in the right ear that is more pronounced around the time of her vertigo spells. Physical exam reveals a horizontal nystagmus, and she is unable to maintain her position during Romberg testing or tandem stepping test. She turns toward the right side and she is unable to walk tandem. Her cerebellar function tests are normal. What is the most likely diagnosis?

January 2, 2021 8:06 am Published by

Meniere’s disease

A 35 years old man presents with a 2-day history of rapid-onset severe ear pain and fullness. The patient complains of otorrhea and mild decreased hearing, which he reports began after swimming. On examination he is afebrile and the external ear canal is diffusely swollen and erythematous. He has tenderness of the tragus and pain with movement of the auricle. The tympanic membrane is only partially visualized due to the swelling. What potential sequelae do you need to be concerned about?

January 2, 2021 8:05 am Published by

Tympanic membrane perforation, cranial nerve palsy and necrotizing otitis externa (skull base osteomyelitis)

A 35 years old man presents with a 2-day history of rapid-onset severe ear pain and fullness. The patient complains of otorrhea and mild decreased hearing, which he reports began after swimming. On examination he is afebrile and the external ear canal is diffusely swollen and erythematous. He has tenderness of the tragus and pain with movement of the auricle. The tympanic membrane is only partially visualized due to the swelling. What are the most important differential diagnoses?

January 2, 2021 8:04 am Published by

Of the relevant differential diagnoses, it is important to rule out cholesteatoma, otosclerosis, tympanosclerosis, tympanic membrane perforation and foreign body... View Article

A 35 years old man presents with a 2-day history of rapid-onset severe ear pain and fullness. The patient complains of otorrhea and mild decreased hearing, which he reports began after swimming. On examination he is afebrile and the external ear canal is diffusely swollen and erythematous. He has tenderness of the tragus and pain with movement of the auricle. The tympanic membrane is only partially visualized due to the swelling. What is the most likely diagnosis?

January 2, 2021 8:04 am Published by

Otitis externa

A 63 years old man presents with persistent sore throat and difficulty swallowing. The week before he started to feel under the weather with what he thought was a cold, but his symptoms have persisted and he now has chills, sweating, restlessness, difficulty swallowing and breathing, nausea, and vomiting. On examination, he is terrible with noticeable stridor and swollen neck. What potential sequelae do you need to be concerned about?

January 2, 2021 8:03 am Published by

Airway obstruction, respiratory distress or failure, and cardiac failure