Clinical QuickieInfectious Disease
Otitis Media / Otitis Externa
The location of inflammation determines the diagnosis and treatment.
Otitis media is behind the tympanic membrane
Bulging TM and middle-ear effusion support AOM; erythema alone is nonspecific.
Otitis externa is the canal
Canal edema/debris and pain with tragal or pinna manipulation point toward external-ear disease.
Avoid treating an uncertain ear exam
Cerumen, crying, fever, and a poorly visualized TM can lead to overdiagnosis.
Risk factors change urgency
Diabetes/immunocompromise with severe otitis externa raises concern for invasive disease; mastoid findings change the AOM pathway.
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