Patients may present with the following:
Otalgia, ranging from mild to severe, typically progressing over 1-2 days
Ear fullness or pressure
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)
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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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Russell W. Steele. Fast Five Quiz: How Familiar Are You With Otitis Externa? - Medscape - May 17, 2016.