Otitis externa

Question 1

What?

Answer 1

Inflammation of external auditory canal

aka swimmers ear

Question 2

Acute?

Answer 2

≤3 weeks

Question 3

Chronic?

Answer 3

> 3 months

Question 4

Who gets it?

Answer 4

All age groups

Children»>

Question 5

Bacterial causes?

Answer 5

Psuedomonas aeruginosa
Staph aureus
Proteus spp

Question 6

Most common bacterial cause?

Answer 6

Psuedomonas aeruginosa

Question 7

Fungal causes?

Answer 7

Aspergillus niger

Candida albicans

Question 8

Symptoms?

Answer 8

Redness and swelling of skin
Itchy
Painful 
Discharge or inc earwax
Hearing affected (if canal blocked)
Tenderness on moving jaw
Tender regional lymphadenitis

Question 9

Signs?

Answer 9

Red, swollen, eczematous with shedding of scaly skin
Swelling (early)
Swelling with white or yellow centre filled with pus (late)
Discharge (serous or purulent)
Inflamed eardrum

Question 10

Describe the pain associated with this condition?

Answer 10

Severe pain disproportionate to size of lesion

Made worse when tragus or pinna is moved, or otoscope inserted

Question 11

Classic presentation?

Answer 11

Discharge and itch = initial symptoms

Followed by pain & reduction in hearing as ear canal closes off

Question 12

Examination?

Answer 12

Debris in canal?
Normal tympanic membrane
In severe cases -> canal swollen and cannot view tympanic membrane

Question 13

Management?

Answer 13

Topical aural toilet (clean ear)
Swab to microbiology
Topical clotrimazole (canisten)
Gentamicin 0.3% drops or ciprofloxacin with dexamethasone

Question 14

What is given if there is a perforation?

Answer 14

Finafloxacin

Question 15

What is given for fungal infection?

Answer 15

Clotrimazole solution 1%