Acute Otitis Externa

Question 1

Acute Otitis Externa

Answer 1

Inflammation of the external ear canal

Question 2

Acute Otitis Externa causative agents

Answer 2

Bacterial:
Pseudomonas aeruginosa
Staphylococcus

Question 3

Acute Otitis Externa Presentation

Answer 3

Rapid onset of ear pain
Tenderness
Itching 
Aural fullness
Hearing loss

Question 4

Acute Otitis Externa Investigations

Answer 4

Pneumatic otoscopy

Tympanometry

Question 5

Acute Otitis Externa Diagnosis

Answer 5

Presence fo rapid onset - 48 hours of sysmptoms within the past 3 weeks
Coupled with signs of ear canal inflammation

Question 6

Acute Otitis Externa Treatment

First Line Options

Answer 6

First Line Options:

• Topical antibiotic or a combined topical antibiotic with a steroid
• if canal debris then remove
• if canal extensively swollen - ear wick

Question 7

Acute Otitis Externa Treatment

Second Line Options

Answer 7

Second Line Options:

• Oral antibiotics (flucloxacillin) if spreads, swab ear canal, empirical use of antifungal agent
• Others: Aural toilet – using otoscope, cotton wool, Jobson Horne Probe, Crocidile forceps
• If non-resolving -with worsening pain - urgent ENT referral.
• If malignant, most common in px with diabetes, treat with ciprofloxacin - covers psuedo aeruginosa.