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ENT · Ear and audiology: bullous myringitis
Sample itemA child with an upper respiratory infection has sudden severe earache. The drum shows haemorrhagic blisters, the pinna and canal are otherwise normal, there is no facial weakness and hearing is almost normal. What is the diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Bullous myringitis
Bullous (haemorrhagic) myringitis presents with painful vesicles on the tympanic membrane and deep canal, usually with a viral or Mycoplasma infection. Treatment is analgesia with antibiotic cover as for acute otitis media, and blebs may be pricked for relief. Ramsay Hunt has vesicles on the pinna or concha with facial palsy.
Option by option
A. Ramsay Hunt syndrome
Ramsay Hunt syndrome shows pinna vesicles with facial palsy and vertigo.
B. Bullous myringitis (correct)
Correct. Haemorrhagic bullae on the drum with earache are typical.
C. Otomycosis
Otomycosis causes itching with fungal debris in the canal.
D. Acute mastoiditis
Mastoiditis causes postauricular swelling and a sagging canal wall.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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