(BMJ) - A 23-yo medical student presented with a 4-week history of an itchy ear that became painful. The patient reported associated hearing loss, and there was scanty, offensive-smelling otorrhea. The ear drum could not be visualized. What is it?
Cholesteatoma
Otitis externa with pinna cellulitis
Impetigo
Cystic chondromalacia
Mastoiditis
You are correct. Cellulitis of the pinna is caused by the spread of infection from the ear canal. Hearing loss is due to ear canal swelling. Pseudomonas aeruginosa and Staphylococcus aureus are the two most likely pathogens. Patients with diffuse otitis externa and cellulitis should be treated with an oral quinolone plus antibiotic ear drops and oral analgesics.