Pediatric EENT case studies: diagnosis and management
Select one of three pediatric eye, ear, nose and throat cases, post a differential diagnosis, argue the most likely diagnosis and its unique characteristics, give a treatment and management plan with dosages, and set out how you would educate the parent and address the fears in the case.
Editorial process
Last reviewed · August 14, 2026
The finding in each case that decides the diagnosis
Each of the three cases is built so that one physical finding separates a self-limiting illness from one needing treatment, and your differential is marked on whether you noticed it. In case one the two ears differ: the right membrane is translucent and neutral, the left is full, opaque and reddish-orange with pus, and that combination of bulging plus effusion is what distinguishes acute otitis media from a middle-ear effusion or a simple viral infection. In case two the discharge the mother reports is thick and green but the examination finds clear rhinorrhoea in an afebrile child with normal appetite and sleep, at two days — colour early in a viral course is not evidence of bacterial sinusitis, and the duration criteria matter more. In case three the picture is exudative tonsillitis with tender anterior nodes, palatal petechiae and a strawberry tongue, pointing at group A streptococcus rather than a viral pharyngitis, though you still test before you treat.
Build the differential properly rather than listing conditions: name three or four plausible diagnoses and for each say which finding in this case supports it and which argues against, then declare the most likely one and explain the unique characteristics that made it identifiable. The management plan must carry actual dosages, which is where posts are most often thin. Weight-based paediatric doses need the drug, the milligrams per kilogram per day, the frequency and the duration, and non-pharmacologic measures belong there too — analgesia, hydration, saline, and the watchful-waiting option where guidelines permit it. The parent education section is a graded component, not a closing courtesy: answer the specific worry the case raises — the disturbed sleep in case one, the colour of the discharge in case two, the fever and the decreased appetite in case three — say what to expect day by day, and give return precautions specific enough that the parent could repeat them back to you before leaving.
Likely learning objectives
Inferred from the brief — check these against your own rubric.
- 01Construct a differential diagnosis from paediatric EENT examination findings.
- 02Apply diagnostic criteria that separate bacterial from viral upper respiratory presentations.
- 03Prescribe weight-based paediatric treatment with correct dose, frequency and duration.
- 04Select non-pharmacologic management and watchful waiting where guidelines support them.
- 05Design parent education that addresses the specific fear presented in the case.
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Turn the brief into deliverables
- 01The case study selected.
- 02A differential diagnosis with the findings supporting and opposing each option.
- 03The most likely diagnosis, with reasoning.
- 04The unique characteristics of that disorder.
- 05A treatment and management plan including appropriate dosages.
- 06Parent education strategies addressing the concerns or fears in the case.
Differential, diagnosis, plan, then the parent
Case selected and the findings that matter
State the case and pull out the examination findings the diagnosis will turn on.
Differential diagnosis with reasoning
Give three or four candidates, each with evidence for and against from this case.
The most likely diagnosis
Declare it and explain what makes it identifiable here.
Unique characteristics of the disorder
Describe the features that separate this condition from its nearest neighbour.
Treatment and management plan with dosages
Give pharmacologic and non-pharmacologic management with weight-based doses.
Educating the parent
Answer the worry in the case, set expectations and give return precautions.
Guideline sources for each of the three presentations
Recommended databases
- StatPearls via NCBI Bookshelf
- American Academy of Pediatrics clinical practice guidelines
- Burns et al., Pediatric Primary Care
- PubMed
- A paediatric dosing reference
Search sequence
- 1.Read the current guideline for the condition you think most likely, and note its diagnostic criteria.
- 2.Check whether observation is an option for your patient's age and severity.
- 3.Confirm first-line antibiotic and dose in mg/kg/day, with duration.
- 4.Note the second-line agent for penicillin allergy or recent antibiotic exposure.
- 5.List the return precautions the guideline specifies for parents.
Reference shortlist
These are authoritative starting points, not a ready-made bibliography. A qualified reviewer must confirm that each source fits the assignment and supports the claim beside which it is cited.
Nothing here is cleared for citation until you have read it.
- 01
Acute Otitis Media
StatPearls, NCBI Bookshelf · 2023
Diagnostic criteria and management for case one, including where observation is appropriate.
- 02
Otitis Media With Effusion
StatPearls, NCBI Bookshelf · 2023
The nearest neighbour to case one's diagnosis, and the differential most often missed.
- 03
Acute Sinusitis
StatPearls, NCBI Bookshelf · 2023
Duration and severity criteria that decide case two against the colour of the discharge.
- 04
Streptococcal Pharyngitis
StatPearls, NCBI Bookshelf · 2023
Clinical decision rules, testing and antibiotic dosing for case three.
- 05
Scarlet Fever
StatPearls, NCBI Bookshelf · 2023
Explains the strawberry tongue and palatal petechiae that make case three's presentation distinctive.
Review before submission
Common mistakes
- Listing differential diagnoses without tying each to a finding in the case.
- Diagnosing acute otitis media from redness alone, ignoring bulging and effusion.
- Treating green nasal discharge as proof of bacterial sinusitis at two days.
- Giving adult doses, or naming a drug with no milligrams per kilogram and no duration.
- Omitting non-pharmacologic management and analgesia.
- Ending with generic advice instead of answering the parent's stated worry.
Submission checklist
- The chosen case is identified at the start.
- Each differential names the supporting and opposing findings.
- The primary diagnosis is justified by the distinguishing feature, not by the whole picture.
- Every medication has a weight-based dose, frequency and duration.
- Non-pharmacologic care and return precautions are included.
- Parent education addresses the concern the case actually raises.
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Written by
Aaron Bishop
MA, Education
assignment interpretation and research-methods coaching across disciplines
Aaron leads the EssayCrackers editorial desk. He works on how assignment briefs are read — what a rubric is actually asking for, and where students most often answer a different question than the one set.
Reviewed by
Dr. Nathan Cole
PhD, Rhetoric & Composition
Argumentation and thesis development
Nathan teaches first-year composition and directs a university writing center. He reviews EssayCrackers guides for argumentative soundness and citation accuracy.