Clinical: swimmer's ear
When to refer:
-Severe otitis externa with intense pain, complete occlusion of ear canal from edema, periauricular erythema, or lymphadenopathy and fever greater than 103 degrees or longer than 3 days. -Potential otomycosis, contact dermatitis, otitis media, or symptoms inconsistent with otitis externa. -Recent trauma (different than described above) to the head or ear(s) - Immunocompromised patients -No relief of symptoms after 3 days of treatment
Mild otitis media
Mild: Minor discomfort and pruritus, minimal canal edema
Moderate otitis media
Moderate: Intermediate degree of pain and pruritus, partially occluded ear canal
Normal otitis media
Normal: The TM is grey, and not bulging. The ear canal has no erythema or swelling.
What is Swimmer's ear?
Otitis externa, also known as swimmer's ear, is defined as diffused inflammation of the external ear canal, almost exclusively caused by a bacterial infection due to water exposure
Severe otitis media
Severe: Intense pain, complete occlusion of ear canal from edema, usually periauricular erythema, lymphadenopathy and fever
Signs and symptoms:
Signs and symptoms of otitis externa include ear pain, pruritus (itching), discharge and hearing loss.
Otitis media
The tympanic membrane appears red, opaque and bulging. Symptoms of otitis media include ear pain, fever >100.4F, headache, apathy, decreased appetite, vomiting or diarrhea and hearing changes.
Treatments:
acetic acid (inhibits bacterial growth) ofloxacin ciprofloxacin dexamethasone until swelling is reduced Additional: acetaminophen ibuprofen
The first line treatment of mild acute otitis externs is:
acetic acid 2% throughout the day