Otitis Externa

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents with a ‍-‍day history of ‍paindischargeitching in the ‍rightleftboth ear.

Symptoms include:

‍ear pain

‍itching in the ear

‍ear discharge

‍hearing loss

‍tinnitus

‍swelling of the ear

‍redness of the ear

‍fever, up to ‍°, over ‍ ‍hoursdays

‍chills



Worsening factors: ‍none

Alleviating factors: ‍none, ‍effectiveineffective



Contributing factors:

‍frequent swimming

‍use of hearing aids

‍use of earplugs

no history of: ‍otitis externa, ‍atopic dermatitis, ‍psoriasis, ‍diabetes, ‍immunodeficiency





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Head: ‍normocephalicatraumatic, scalp ‍normalrashlesion

Ears: tympanic membranes ‍normal ‍, auditory canal ‍ on ‍rightleft, hearing ‍intact

Nose: ‍clear, discharge ‍clear, ‍

Throat: ‍normal, ‍erythema, ‍exudate, ‍

Neck: ‍normal, ‍lymphadenopathy, ‍, c-spine ‍





ASSESSMENT:

‍Otitis Externa ‍likelysuspectedpossible

DDx: acute otitis externa, chronic otitis externa, malignant otitis externa, impacted cerumen, acute otitis media, otitis media with perforation, foreign body in the ear, eczema of the ear canal, psoriasis of the ear canal, contact dermatitis of the ear canal, fungal otitis externa, cellulitis of the pinna, herpes zoster oticus, neoplasia of the external auditory canal, ramsay hunt syndrome, temporomandibular joint disorder, neck adenopathy





PLAN:

Investigations:

- Ear swab for culture

Treatments:

- ‍Topical antibiotics

- ‍Topical corticosteroids

- ‍Analgesics

- Avoid water exposure to the ear

- Avoid use of ear plugs or hearing aids until symptoms resolve

Further care:

- Referral to otolaryngologist

- Follow-up in ‍ ‍daysweeks

- Return if symptoms worsen or if new symptoms develop such as fever, dizziness, or discharge from the ear