Otitis externa

Question 1

What is Otitis externa

Answer 1

Inflammation of the skin in the external ear canal due to infection

Question 2

Otitis externa presentation

Answer 2

Irritation and pain in the ear, mild conductive hearing loss, discharge from ear. Erythema and swelling in ear canal.

Question 3

Otitis externa causes

Answer 3

Recent swimming or trauma to ear. Bacterial or fungal infection - most common bacterial Staph aureus, Pseudomonas aeruginosa (gram -ve aerobic rod-shaped bacteria).

Question 4

Otitis externa differentials

Answer 4

Acute otitis media, malignant otitis externa, ear wax

Question 5

Otitis externa management

Answer 5

Avoid swimming. Otomize ear spray. Acetic acid 2% ear drops - antibacterial and antifungal. Severe or systemic symptoms - oral antibiotics?

Question 6

What is malignant otitis externa

Answer 6

severe, potentially life-threatening. Infection spreads to bones surrounding ear canal and skull. Progresses to osteomyelitis or the temporal bone of the skull

Question 7

Risk factors for malignant otitis externa

Answer 7

Diabetes, Immunosuppressant medications e.g. chemotherapy, HIV

Question 8

Malignant otitis externa presentation

Answer 8

More severe symptoms than normal otitis externa - persistent headache, severe pain and fever