Final answer:
The likely diagnosis for a toddler with a recent tympanic membrane perforation seen on otoscopic examination is Acute Otitis Media, which involves the accumulation of pus and pressure in the middle ear.
Step-by-step explanation:
Based on the otoscopic exam findings in a toddler with a recent history of tympanic membrane perforation, the likely diagnosis is Otitis Media. Acute otitis media (AOM) is characterized by the formation and accumulation of pus in the middle ear, which can result in moderate to severe bulging of the tympanic membrane and otalgia. Should the pus be unable to drain, symptoms such as fever, nausea, vomiting, and diarrhea, in addition to ear pain, are common, especially in young children who are also more prone to ear infections due to the anatomical structure of their eustachian tubes.
Another condition that can occur after tympanic membrane perforation is otitis media with effusion (OME), where fluid accumulates in the middle ear without infection or following an AOM. Cholesteatoma and tympanosclerosis are other complications associated with chronic ear infections, but their presence is typically identified with distinct otoscopic findings such as growth of abnormal skin in the middle ear for cholesteatoma or scarring and calcium deposits for tympanosclerosis. Otitis externa, an infection of the external ear canal, would not be indicated by a tympanic membrane perforation, which is internal to the ear canal.