From the Guidelines
Acute otitis externa typically presents with otalgia, otorrhea, and itching of the external ear canal.
Clinical Presentations
The clinical presentations of acute otitis externa include:
- Otalgia: sharp and stabbing pain that may be exacerbated by movement of the outer ear or jaw
- Otorrhea: purulent and malodorous discharge
- Itching and fullness of the ear canal
- Hearing loss or a sensation of ear fullness due to blockage of the ear canal by debris or edema
- The external ear canal may appear red, swollen, and tender to the touch, with visible pus or discharge
Diagnosis and Treatment
Diagnosis of acute otitis externa can be challenging, especially in cases where the tympanic membrane is difficult to visualize due to cerumen or inflammation 1. Treatment options may include topical antifungal creams or ointments, as well as oral antifungal medications such as itraconazole, voriconazole, or posaconazole 1. However, it is essential to note that the provided evidence primarily focuses on otitis media, and the information on acute otitis externa is limited. Therefore, the diagnosis and treatment of acute otitis externa should be guided by specific clinical guidelines and expert recommendations.
From the Research
Clinical Presentations of Acute Otitis Externa
The clinical presentations of acute otitis externa (AOE) include:
- Otalgia (ear pain) 2, 3, 4, 5
- Itching 2, 3, 4, 6
- Fullness 2
- Hearing loss 2
- Redness and swelling of the canal 3, 5
- Otorrhea (discharge) 3
- Tenderness with movement of the tragus or pinna, which is a classic finding 2, 3, 5
- Canal edema and canal erythema 3
Patient Characteristics
AOE often occurs in adults or children older than the age of 2, with little morbidity in children under the age of 2 2. The lifetime incidence of AOE is up to 10% in a person's life 2.
Causes and Complications
The condition is influenced by factors like pH levels, inflammation, and bacterial or fungal invasion 4. The most common bacteria involved are Pseudomonas aeruginosa and Staphylococcus aureus, and the most common fungi are Aspergillus and Candida species 4. AOE can lead to serious complications, such as necrotizing otitis externa, which requires prompt medical attention 4.