What are the clinical presentations of acute otitis externa (inflammation of the external ear canal)?

From the Guidelines

Acute otitis externa typically presents with otalgia, otorrhea, and itching of the external ear, often accompanied by a sensation of fullness or blockage, decreased hearing, and fever.

Clinical Presentations

The clinical presentations of acute otitis externa include:

• Otalgia: Severe pain that worsens with movement of the outer ear, such as chewing or talking 1
• Otorrhea: Visible discharge or debris in the external ear canal 1
• Itching: Pruritus of the external ear canal 1
• Sensation of fullness or blockage: Feeling of fullness or blockage in the ear 1
• Decreased hearing: Conductive hearing loss due to impaired transduction of sound waves in the external ear canal 1
• Fever: Elevated body temperature, often accompanied by other symptoms such as malaise and headache 1

Physical Examination

The external ear canal may appear:

• Red and swollen: Inflamed and tender to the touch 1
• Tender: Painful to the touch, especially with movement of the outer ear 1
• With visible discharge or debris: Presence of pus, debris, or other material in the external ear canal 1

Note: The provided evidence primarily discusses otitis media, but 1 provides relevant information on the clinical presentations of acute otitis externa.

From the Research

Clinical Presentations of Acute Otitis Externa

The clinical presentations of acute otitis externa (AOE) include:

• Otalgia (ear pain) 2, 3, 4
• Itching 2, 3
• Fullness 2
• Hearing loss (sometimes) 2
• Tenderness with movement of the tragus or pinna (hallmark sign) 2, 3, 4
• Canal edema (swelling) 3
• Canal erythema (redness) 3
• Otorrhea (discharge) 3

Patient Characteristics

AOE often occurs in:

• Adults 2
• Children older than 2 years 2
• Individuals with a lifetime incidence of up to 10% 2

Causes and Risk Factors

AOE is commonly caused by:

• Bacterial infections, primarily Pseudomonas aeruginosa and Staphylococcus aureus 3, 5, 4
• Fungal infections, such as Aspergillus and Candida species 5
• Swimming or minor trauma from inappropriate cleaning 3
• Allergies or underlying inflammatory dermatologic conditions (in chronic cases) 3