Ear infection

A 70 years old male with history of T2 DM on OHA, come to clinic with complaints of severe pain in the Right Ear since two days. Associated with fever, head ache, decreased hearing and jaw pain. His diabetes is fairly controlled. Diagnosis and management ?

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it looks like cellulitis,first a furuncle should be considered,as there is negligible space in ext.auditory cannal between skin and the bone,so the pain and swelling ll spread to the pinna,and the furncle and the resultant swelling can hinder hearing,the space occupying swelling ll give severe pain inside our and pain ll refer to jaw too

agree with dr.vora,it can be malignant otitis externa,Antibiotic i ll prefer co amoxiclav,or cephalosporin,as patient is old and diabetic,Iv antibiotics ll be safe option,anti inflamatory with serratiopeptidase,drainage if there is discharge,may need debridement,and dressing ,

D/D.. ? MALIGNANT OTITIS EXTERNA .. ? PERICHONDRITIS .. ? CELLULITIS .. EXT. EAR .. MANAGEMENT .. BS..ANTIBIOTICS WITH..NSAIDS AS PER REQUIREMENT .. BLOOD..URINE..SOS.. ENT..SURGEONS OPINION..

malignant otitis externa..

management includes antibiotics .. antipseudomonal antibiotics.. FQS/ aminoglycosides, antipseudomonal cephalosporins...
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Looking to the picture it looks like malingnant otitis externa. Even if the DM is well controlled it should be treated with higher antibiotics, both local cream and systemic( may be after c/s of pus ),potent analgesic and debridgement if required

Otitis externa

The ear lobe will typically be spared in perichondritis.... Here it looks like the entire ear is affected

perochondritis, was there any h/o similar episode in the past, relapsing perochondritis . other dd include cellulitis, erysipelas

Cellulitis probably

Malignant otitis externa caused by pseudomonas..Treat with antipseudomonal drugs

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