Sandbox:Otitis externa physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Physical examination of the [[ear canal]] will reveal findings indicative of acute, chronic, and malignant necrotizing otitis externa. For acute otitis externa, the patient can appear ill if the cause is infectious and is accompanied by [[fever]]. Patients with chronic otitis externa are usually well-appearing. Malignant necrotizing otitis externa patients are usually ill-appearing due to the accompanying [[fever]] and [[facial palsy|facial palsies]]. | |||
==Physical Examination== | ==Physical Examination== | ||
===HEENT and Neck=== | ===HEENT and Neck=== | ||
*The following physical exam findings in the [[ear canal]] are indicative of otitis externa:<ref name="pmid23198673">{{cite journal |vauthors=Schaefer P, Baugh RF |title=Acute otitis externa: an update |journal=Am Fam Physician |volume=86 |issue=11 |pages=1055–61 |year=2012 |pmid=23198673 |doi= |url=}}</ref> | *The following physical exam findings in the [[ear canal]] are indicative of otitis externa:<ref name="pmid23198673">{{cite journal |vauthors=Schaefer P, Baugh RF |title=Acute otitis externa: an update |journal=Am Fam Physician |volume=86 |issue=11 |pages=1055–61 |year=2012 |pmid=23198673 |doi= |url=}}</ref> | ||
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**[[Stenosis]] of the [[ear canal]]. | **[[Stenosis]] of the [[ear canal]]. | ||
**Buildup of [[otomycosis|mycotic]] debris.<ref name="pmid21625307">{{cite journal |vauthors=Viswanatha B, Naseeruddin K |title=Fungal infections of the ear in immunocompromised host: a review |journal=Mediterr J Hematol Infect Dis |volume=3 |issue=1 |pages=e2011003 |year=2011 |pmid=21625307 |pmc=3103236 |doi=10.4084/MJHID.2011.003 |url=}}</ref> | **Buildup of [[otomycosis|mycotic]] debris.<ref name="pmid21625307">{{cite journal |vauthors=Viswanatha B, Naseeruddin K |title=Fungal infections of the ear in immunocompromised host: a review |journal=Mediterr J Hematol Infect Dis |volume=3 |issue=1 |pages=e2011003 |year=2011 |pmid=21625307 |pmc=3103236 |doi=10.4084/MJHID.2011.003 |url=}}</ref> | ||
**Lack of [[cerumen]]. | |||
*In the neck, [[lymphadenitis]] may be present in acute otitis externa.<ref name="pmid24421666">{{cite journal |vauthors=Hui CP |title=Acute otitis externa |journal=Paediatr Child Health |volume=18 |issue=2 |pages=96–101 |year=2013 |pmid=24421666 |pmc=3567906 |doi= |url=}}</ref> | *In the neck, [[lymphadenitis]] may be present in acute otitis externa.<ref name="pmid24421666">{{cite journal |vauthors=Hui CP |title=Acute otitis externa |journal=Paediatr Child Health |volume=18 |issue=2 |pages=96–101 |year=2013 |pmid=24421666 |pmc=3567906 |doi= |url=}}</ref> | ||
*In malignant necrotizing otitis externa, the patient may present signs of [[trismus]] and partial [[facial palsy]].<ref name="pmid12892351">{{cite journal |vauthors=Handzel O, Halperin D |title=Necrotizing (malignant) external otitis |journal=Am Fam Physician |volume=68 |issue=2 |pages=309–12 |year=2003 |pmid=12892351 |doi= |url=}}</ref> | *In malignant necrotizing otitis externa, the patient may present signs of [[trismus]] and partial [[facial palsy]].<ref name="pmid12892351">{{cite journal |vauthors=Handzel O, Halperin D |title=Necrotizing (malignant) external otitis |journal=Am Fam Physician |volume=68 |issue=2 |pages=309–12 |year=2003 |pmid=12892351 |doi= |url=}}</ref> | ||
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*Patients with chronic otitis externa are usually well-appearing. | *Patients with chronic otitis externa are usually well-appearing. | ||
