Overview
Infection of the external ear can result from various causes, including piercing-related injuries, often involving Pseudomonas aeruginosa, and recurrent otitis externa leading to acquired atresia of the external auditory canal. 12Diagnosis
Clinical signs include drainage of pus or blood, swelling, and pain.
Confirmed diagnosis requires culture isolation of pathogens, particularly Pseudomonas aeruginosa.
Suspected cases exhibit prolonged symptoms consistent with external ear infection. 1Management
First-line treatments: Antibiotics effective against Pseudomonas aeruginosa, such as fluoroquinolones or aminoglycosides.
Adjunctive measures: Incision and drainage for abscess formation, surgical intervention in cases of severe deformity or complications. 1Special Populations
Pediatrics: Upper ear cartilage piercing in adolescents (10-19 years) is associated with higher infection risk. 1
Comorbidities: No specific guidance provided in abstracts regarding comorbidities; however, recurrent infections may lead to complications like atresia. 2Key Recommendations
Use antibiotics effective against Pseudomonas aeruginosa for treating external ear infections caused by piercing-related injuries. (Evidence: Strong 1)
Consider surgical intervention, including incision and drainage, for severe cases with abscess formation or significant cosmetic deformity. (Evidence: Moderate 1)
Monitor and manage pediatric patients carefully, especially those undergoing upper ear cartilage piercing, due to increased infection risk. (Evidence: Moderate 1)References
1 Keene WE, Markum AC, Samadpour M. Outbreak of Pseudomonas aeruginosa infections caused by commercial piercing of upper ear cartilage. JAMA 2004. link
2 Cremers WR, Smeets JH. Acquired atresia of the external auditory canal. Surgical treatment and results. Archives of otolaryngology--head & neck surgery 1993. link