Always consider gastroesophageal reflux disease (GERD) as a causative factor in a patient with chronic or recurrent ear pain, especially if the pain is bilateral. — Kristen Johnson, NP, Savannah, Ga. (173-5)


These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.