Ear - Otitis Externa
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Infection of the external ear canal, which may be localised (furunculosis) or generalised (diffuse)
Cause
- Bacterial, fungal, viral infections
Clinical features
- Pain, tenderness on pulling the pinna (external ear)
- Itching (especially for fungal infections)
- Swelling
- Pus discharge
Differential diagnosis
- Foreign body
- Otitis media (especially with pus discharge)
- Traumatic injury
Investigations
- Good history and physical examination are important in making a diagnosis
- If there is a discharge: Pus swab for microscopy, C&S
- If discharge is white or black, it is fungal
- If discharge is yellow, it is bacterial
ManagementTreatment
Thoroughly clean external ear canal
- Apply antibiotic drops, e.g. Chloramphenicol ear drops 0.5% 2 drops into the ear every 8 hours for 14 days
- Give analgesics e.g. Paracetamol
If severe
- Cloxacillin 250-500 mg every 6 hours for 5-7 days
- Child: 12.5-25 mg/kg per dose
If fungal infection is suspected
- Remove any crusting by syringing
- Apply Clotrimazole solution once a week for 4-8 weeks
- Or fluconazole 200 mg once a day for 10 days