Rosh Pediatrics Practice Exam

What diagnostic study would be most beneficial for determining the appropriate antibiotic intervention in a case of persistent fever and right-sided ear pain?

1. Blood culture

2. Cerebrospinal fluid analysis

3. CT scan of the head with contrast

4. Middle ear specimen culture

The correct answer is: CT scan of the head with contrast

In a case of persistent fever and right-sided ear pain, it is critical to identify the underlying infection accurately to guide appropriate antibiotic therapy. A CT scan of the head with contrast can be beneficial in certain scenarios, particularly when there is a suspicion of complications from an ear infection, such as mastoiditis or the presence of abscesses in the surrounding areas. This imaging study provides a detailed view of the structures of the head and ear and can help identify serious conditions that might require more aggressive intervention. However, focusing specifically on the need for an accurate diagnosis to provide targeted antibiotic therapy, obtaining a middle ear specimen culture would typically be the most direct and informative method. This culture allows for the identification of the specific pathogens involved in the ear infection, enabling the provider to select the most effective antibiotics based on the organism and its sensitivities. While the CT scan offers valuable information about anatomy and potential complications, it does not directly inform the choice of antibiotics. Hence, middle ear specimen culture is seen as a more beneficial diagnostic study for this purpose, directly correlating with the need to tailor antibiotic treatment effectively. In conclusion, while imaging studies can play a role in assessing the situation, the middle ear specimen culture stands out as the most advantageous in guiding