Differentiating otitis externa from other diseases
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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
Acute otitis externa must be differentiated from other diseases that cause otalgia, ear itching, otorrhea, erythema and edema of the ear canal, hearing loss, ear pressure, and dermatitis. Malignant otitis externa must be differentiated from other diseases that cause facial palsy, osteitis, difficulty swallowing, and hoarseness.
Differentiating Otitis Externa From Other Diseases
Acute otitis externa must be differentiated from other diseases that cause otalgia, ear itching, otorrhea, erythema and edema of the ear canal, hearing loss, ear pressure, and dermatitis.[1][2] Malignant otitis externa must be differentiated from other diseases that cause facial palsy, osteitis, difficulty swallowing, and hoarseness.[3][4]
| Disease | Findings |
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| EHEC | May present with fever, chills vomiting, diarrhea, generalized pain or malaise, and gastointestinal bleeding that follow an incubation period of 3-7 days. Unlike E. coli, Shigella cannot ferment lactose or decarboxylate lysine.[5] |
| Ebola | Presents with fever, chills vomiting, diarrhea, generalized pain or malaise, and sometimes internal and external bleeding, that follow an incubation period of 2-21 days. |
| Typhoid fever | Presents with fever, headache, rash, gastrointestinal symptoms, with lymphadenopathy, relative bradycardia, cough and leucopenia and sometimes sore throat. Blood and stool culture can confirm the presence of the causative bacteria. |
| Malaria | Presents with acute fever, headache and sometimes diarrhea (children). A blood smears must be examined for malaria parasites. The presence of parasites does not exclude a concurrent viral infection. An antimalarial should be prescribed as an empiric therapy. |
| Lassa fever | Disease onset is usually gradual, with fever, sore throat, cough, pharyngitis, and facial edema in the later stages. Inflammation and exudation of the pharynx and conjunctiva are common. |
| Yellow fever and other Flaviviridae | Present with hemorrhagic complications. Epidemiological investigation may reveal a pattern of disease transmission by an insect vector. Virus isolation and serological investigation serves to distinguish these viruses. Confirmed history of previous yellow fever vaccination will rule out yellow fever. |
| Others | Viral hepatitis, leptospirosis, rheumatic fever, typhus, and mononucleosis can produce signs and symptoms that may be confused with Ebola in the early stages of infection. |
References
- ↑ "Otitis externa - Symptoms - NHS Choices".
- ↑ "Swimmer's ear : MedlinePlus Medical Encyclopedia".
- ↑ "Malignant otitis externa: MedlinePlus Medical Encyclopedia".
- ↑ Handzel O, Halperin D (2003). "Necrotizing (malignant) external otitis". Am Fam Physician. 68 (2): 309–12. PMID 12892351.
- ↑ Hale, TL; Keusch, GT (1996). "Shigella. In: Baron S, editor. Medical Microbiology. 4th edition". Galveston (TX): University of Texas Medical Branch at Galveston. Retrieved 4 April 2015.