External Ear Infections Clinical Presentation

  • Author: Ashutosh Kacker, MD; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Apr 16, 2012
 

History

Usually a history of preceding ear trauma in the form of forceful ear cleaning, use of cotton swabs, or water in the ear canal is present.

Severe throbbing pain with ear discharge follows, which can then lead to a hearing loss due to occlusion of the ear canal.

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Physical

Pseudomonal infection produces purulent otorrhea that may be green or yellow, while Aspergillus otomycosis looks like a fine white mat topped by black spheres. In addition to otorrhea, erythema and edema of the EAC is common. In severe cases, soft tissue stenosis may be present. Extension of the infection from the EAC may manifest as cellulitic skin changes involving the concha of the auricle and the tragus.

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Causes

Common predisposing causes are swimming, forceful cleaning of the ear, and trauma.

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Contributor Information and Disclosures
Author

Ashutosh Kacker, MD  Associate Professor of Otorhinolaryngology, Department of Otolaryngology, Weill Cornell Medical College; Associate Attending Physician, Otolaryngologist, New York Presbyterian Hospital; Attending Physician, New York Hospital of Queens; Attending Physician, Lenox Hill Hospital

Ashutosh Kacker, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Rhinologic Society, and Triological Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Jack A Shohet, MD  President, Shohet Ear Associates Medical Group, Inc; Associate Clinical Professor, Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, School of Medicine

Jack A Shohet, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Neurotology Society, American Tinnitus Association, and California Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Gerard J Gianoli, MD  Clinical Associate Professor, Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine; Vice President, The Ear and Balance Institute; Chief Executive Officer, Ponchartrain Surgery Center

Gerard J Gianoli, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Neurotology Society, American Otological Society, Society of University Otolaryngologists-Head and Neck Surgeons, and Triological Society

Disclosure: Vesticon, Inc. None Board membership

Christopher L Slack, MD  Private Practice in Otolaryngology and Facial Plastic Surgery, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders

Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA  Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation Unrestricted gift Unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Medvoy Ownership interest Management position; Cerescan Imaging Consulting; Headwatersmb Consulting fee Consulting; Venturequest Royalty Consulting

References

  1. Estimated burden of acute otitis externa--United States, 2003-2007. MMWR Morb Mortal Wkly Rep. May 20 2011;60(19):605-9. [Medline].

  2. Kaushik V, Malik T, Saeed SR. Interventions for acute otitis externa. Cochrane Database Syst Rev. Jan 20 2010;CD004740. [Medline].

  3. Alva B, Prasad KC, Prasad SC, Pallavi. Temporal bone osteomyelitis and temporoparietal abscess secondary to malignant otitis externa. J Laryngol Otol. Apr 17 2009;1-4. [Medline].

  4. [Guideline] Rosenfeld RM, Brown L, Cannon CR, Dolor RJ, Ganiats TG, Hannley M, et al. Clinical practice guideline: acute otitis externa. Otolaryngol Head Neck Surg. Apr 2006;134(4 Suppl):S4-23. [Medline].

  5. Brook I. Treatment of otitis externa in children. Paediatr Drugs. Oct-Dec 1999;1(4):283-9. [Medline].

  6. Mirza N. Otitis externa. Management in the primary care office. Postgrad Med. May 1996;99(5):153-4, 157-8. [Medline].

  7. Morden NE, Berke EM. Topical fluoroquinolones for eye and ear. Am Fam Physician. Oct 15 2000;62(8):1870-6. [Medline].

  8. Selesnick SH. Otitis externa: management of the recalcitrant case. Am J Otol. May 1994;15(3):408-12. [Medline].

  9. Tierney MR, Baker AS. Infections of the head and neck in diabetes mellitus. Infect Dis Clin North Am. Mar 1995;9(1):195-216. [Medline].

 
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Anatomy of the external and middle ear.
 
 
 
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