Ear - Acute otitis externa ( outer ear infection )

Question 1

what is acute otitis externa ?

Answer 1

Can be described as inflammation of the ear canal which may include a small portion of the auricle

Question 2

what are the causes of acute otitis externa ?

Answer 2

A bacterial or fungal infection, contact sensitivity, trauma or discharge from otitis media

Common in patients who have long exposure to water. It is frequently referred to as swimmers ear

Question 3

what are the presenting symptoms ?

Answer 3

Itching

Pain which may be severe and
extend to the jaw

Temporary loss of hearing

Discharge which may include debris

Redness and swelling

Usually only one ear infected

Ear may feel blocked or full

Question 4

Management of acute otitis externa

Answer 4

avoid damage to the ear canal. keep ears clean and dry

For patients aged 12 or more, consider OTC acetic 2% ear drops or spray.

Where appropriate consider a topical antibiotic preparation for 7-14 days.

Consider analgesia

Question 5

Safety Netting

Answer 5

If symptoms worsen suddenly or significantly

If symptoms do not improve within the expected timeframe

If the patient becomes systemically unwell

Question 6

Red Flag Management

Answer 6

Referrals should me made if patients are :

Experiencing chronic or recurring otitis externa

Ear canal occlusion prevents topical medication from working effectively

The infection is severe

The patient has complications or other medical conditions which require attention