Otitis Externa

Question 1

ESSENCE

Answer 1

Inflammation of skin in external ear canal

Also called swimmers ear

Question 2

AETIOLOGY

Answer 2

• Bacterial infection
• Fungal infection
• Eczema
• Seborrhoeic dermatitis
• Contact dermatitis

Question 3

AETIOLOGY

Most common bacterial causes

Answer 3

• Pseudonomas aeruginosa
• Staphlococcus aureus

Question 4

PRESENTATION

Symptoms

Answer 4

• Ear pain
• Discharge
• Itchiness
• Conductive hearing loss (if ear becomes blocked)

Question 5

PRESENTATION

Signs

Answer 5

• Erythema and swelling
• Tenderness
• Pus or discharge
• Lymphadenopathy

Question 6

INVESTIGATIONS

First line

Answer 6

• Otoscopy for diagnosis
• Maybe ear swab for culturing but usually not required

Question 7

MANAGEMENT

If mild

Answer 7

Acetic acid 2% (OTC as EarCalm)

Question 8

MANAGEMENT

Moderate

Answer 8

• Topical antibiotic and steroid such as
  
  • Neomycin, dexamethasone and acetic acid (otomize spray)
  • Neomycin and betamethasone
  • Gentamicin and hydrocortisone
  • Ciprofloxacin and dexamethasone

Question 9

MANAGEMENT

What must be checked before giving aminoglycosides

Answer 9

There is no perforation, as they are ototoxic so rarely can cause hearing loss if get past tympanic membrane

Question 10

MANAGEMENT

Severe or systemic symptoms

Answer 10

May need oral antibiotics (flucloxacillin or clarithromycin)

Question 11

MANAGEMENT

Medication for fungal infection

Answer 11

Clotimazole ear drops