Otitis externa classification: Difference between revisions

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Latest revision as of 23:29, 29 July 2020

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

Otitis externa is classified as acute, chronic, or malignant based on the duration of the disease, diffusion of the infection, and the severity of symptoms.

Classification

Otitis externa is classified by duration, diffusion, and symptom severity.

Acute Otitis Externa

Onset within 48 hours.^[1]
Acute otitis externa is localized to the [[ear canal]..

Chronic Otitis Externa

Otitis externa is considered chronic in cases that persist greater than 3 months with treatment.^[1]

Malignant Necrotizing Otitis Externa

Acute otitis externa becomes reclassified as malignant and necrotizing when the infectious pathogen diffuses from the ear canal and infects the temporal bones, as well as bones in the ear adjacent to the canal, leading to damage and degradation.^[2]^[3]

References

↑ ^1.0 ^1.1 Hui CP (2013). "Acute otitis externa". Paediatr Child Health. 18 (2): 96–101. PMC 3567906. PMID 24421666.
↑ Handzel O, Halperin D (2003). "Necrotizing (malignant) external otitis". Am Fam Physician. 68 (2): 309–12. PMID 12892351.
↑ "Malignant otitis externa: MedlinePlus Medical Encyclopedia".

Template:WH Template:WS

[pmid24421666-1] 1.0 ^1.1 Hui CP (2013). "Acute otitis externa". Paediatr Child Health. 18 (2): 96–101. PMC 3567906. PMID 24421666.

[pmid12892351-2] Handzel O, Halperin D (2003). "Necrotizing (malignant) external otitis". Am Fam Physician. 68 (2): 309–12. PMID 12892351.

[urlMalignant_otitis_externa:_MedlinePlus_Medical_Encyclopedia-3] "Malignant otitis externa: MedlinePlus Medical Encyclopedia".

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 ==Overview==
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 ===Acute Otitis Externa===
-*Otitis externa is characterized as "acute" if the following conditions are satisfied:<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>
+*Onset within 48 hours.<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>
-**Onset within 48 hours.
+*Acute otitis externa is localized to the [[ear canal]..
-**Primarily caused by [[bacterial]] infection of ''[[Pseudomonas aeruginosa]]'' and ''[[Staphylococcus aureus|Staphylococcus aureus]]''.<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>
-**[[Otalgia]] and feelings of [[itchiness]] or "fullness" of the [[ear canal]].
-**[[Erythema]] or [[edema]] of [[ear canal]].<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>
-**Tenderness of the tragus and [[pinna]].
-*Hearing loss is not usually associated with acute presentations of 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>
-*Acute otitis externa is localized to the [[ear canal]] and is not characterized by diffusion of infection throughout the ear and head.
 ===Chronic Otitis Externa===
 *Otitis externa is considered chronic in cases that persist greater than 3 months with treatment.<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>
-**It is usually diagnosed in cases which [[antibiotic]] therapy does not alleviate symptoms.
 ===Malignant Necrotizing Otitis Externa===
 *Acute otitis externa becomes reclassified as malignant and necrotizing when the infectious pathogen diffuses from the [[ear canal]] and infects the [[temporal bones]], as well as bones in the ear adjacent to the canal, leading to damage and degradation.<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><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>
-*It is usually caused by the [[bacterial]] pathogen responsible for the acute variant, usually ''[[Pseudomonas aeruginosa]]''.
-*Otitis externa becomes malignant when the patient is [[immunocompromise|immunocompromised]].
-**It usually occurs in acute otitis externa patients with [[diabetes]] or undergoing [[chemotherapy]], leading to reduced ability to counter the spread of the pathogen.
-*Malignant otitis externa will usually manifest with the following symptoms:
-**Severe [[otalgia]] and [[otorrhea]] that is not responsive to treatment.
-**Granulated tissue in the [[ear canal]]
-**Intracranial and neck complications:
-***[[Fever]]
-***Nerve damage in the head and neck.
-***[[Osteitis]]
-***[[Lymphadenitis]]
-***Difficulty speaking or swallowing.
-***[[Facial palsy]]
-*Treatment of malignant otitis externa requires therapy targeting the pathogen as well as the source for [[immunocompromise|immunocompromisation]].
 ==References==
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-[[Category:Inflammations]]
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-{{WH}}
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