Acute Diffuse Otitis Externa of the Right Ear: A Case Report

Abstract

Background:
Diffuse otitis externa is an inflammatory disorder affecting the external auditory canal. It is commonly associated with bacterial infection and promoted by disruption of the local protective barrier. Predisposing factors for diffuse otitis externa include local trauma, moisture, altered canal pH and use of earphones or other devices.

Case Report:

A 34-year-old man presented to the Ear, Nose and Throat clinic of RSU UKI with a four-day history of intense right-sided otalgia. The pain was accompanied by pruritus, otorrhea and pain during chewing and talking. He reported sleeping with earphones and using cotton buds almost daily. Examination showed tragal tenderness and pain on auricular traction, with a narrow, hyperemic external auditory canal and secretion in the right ear. The left ear showed no comparable external auditory canal inflammatory findings. The clinical diagnosis was diffuse otitis externa of the right ear. Differential diagnoses included localized  otitis externa and otomycosis. Management included local ear care, avoidance of further trauma and water exposure, and lidocaine hydrochloride as documented in the patient-specific prescription.

Conclusion:
The diagnosis of diffuse otitis externa can be established primarily from the characteristic history and physical examination. In this case, repeated mechanical trauma from cotton-bud use was an important predisposing factor, while prolonged earphone use may also have contributed to local irritation or canal occlusion. Patient education regarding avoidance of further ear manipulation and maintenance of dry-ear precautions is an essential component of management.