A 5-year-old girl presented with earache since the previous morning, restricted to the left side. The parents denied of observing otorrhea, hearing loss, or fever. History The patient’s brother had been coughing and sneezing a few days ago. The patient had no medical/surgical history.

She had not been taking any medication/antibiotics, and was not allergic to any drug. Examination Temperature: 37.1°C Pulse rate, respiratory rate, BP, O 2 saturation: Normal Appearance: Wide awake, fidgety, comfortable during ear examination Left auricle, mastoid, external auditory canal: Appeared normal Tympanic membrane: Intact but mildly bulging, inflamed, decreased mobility Right ear otoscopy: Normal *This Case Challenge is from the Editorial Team of Docplexus and is meant for educational purposes only. ##Disclaimer## The content provided on Docplexus is intended for educational purposes only. While…