Otitis externa: Difference between revisions
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==Background== | ==Background== | ||
===Microbiology=== | |||
#Pseudomonas | |||
#staph | |||
#strep | |||
#anerobes | |||
#Fungal infection may present after Abx tx | |||
===Risk Factors=== | |||
#Swimming | |||
#excessive Q-tip use | |||
==Diagnosis== | ==Diagnosis== | ||
#Otalgia | |||
##Elicited by tragal pressure, pulling the auricle superiorly | |||
#Pruritis | |||
#Discharge | |||
#Hearing loss-pain on gentle traction of the external ear structures | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
#Necrotizing otitis externa | |||
##Spread of infection to soft tissue, cartilage, bone of temporal region | |||
##Most common in elderly, diabetic patients | |||
##Granulation tissue often seen in the ear canal floor | |||
##Prompt referral to ENT; treat with anti-pseudomonal agents | |||
#Otomycosis | |||
##Pts complain more of itching than pain | |||
##Characteristic apperance 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 | |||
==Treatment== | ==Treatment== | ||
#Clean the ear canal | |||
##Cerumen wire loop or cotton swab | |||
##1:1 dilution of 3% hydrogen peroxide if TM is visible and intact | |||
#Topical antibiotic therapy | |||
##Floxin Otic: 5 drops in affected ear BID x 7 days | |||
##Cipro HC Otic: 3 drops in affected ear BID x 7 days | |||
###Contains hydrocortisone = faster healing | |||
##Cortisporin Otic suspension: 4 drops TID x 7 days | |||
###Avoid in pts with perforated TM | |||
#Analgesia | |||
##NSAIDs | |||
#Avoiding promoting factors | |||
##Keep ear canal dry | |||
##Abstain from water sports for 7-10 days | |||
#Follow-up | |||
##1-2 weeks for pts with moderate disease | |||
==See Also== | ==See Also== | ||
ENT: Otitis media | ENT: Otitis media | ||
==Source== | ==Source== | ||
UpToDate | UpToDate | ||
[[Category:ENT]] | [[Category:ENT]] |
Revision as of 13:48, 12 March 2011
Background
Microbiology
- Pseudomonas
- staph
- strep
- anerobes
- Fungal infection 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-pain on gentle traction of the external ear structures
Differential Diagnosis
- Necrotizing otitis externa
- Spread of infection to soft tissue, cartilage, bone of temporal region
- Most common in elderly, diabetic patients
- Granulation tissue often seen in the ear canal floor
- Prompt referral to ENT; treat with anti-pseudomonal agents
- Otomycosis
- Pts complain more of itching than pain
- Characteristic apperance 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
Treatment
- Clean the ear canal
- Cerumen wire loop or cotton swab
- 1:1 dilution of 3% hydrogen peroxide if TM is visible and intact
- Topical antibiotic therapy
- Floxin Otic: 5 drops in affected ear BID x 7 days
- Cipro HC Otic: 3 drops in affected ear BID x 7 days
- Contains hydrocortisone = faster healing
- Cortisporin Otic suspension: 4 drops TID x 7 days
- Avoid in pts with perforated TM
- Analgesia
- NSAIDs
- Avoiding promoting factors
- Keep ear canal dry
- Abstain from water sports for 7-10 days
- Follow-up
- 1-2 weeks for pts with moderate disease
See Also
ENT: Otitis media
Source
UpToDate