Furunculosis of external auditory canal


#1

FURUNCULOSIS OF EXTERNAL AUDITORY CANAL
• It is also known as acute localised otitis externa / circumscribed otitis externa.
• This is a localised infection usually found to involve the lateral 1/3 of the external canal.
• It also has a propensity to involve the posterior superior aspect of the external canal. This is caused due to obstruction of the apopilosebaceous units found extensively in this area.
Etiology:
• Trauma to skin in this area followed by infection is commonly attributed cause.
• The organism responsible is commonly staphylococcus aureus.
Symptoms:

  1. Localised pain
  2. Localised itching
  3. Purulent discharge if the abscess ruptures
  4. If oedema or abscess occludes the external canal hearing loss can occur.
    Signs:
  5. Erythema of the skin
  6. Localised abscess formation
  7. Positive tragus sign
  8. Obliteration of retroauricular groove
    Management:
    • Avoid water entry
    • Oral antibiotics should be used.
    • The preferred drug of choice is penicillin of first generation cephalosporins.
    • Topical antibiotics plus steroid ear drops
    • Anti inflammatory drugs can be used to reduce inflammation and pain.
    • If the abscess is pointing it can be treated by incision and drainage.
    • These patients must be advised to cut their nails short and to keep their hands clean, since this is the commonest route of infection.