OTITIS EXTERNA

Infection of the external ear canal, which may be localised (furunculosis) or generalised (diffuse)

Causes

  • 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

  • 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