Otitis externa classification: Difference between revisions

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*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>
*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.
**Onset within 48 hours.
**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]].
**[[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>
**[[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>

Revision as of 20:40, 6 August 2016

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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

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

  • Otitis externa is characterized as "acute" if the following conditions are satisfied:[1]
  • Hearing loss is not usually associated with acute presentations of otitis externa.[1]
  • 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.[1]
    • 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.[2][3]
  • It is usually caused by the bacterial pathogen responsible for the acute variant, usually Pseudomonas aeruginosa.
  • Otitis externa becomes malignant when the patient is 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:
  • Treatment of malignant otitis externa requires therapy targeting the pathogen as well as the source for immunocompromisation.

References

  1. 1.0 1.1 1.2 1.3 Hui CP (2013). "Acute otitis externa". Paediatr Child Health. 18 (2): 96–101. PMC 3567906. PMID 24421666.
  2. Handzel O, Halperin D (2003). "Necrotizing (malignant) external otitis". Am Fam Physician. 68 (2): 309–12. PMID 12892351.
  3. "Malignant otitis externa: MedlinePlus Medical Encyclopedia".

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