Ear: Otitis externa

Question 1

What is the clinical presentation of Otitis Externa?

Answer 1

pain, itchiness to ear, drainage (discharge), hearing loss

Question 2

What is the epidemiology of Otitis Externa?

Answer 2

hx of swimming, trauma, or pH altered (usually occurs in older children or adults), foreign body

Question 3

What are the risk factors for Otitis Externa?

Answer 3

swimmers, ear plugs, hearing aids, q-tips (trauma to the ear)

Question 4

What are the PE findings of Otitis Externa?

Answer 4

manipulate ear to determine discomfort, will be painful with inflammation, redness of canal, tenderness of tragus (hallmark of Otitis Externa) and pinna, discharge, cellulitis (redness and swelling) on outer ear
i. Can be fungal: black or cauliflower type growths: usually in diabetics or immunocompromised

Question 5

What is the hallmark sign of Otitis Externa?

Answer 5

tenderness of tragus

Question 6

What are signs of fungal Otitis Externa?

Answer 6

black or cauliflower type growths: usually in diabetics or immunocompromised

Question 7

What is the diagnosis of Otitis Externa?

Answer 7

Clinical based on HX (AOM) & PE, important to differentiate between fungal vs bacterial

Question 8

What is the treatment for Otitis Externa?

Answer 8

polymyxin B sulfate, fluoroquinolones (ciprodex - steroid/drop combo), aminoglycosides (topical drops (auralgan) or oral), clotrimazole for fungal, analgesics helpful; steroid makes a big difference versus just the antibiotic acting, pain reliever, wick to get inside the ear

Question 9

What can be complications to Otitis Externa?

Answer 9

meningitis, infection of the bone