12 years old fever unilateral post auricular pain, mastoid bulging displacing the pinna forward outwards with loss of bony trabeculae. This patient has history of chronic persistent pus discharge from same ear. Treatment of choice is-
**Core Concept**
The patient described has chronic suppurative otitis media (CSOM) with mastoiditis, an infection of the mastoid bone that has spread from the middle ear. This condition requires prompt and effective treatment to prevent complications such as intracranial spread of infection.
**Why the Correct Answer is Right**
The correct answer is **C. Intravenous antibiotics with or without surgical intervention**. The patient's symptoms, including fever, post-auricular pain, mastoid bulging, and history of chronic discharge, indicate a severe infection that requires aggressive treatment. Intravenous antibiotics are necessary to cover a broad spectrum of bacteria, including Pseudomonas aeruginosa, which is commonly involved in CSOM. Surgical intervention, such as mastoidectomy, may be required to drain the infected mastoid bone and remove any infected tissue.
**Why Each Wrong Option is Incorrect**
**Option A:** **Topical antibiotics** are not sufficient for this patient, as the infection has spread to the mastoid bone and requires systemic therapy.
**Option B:** **Observation** is not appropriate, as the patient's symptoms indicate a severe infection that requires prompt treatment to prevent complications.
**Clinical Pearl / High-Yield Fact**
Chronic suppurative otitis media with mastoiditis is a medical emergency that requires prompt treatment to prevent complications such as intracranial spread of infection, meningitis, and facial paralysis.
**Correct Answer:** C. Intravenous antibiotics with or without surgical intervention