Fast Five Quiz: How Familiar Are You With Otitis Externa?

Russell W. Steele, MD


October 17, 2018

Patients may present with the following:

  • Otalgia, ranging from mild to severe, typically progressing over 1-2 days

  • Hearing loss

  • Ear fullness or pressure

  • Tinnitus

  • Fever (occasionally)

  • Itching (especially in fungal OE or chronic OE)

  • Severe deep pain – If this is experienced by a patient who is immunocompromised or diabetic, be alert to the possibility of necrotizing (malignant) OE

  • Discharge – Initially, the discharge may be clear and odorless, but it quickly becomes purulent and foul-smelling

  • Bilateral symptoms (rare)

  • Frequently, a history of exposure to or activities in water (eg, swimming, surfing, and kayaking)

  • Usually, a history of preceding ear trauma (eg, forceful ear cleaning, use of cotton swabs, or water in the ear canal)

Complications of OE are rare and may include the following:

  • Necrotizing OE (the most significant complication)

  • Mastoiditis

  • Chondritis of the auricle (from spread of acute OE to the pinna, particularly in patients with newly pierced ears)

  • Bony erosion of the base of the skull (skull base osteomyelitis)

  • Central nervous system infection

  • Cellulitis or lymphadenitis

For more on the presentation of OE, read here.


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