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