Acute Bacterial Otitis Externa

DR. J.N.PATEL
20, New Jaganath, RAJKOT
Email; doctorjitendra@yahoo.com
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 Acute Bacterial Otitis Externa
• Classification
• Etiology
• Pathology
• Symptoms
• Signs
• Differantial Diagnosis
• Treatment

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 Classification
• Localised (furuncle)
• Generalised

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 Etiology
• Age : Any
• Water : may carry organism (Swimmer’s Ear)
• Scratching
• Otitis Media
• Diabetes Mellitus

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 Pathology
• Furuncle : Staphylococcal infection of Hair
follicle or sebaceous gland. (only cartilaginous
part)
• Generalised: Staphylo, Strepto, gram –ve
infection

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 Symptoms
1. Pain

1. Otorhhoea
2. Deafness
3. Itching
4. Tinitus
5. Trismus
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 Signs
1 ) Swelling :

- Furuncle : -Generalized O.E.:

Localized swelling Generalized swelling
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 Signs ( cont….)
2) Tenderness :
- Furuncle : Pressure over Tragus causes pain
- Generalised : Movement of Pinna causes pain
3) Discharge :
4) Trismus :
5) Hearing loss (if lesion occludes canal)

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 Differantial Diagnosis
Acute Otitis Externa Acute Otitis Media

Tenderness : Bellow or anterior Mastoid region.

to Pinna.
Movement of Pinna Movement of Pinna
is painful is not painful
Tympanic Normal Congested /
Membrane perforated
X-Ray Mastoid Normal Loss of air cells

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 Treatment
1). Local Rx:
1. Wick : 10% Icthammol in Glycerin or Glycerin
Megsulf wick

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 Treatment
1). Local Rx: ( cont…)

2. Antibiotic Ear Drops: if Purulent Discharge

3.Fomentation
4. Ear Toilet : - Water should not enter in the ear,
- Cleaning the Discharge
5. I & D of furuncle : if it causes severe pain

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 Treatment
2). General Rx:
1. Antibiotic : Cloxacilin
2. Analgesic :
3. Rx of D.M if it is present.
3) Prevention:
1. Water should not enter in the Ear
2. No Scratching inside the ear canal

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 Treatment
3). Nasal Rx:

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 Treatment
3). Nasal Rx:
If there is recurrent Otitis Externa,
organism often carried out from nasal vestibule.
So, Neosporine ointment should be applied at
nose twice daily in recurrent cases.

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