AOM – Otitis Externa
Otitis externa (“swimmer’s ear”) is inflammation of the external ear canal leading to severe otalgia and tenderness to palpation. Erythema, edema, drainage, and pruritis may be present. It is often preceded by frequent swimming, trauma, or a foreign body. It is typically caused by infection, often bacterial and sometimes fungal. Common bacteria include Pseudomonas aeruginosa and Staphylococcus aureus.
Symptoms:
- Otalgia, itching, fullness, hearing loss, otorrhea, tenderness of the tragus when pushed, tenderness of pinna when pulled.
Treatment:
- Severe otitis externa (severe ear canal swelling where the eardrum is not visible). Ear wick placement, Ciprofloxacin/dexamethasone BID until wick comes out, strict dry ear precautions and f/u in 5-7 days for wick removal.
- With less severe otitis externa, where the eardrum is visible, Ciprofloxacin/dexamethasone drops without wick placement.
- Consider appropriate pain management.
These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.