This is a localized infection of the hair follicle on the outer one-third of the external auditory canal. It is caused by Staphylococcus aureus
Clinical Presentation
- Ear pain that is severe and disproportional to the visible lesion
- Reduced hearing
- Localized swelling on the external auditory canal
- There may be a purulent discharge if the swelling ruptures
Non-Pharmacological Management
-
Aural toilet if there is otorrhea (ear suctioning under direct vision).
-
Instruct the patient to keep the ear dry and avoiding scratching
Pharmacological Management
B: ampicillin + cloxacillin (FDC) (PO) Adults: 500mg 8hourly for 7 to 10days Children: 15mg/kg hourly for 7 to 10days
OR
C: amoxycillin + clavulanic acid (FDC) (PO) Adults: 625mg to 1g 12hourly for 7 to 10days.
Children ≤ 3 months: 30mg/kg/day in 2 divided doses for 7-10 days.
Children >3 months: 25mg/kg/day in 2 divided doses for 7 to 10 days.
AND
A: paracetamol (PO) Adults: 500mg to 1g 4 to 8hourly as needed.
Children ≤ 10kg: 10mg/kg 4 to 8 hourly as needed. Children >10kg: 15mg/kg 4 to 8 hourly as needed
OR
A: ibuprofen (PO) Adults: 200 mg to 400mg 4 to 8hourly as needed.
Children ≥ 6 months: 5mg to 10mg/kg 4 to 8hourly as needed OR combined ibuprofen and paracetamol
Surgical Management
- Incision and drainage