Draining ear
A 25-year-old man asked his family physician (FP) to look at his ear, which had been draining on and off for 2 years. He said that it typically got better with antibiotics, but began to drain again within 2 months of going off the antibiotic. The patient had no fever and was otherwise healthy.
What’s your diagnosis?
The patient had chronic suppurative otitis media with purulent discharge. The FP started the patient on amoxicillin/clavulanate 875 mg/125 mg bid for 10 days and referred him to an ear nose and throat (ENT) specialist. The ENT ordered a computed tomography scan to see if the patient had a cholesteatoma, but did not find any evidence of one.
When the acute infection cleared, the ear canal was cleaned with an operating microscope and a perforated tympanic membrane (TM) was found. The patient opted to have a tympanoplasty to repair his TM.
Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Rayala B. Otitis externa. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:180-184.
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