What are the signs and symptoms of otitis externa (OE)?

Updated: Mar 09, 2020
  • Author: Ariel A Waitzman, MD, FRCSC; Chief Editor: Ravindhra G Elluru, MD, PhD  more...
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Answer

The key physical finding of OE is pain upon palpation of the tragus (anterior to ear canal) or application of traction to the pinna (the hallmark of OE). Patients may also have the following signs and symptoms:

  • Otalgia - Ranges from mild to severe, typically progressing over 1-2 days
  • Hearing loss
  • Ear fullness or pressure
  • Erythema, edema, and narrowing of the EAC
  • Tinnitus
  • Fever (occasionally)
  • Itching (especially in fungal OE or chronic OE)
  • Severe deep pain - Immunocompromised patients may have necrotizing (malignant) OE
  • Discharge - Initially, clear; quickly becomes purulent and foul-smelling
  • Cellulitis of the face or neck or lymphadenopathy of the ipsilateral neck (occasionally)
  • Bilateral symptoms (rare)
  • History of exposure to or activities in water (frequently) (eg, swimming, surfing, kayaking)
  • History of preceding ear trauma (usually) (eg, forceful ear cleaning, use of cotton swabs, or water in the ear canal)

See Clinical Presentation for more detail.


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