A 66-year-old patient has bilateral otitis media with effusion and white patches in the mouth. What should the patient be evaluated for?

The presence of bilateral otitis media with effusion and white patches in the mouth suggests a possible underlying immunocompromised state. In adults, particularly those over 50, an increase in opportunistic infections, such as oral thrush (which presents as white patches), may occur as a result of conditions like HIV infection. HIV can lead to a significant decline in immune function, resulting in numerous opportunistic infections and hematological conditions.

Evaluating the patient for HIV infection is prudent given the combination of symptoms. Otitis media with effusion can occur in immunocompromised individuals due to increased susceptibility to infections, and oral candidiasis (the white patches) is often associated with a weakened immune system, which can occur with HIV. Identifying a potential HIV infection is crucial for initiating appropriate antiretroviral therapy and managing any resultant complications effectively.

While other options might relate to hematologic or oncological conditions, they do not directly correlate with the presented symptoms in the same way as HIV, making the evaluation for HIV the most relevant course of action given the clinical picture.