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 |
|---|---|
| Otitis media | The inflammation of the middle ear. Usually presents with otalgia, feelings of "fullness" in the ear, otorrhea, partial hearing loss. Differentiates itself from otitis externa by also usually presenting with common cold symptoms from the causative pathogen, as well as neurological symptoms from the buildup of effusion in the tympanic membrane, including poor attention span, delayed speech development, clumsiness, and poor balance. Otitis media is differentiated from otitis externa in that it primarily affects children up to 5 years old.[5][6] |
| Infectious Myringitis | The inflammation of the tympanic membrane. Usually presents with otalgia, otorrhea, and partial hearing loss. Differentiates itself from otitis externa by presenting blisters on the tympanic membrane. Additionally, the primary cause is mycoplasmic bacterial infection.[7] |
| 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.
- ↑ "Ear infection - acute: MedlinePlus Medical Encyclopedia".
- ↑ Qureishi A, Lee Y, Belfield K, Birchall JP, Daniel M (2014). "Update on otitis media - prevention and treatment". Infect Drug Resist. 7: 15–24. doi:10.2147/IDR.S39637. PMC 3894142. PMID 24453496.
- ↑ "Infectious myringitis: MedlinePlus Medical Encyclopedia".