Case #7 -- Acute Illness in a Patient With Recurrent Ear Infections

L Kumar, MD, L Crews, MD, R Gacek, MD, ED Weber, MD, R Wesenberg, MD

August 28, 2003

Physical Examination

Vital signs:

Oral temperature 102° F (38.9°C)
Pulse 135-145
Respiratory rate 18/minute
Blood pressure 144/60 mm Hg
Peripheral oxygen saturation of 91% on room air

Significant physical findings:
Right facial edema and right-sided neck edema were noted. There was marked nuchal rigidity. Mucopurulent discharge was oozing from the right ear. The patient refused to move his lower extremities secondary to back pain. Somnolence was noted, but the patient would follow verbal commands when stimulated. There were no cranial nerve deficits other than audition. Sensation was intact, DTR 2/4.