Otitis Externa Flashcards
What is otitis externa?
Inflammation of the skin in the external ear canal
May also be called ‘swimmer’s ear’ due to water exposure while swimming
How long do acute and chronic cases of otitis externa last?
Acute cases are <3 weeks, chronic cases are >3 weeks
Duration helps in diagnosis and management
What are typical symptoms of otitis externa?
- Ear pain
- Discharge
- Itchiness
- Conductive hearing loss
These symptoms can vary in severity
What are the common causes of otitis externa?
- Bacterial infection
- Fungal infection
- Derm conditions
Each cause requires different management strategies
What is a common bacterial cause of otitis externa?
Pseudomonas aeruginosa
Gram-negative aerobic rods that thrive in moist environments
What is the treatment for Pseudomonas aeruginosa?
- Aminoglycosides (e.g. gentamicin)
- Quinolones (e.g. ciprofloxacin)
Important for effective management of infections
What fungal infections are associated with otitis externa?
- Aspergillus
- Candida
Fungal infections can occur after multiple courses of topical antibiotics
What are some derm conditions that can lead to otitis externa?
- Eczema
- Seborrhoeic dermatitis
- Contact dermatitis
Skin conditions can predispose to ear canal inflammation
What examination findings are indicative of otitis externa?
- Erythema and swelling in ear canal
- Tenderness in ear canal
- Pus or discharge in ear canal
- Lymphadenopathy
- Red tympanic membrane
These findings help confirm diagnosis
What is the purpose of otoscopy in diagnosing otitis externa?
To visualize the ear canal and tympanic membrane
Essential for accurate diagnosis
What is the treatment for mild otitis media?
Acetic acid 2% (EarCalm)
It has antifungal and antibacterial effects
What is the management for moderate otitis media?
- Topical antibiotic + steroid
- Examples: neomycin + dexamethasone, gentamicin + hydrocortisone, ciprofloxacin + betamethasone
Combination therapy is often more effective
What are the risks associated with aminoglycosides in treating otitis externa?
Potential to be ototoxic
Important to exclude perforated tympanic membrane before use
What oral antibiotics may be used for severe otitis media?
- Flucloxacillin
- Clarithromycin
These antibiotics are crucial for managing severe infections
What is malignant otitis externa?
A severe, potentially life-threatening form of otitis externa
It involves the spread of infection to surrounding bones
What are the risk factors for malignant otitis externa?
- Diabetes
- Immunosuppressant medications
- HIV
These conditions increase susceptibility to severe infections
What are symptoms of malignant otitis externa?
- Persistent headache
- Severe pain
- Fever
Symptoms are more severe than in regular otitis externa
What management is required for malignant otitis externa?
- Admission under ENT
- IV antibiotics
- Imaging (CT or MRI head)
Aggressive management is necessary to prevent complications
What complications can arise from malignant otitis externa?
- Facial nerve damage and palsy
- Cranial nerve involvement
- Meningitis
- Intracranial thrombosis
- Death
These complications highlight the seriousness of the condition
