Julie, a 3 – year – old preschool child, presents to the office with a complaint of left ear pain for 2 days.

Julie, a 3 – year – old preschool child, presents to the office with a complaint of left ear pain for 2 days. She is accompanied by her mother, Mary. She has had an intermittent fever and her maximum temperature at home was 101 ° F (axillary). The pain is worse sometimes when she is lying down. The pain is occasionally relieved with the use of over – the – counter pain relievers. Julia has had no vomiting or diarrhea. She has had a slight runny nose, but no

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