This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: ENT
A 3 year old child presents with fever and ear ache. On examination there is congested tympanic membrane with slight bulge. The treatment of choice is: 
Select and explain. 
A. Myringotomy with penicillin, B. Myringotomy with grommet, C. Only antibiotics, D. Wait and watch
A: Myringotomy with penicillin
Answer: A: Myringotomy with penicillin 
Explanation: Fever + earache + congested and bulging tympanic membrane in a four year old child points towards Acute suppurative otitis media as the diagnosis. Antibiotics (Penicillin) form the mainstay of treatment of acute otitis media and should be administered in a child with Acute otitis media and once tympanic membrane is bulging, myringotomy should be done. Grommet inseion is not indicated in Acute suppurative otitis media. It may be used in cases of myringotomy for serous or secretory otitis media.