Otitis External

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ICD10 CODE: H60

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

Management

Treatment	LOC
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	HC2
If severe Cloxacillin 250-500 mg every 6 hours for 5-7 days Child: 12.5-25 mg/kg per dose	HC4
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	HC3