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==Overview==
Physical examination of the [[ear canal]] will reveal findings indicative of acute, chronic, and malignant necrotizing otitis externa. In 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]].


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==Physical Examination==
===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>
**[[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 [[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 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>


===Physical Examination===
===Appearance of the Patient===
<div align="left">
*For acute otitis externa, the patient can appear ill if the cause is infectious and is accompanied by [[fever]].<ref name="urlMalignant otitis externa: MedlinePlus Medical Encyclopedia">{{cite web |url=https://www.nlm.nih.gov/medlineplus/ency/article/000672.htm |title=Malignant otitis externa: MedlinePlus Medical Encyclopedia |format= |work= |accessdate=}}</ref>
<gallery heights="175" widths="175">
*Patients with chronic otitis externa are usually well-appearing.
Image:Otitis Externa Oct2004 044 2 op .jpg|Boil (furuncle) occluding the right external auditory meatus<ref>http://www.ghorayeb.com</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>
Image:Otitis Externa GG .jpg|Otitis externa.<ref>http://www.ghorayeb.com</ref>
</gallery>
</div>
 
<div align="left">
<gallery heights="175" widths="175">
Image:Otitis Externa .jpg|Magnified picture of the furuncle. Note the complete occlusion of the external auditory meatus, the redness and the crusted exudate.<ref>http://www.ghorayeb.com</ref>
Image:Allergy to Neomycin 350 SQ.jpg|Allergic otitis externa, a reaction to Neomycin. The skin of the external auditory meatus, concha, incisura intertragica is swollen, bumpy and itchy.<ref>http://www.ghorayeb.com</ref>
</gallery>
</div>


<div align="left">
==Key Examples of Otitis Externa Physical Findings==
<gallery heights="175" widths="175">
<gallery>
Image:AURICLEDERMATITISG.jpg|Otitis externa and seborrheic dermatitis.<ref>http://www.ghorayeb.com</ref>
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:Seborrheic Dermatitis and Otitis Externa op.jpg|Otitis externa and seborrheic dermatitis.<ref>http://www.ghorayeb.com</ref>
Image:OtitisExterna002.jpg|A mild case of otitis externa. Case presented by Klaus D. Peter.
</gallery>
</gallery>
</div>


==References==
==References==
{{reflist|2}}
{{reflist|2}}


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Latest revision as of 23:30, 29 July 2020

Otitis externa Microchapters

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Overview

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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.; Tarek Nafee, M.D. [2]

Overview

Physical examination of the ear canal will reveal findings indicative of acute, chronic, and malignant necrotizing otitis externa. In 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

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 severe case of acute otitis externa. Note the narrowing of the external auditory channel, the prominent amounts of exudate and swelling of the auricle. Case presented by James Heilman, MD.

    A severe case of acute otitis externa. Note the narrowing of the external auditory channel, the prominent amounts of exudate and swelling of the auricle. Case presented by James Heilman, MD.

  • A mild case of otitis externa. Case presented by Klaus D. Peter.

    A mild case of otitis externa. Case presented by Klaus D. Peter.

References

  1. ↑ Schaefer P, Baugh RF (2012). "Acute otitis externa: an update". Am Fam Physician. 86 (11): 1055–61. PMID 23198673.
  2. ↑ 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.
  3. ↑ Hui CP (2013). "Acute otitis externa". Paediatr Child Health. 18 (2): 96–101. PMC 3567906. PMID 24421666.
  4. ↑ 4.0 4.1 Handzel O, Halperin D (2003). "Necrotizing (malignant) external otitis". Am Fam Physician. 68 (2): 309–12. PMID 12892351.
  5. ↑ "Malignant otitis externa: MedlinePlus Medical Encyclopedia".

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