*Malignant necrotizing otitis externa patients are usually ill-appearing due to the accompanying [[fever]] and [[facial palsy|facial palsies]].<ref name="pmid12892351">{{cite journal |vauthors=Handzel O, Halperin D |title=Necrotizing (malignant) external otitis |journal=Am Fam Physician |volume=68 |issue=2 |pages=309–12 |year=2003 |pmid=12892351 |doi= |url=}}</ref> | *Malignant necrotizing otitis externa patients are usually ill-appearing due to the accompanying [[fever]] and [[facial palsy|facial palsies]].<ref name="pmid12892351">{{cite journal |vauthors=Handzel O, Halperin D |title=Necrotizing (malignant) external otitis |journal=Am Fam Physician |volume=68 |issue=2 |pages=309–12 |year=2003 |pmid=12892351 |doi= |url=}}</ref> | ||
==Key Examples of Otitis Externa Physical Findings== | |||
<gallery> | |||
Image:OtitisExterna001.jpg|A severe case of acute otitis externa. Note the narrowing of the external auditory channel, the prominent amounts of [[exudate]] and swelling of the [[Pinna (anatomy)|auricle]]. Case presented by James Heilman, MD. | |||
Image:OtitisExterna002.jpg|A mild case of otitis externa. Case presented by Klaus D. Peter. | |||
</gallery> | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Inflammations]] | [[Category:Inflammations]] | ||
[[Category:Otolaryngology]] | [[Category:Otolaryngology]] | ||
Latest revision as of 06:43, 28 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.
Overview
Physical examination of the ear canal will reveal findings indicative of acute, chronic, and malignant necrotizing otitis externa. For acute otitis externa, the patient can appear ill if the cause is infectious and is accompanied by fever. Patients with chronic otitis externa are usually well-appearing. Malignant necrotizing otitis externa patients are usually ill-appearing due to the accompanying fever and facial palsies.
Physical Examination
HEENT and Neck
- The following physical exam findings in the ear canal are indicative of otitis externa:[1]
- Erythema and edema.
- Tenderness of the tragus and auricle.
- Cellulitis of the auricle and ear canal.
- Otorrhea
- Granulation tissue
- Stenosis of the ear canal.
- Buildup of mycotic debris.[2]
- Lack of cerumen.
- In the neck, lymphadenitis may be present in acute otitis externa.[3]
- In malignant necrotizing otitis externa, the patient may present signs of trismus and partial facial palsy.[4]
Appearance of the Patient
- For acute otitis externa, the patient can appear ill if the cause is infectious and is accompanied by fever.[5]
- Patients with chronic otitis externa are usually well-appearing.
- Malignant necrotizing otitis externa patients are usually ill-appearing due to the accompanying fever and facial palsies.[4]
Key Examples of Otitis Externa Physical Findings
-
-
A mild case of otitis externa. Case presented by Klaus D. Peter.
References
- ↑ Schaefer P, Baugh RF (2012). "Acute otitis externa: an update". Am Fam Physician. 86 (11): 1055–61. PMID 23198673.
- ↑ Viswanatha B, Naseeruddin K (2011). "Fungal infections of the ear in immunocompromised host: a review". Mediterr J Hematol Infect Dis. 3 (1): e2011003. doi:10.4084/MJHID.2011.003. PMC 3103236. PMID 21625307.
- ↑ Hui CP (2013). "Acute otitis externa". Paediatr Child Health. 18 (2): 96–101. PMC 3567906. PMID 24421666.
- ↑ 4.0 4.1 Handzel O, Halperin D (2003). "Necrotizing (malignant) external otitis". Am Fam Physician. 68 (2): 309–12. PMID 12892351.
- ↑ "Malignant otitis externa: MedlinePlus Medical Encyclopedia".