Otitis externa: Difference between revisions
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##Chronic suppurative otitis media | ##Chronic suppurative otitis media | ||
##Ear canal findings are usually mild compared with bacterial external otitis | ##Ear canal findings are usually mild compared with bacterial external otitis | ||
#Ramsay Hunt syndrome | #[[Ramsay Hunt syndrome]] | ||
==Treatment== | ==Treatment== | ||
Revision as of 02:16, 5 June 2014
Background
Microbiology
- Staph/Strep
- Pseudomonas
- Enterobacter
- Proteus
- Fungus
- Aspergillus, candida (may present after abx tx)
Risk Factors
- Swimming
- Excessive Q-tip use
Diagnosis
- Otalgia
- Elicited by tragal pressure, pulling the auricle superiorly
- Pruritis
- Discharge
- Hearing loss
Differential Diagnosis
- Malignant Otitis Externa
- Otomycosis
- Pts complain more of itching than pain
- Characteristic appearance on exam; like mold growing on spoiled food
- Treatment
- Cleaning of ear canal
- Topical antifungal
- Contact Dermatitis
- Chronic suppurative otitis media
- Ear canal findings are usually mild compared with bacterial external otitis
- Ramsay Hunt syndrome
Treatment
- Clean the ear canal
- Cerumen wire loop or cotton swab
- 1:1 dilution of 3% hydrogen peroxide if TM is visible and intact
- Antibiotics
- Floxin Otic: 5 drops in affected ear BID x 7 days
- Safe with perforations
- Cipro HC Otic: 3 drops in affected ear BID x 7 days
- Contains hydrocortisone = faster healing
- Not safe with perforation
- Floxin Otic: 5 drops in affected ear BID x 7 days
- Cortisporin Otic (neomycin/polymixin B/hydrocortisone)
- 4 gtt in ear ITD-QID x 7dy
- Use suspension (NOT solution) if possiblity of perforation
- Analgesia
- NSAIDs
- Avoiding promoting factors
- Keep ear canal dry
- Abstain from water sports for 7-10 days
Disposition
- F/u in 1-2wks for pts with moderate disease
See Also
Source
- UpToDate
- Tintinalli