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Otitis Externa

Douglas S Parks, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

Inflammation of the external auditory canal: 
  • Acute diffuse otitis externa: the most common form; an infectious process; usually bacterial; occasionally fungal (10%)

  • Acute circumscribe...

DIAGNOSIS

HISTORY

Variable length history of itching, plugging of ear, ear pain, and discharge from ear 

PHYSICAL EXAM

  • Ear canal: red, containing purulent discharge and debris

  • Pain on manipulation of the ...

TREATMENT

GENERAL MEASURES

  • Cleaning the external canal may facilitate recovery.

  • Analgesics as appropriate for pain

  • Antipruritic and antihistamines (eczematous form)

  • Ear wick (Pope) for nearly occluded ear...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Chronic otitis externa 
  • Every 2 to 3 weeks for repeated cleansing of canal

  • May require alterations in topical medication, including antibiotics an...

REFERENCES

1
Kaushik  V, Malik  T, Saeed  SR. Interventions for acute otitis externa. Cochrane Database Syst Rev.  2010;(1):CD004740. [View Abstract on OvidMedline] ...

ADDITIONAL READING

Wipperman J. Otitis Externa. Prim Care. 2014 Mar;41(1):1-9.  

SEE ALSO

Algorithm: Ear Pain/Otalgia 

CODES

ICD10

  • H60.523 Acute chemical otitis externa, bilateral

  • H60.593 Other noninfective acute otitis externa, bilateral

  • B37.84 Candidal otitis externa

  • H60.6 Unspecified chronic otitis externa

  • H60.329 Hemor...

CLINICAL PEARLS

  • Acute diffuse otitis externa is the most common form: bacterial (90%), occasionally fungal (10%).

  • Pseudomonas is the most common bacteria, and it is more susceptible to fluoroquinolones...

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