Seven year old boy with fever and ear discharge – Microbiology MCQ

A seven year old boy presented to the OPD with complaints of pain and discharge from left ear. On examination the patient was febrile with neck rigidity and positive Kernig’s sign. Gram positive cocci were visualised in the gram stained specimen of the discharge. Most likely pathogen is?

A. Streptococcus pneumoniae
B. Staphylococcus aureus
C. Haemophilus influenzae
D. Staphylococcus epidermidis

Correct answer : A. Streptococcus pneumoniae

Scanning Electron Micrograph of Streptococcus pneumoniae
(colour added for illustrative purposes)

• The history and clinical features are suggestive of otitis media with meningitis.
• Pneumococci are the most common cause of otitis media in children.

Exclusion of the other options:

• Haemophilus influenzae is a gram negative bacilli
• Streptococcus pneumoniae and Staphylococcus epidermidis are not commonly implicated in the causation of otitis media