If Not Otitis Externa...Then What?
Braveheart Group LLC
JUCM: Journal of Urgent Care Medicine
Ear pain is one of the most common presentations in urgent care, especially among pediatric patients. Further, acute otitis media (AOM) is the most common condition for which antibacterial agents are prescribed for children in the United States. Clinician visits make up 634 per 100 children during 2005-2006. It is imperative that clinicians differentiate AOM from new onset of otorrhea not due to acute otitis externa (AOE), the most common diagnoses made by clinicians with regional variations based on age and geography.1
The majority of AOE-related visits occur during the summer months (June through August); visits occur most commonly in the South and least commonly in the West.2-4
Rosenfeld, et al noted that data from ambulatory care centers suggest there are about 2.4 million visits for AOE, affecting 1 in 123 persons in the United States. Just less than half of all visits for AOE were for children 5 to 14 years of age. Direct costs are estimated at half a billion dollars annually, and ambulatory care providers spent about 600,000 hours treating AOE.2-4
Clearly, urgent care providers must be able to distinguish AOE and AOM from other causes of otalgia, otorrhea, and inflammation of the external auditory canal. “Ear infections” that do not present as AOE or AOM make for a difficult case in an urgent care setting. In such cases, the treatment and management differ from AOE and AOM. In addition, coordination with a subspecialist is often necessary.
Here, we offer three illustrative cases involving children who presented to Children’s Wisconsin Urgent Care facilities with chief complaints of “ear infection” or “ear pain.”
Flasch, Elizabeth; Ansari, Sadia; and Martin, Timothy, "If Not Otitis Externa...Then What?" (2021). College of Nursing Faculty Research and Publications. 791.