Otitis externa: The Daily PANCE Blueprint
A 7-year-old female presents to the clinic with her mother, complaining of left ear pain and pruritus for the past few days. Physical exam is remarkable for drainage and pain on tragal pressure. Which of the following is the most likely diagnosis?
A. Cellulitis
B. Cholesteatoma
C. Perichondritis
D. Otitis media
E. Otitis externa
Answer and topic summary
The answer is E. Otitis externa
The patient likely has otitis externa (“swimmer’s ear), which is essentially inflammation of the external auditory canal. The most common bacterial cause is Pseudomonas aeruginosa (~40%). Risk factors include water exposure, trauma, and ear devices. Clinical manifestations include ear pain, pruritus, auricular discharge, pain/tenderness when pressure is applied to the tragus, and hearing loss. The preferred pharmacological treatment is topical ear antibiotic/steroid drops. Medication options include ciprofloxacin/dexamethasone or neomycin/polytrim B /hydrocortisone. Remember that aminoglycosides are ototoxic and should be avoided when the tympanic membrane can’t be visualized!
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint EENT ⇒ ⇒ ⇒
Also covered as part of the Pediatric EOR, Family Medicine EOR, and Emergency Medicine PAEA EOR topic list
