Browse categories and answer follow-up questions to refine your symptom profile.
Immediate priorities and red flags
Triage and stabilization
Airway patency
Respiratory distress
Hemodynamic instability
Sepsis physiology
If toxic appearance or altered mental status, escalate to resuscitation workflow
High risk features for complicated otitis externa
Diabetes mellitus
Immunocompromised state
Older age with severe otalgia
Refractory symptoms despite 48 to 72 hours of topical therapy
Cranial neuropathies
Severe nocturnal otalgia
Granulation tissue at bony cartilaginous junction
Cellulitis beyond ear canal
Trismus
Mastoid tenderness or swelling
If concern for malignant otitis externa, urgent ENT and imaging
Pain and nausea control
Rapid analgesia pathway
Antiemetic support when pain related vomiting
Hearing and tympanic membrane safety
If tympanic membrane perforation cannot be excluded, avoid ototoxic drops
If foreign body suspected, avoid blind instrumentation
Key concepts
Condition framing
Acute otitis externa as inflammation or infection of external auditory canal skin
Predominant pathogens
Pseudomonas aeruginosa
Staphylococcus aureus
Time sensitive inflection points
Meaningful improvement usually within 48 to 72 hours of appropriate topical therapy
If worsening after 48 to 72 hours, reassessment for obstruction, wrong diagnosis, or extension
Evidence and guideline anchors
Topical therapy as first line for uncomplicated acute otitis externa
Class I recommendation based on specialty guideline consensus
ACEP Level C recommendation for ED management workflow
Systemic antibiotics not routine for uncomplicated disease
Class I recommendation based on specialty guideline consensus
ACEP Level C recommendation
Consultation triggers
ENT escalation
Suspected malignant otitis externa or skull base osteomyelitis
Cranial nerve deficits
Immunocompromised with severe disease
Canal fully occluded with inability to deliver drops despite wick attempts
Recurrent disease with suspected anatomic obstruction
ID or medicine escalation
Suspected invasive infection
Need for IV antipseudomonal therapy
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.