<unk>  is the inflammation of the<unk> l auditory canal. It is primarily caused by Pseudomonas aeruginosa and Staphylococcus aureus infection. Less commonly, it is also caused by otomycosis by Candida albicans and Aspergillus niger, as well as the spread of inflammatory dermatoses such as eczema, seborrhea, and psoriasis. The<unk> l auditory canal becomes susceptible to infection due to sudden, invasive changes in the conditions of the ear canal epithelium. This includes abrupt changes in humidity, causing epithelial degradation, cerumen decreases, and increased pH levels to increase predisposition to infection from bacterial or fungal pathogens. This can also be caused by localized physical trauma, such as injury or contact with abrasive surfaces (i.e. chemicals or physical cleaning products, such as cotton swabs). Gross pathology for<unk>  will include erythema of the ear canal, along with eczema-esque scaly, shedding of the skin. It also includes visible ear canal swelling, as well as potentially cellulitis of the pinna and otorrhea.<unk>  is classified as acute, chronic, or malignant based on the duration of the disease, as well as diffusion and severity of infection and symptoms. It must be differentiated from other diseases that cause otalgia, ear itching, otorrhea, erythema and edema of the ear canal, hearing loss, ear pressure, and dermatitis; this includes otitis media, infectious myringitis, sinusitis, and meniere's disease. The annual incidence of acute<unk>  is usually high, as approximated to be 801 per 100,000 individuals in the U.S. and 140 per 100,000 individuals in the Netherlands. The annual Case Fatality Rate for malignant necrotizing<unk>  is approximately 10-20%. The majority of acute<unk>  cases occur in adults between 65 and 74 years old. The majority of malignant<unk>  patients are aged 50 and older; this is due to the primary cause of immunocompromise resulting in maligant<unk>  being diabetes mellitus. Risk factors for acute and chronic<unk>  include activities and conditions that predispose an individual to ear canal inflammation. They also include being a female between 65 and 74 years old. Risk factors for malignant necrotizing<unk>  include conditions predisposing an individual to immunocompromise, including undergoing chemotherapy or suffering from diabetes mellitus. Symptoms for all forms of<unk>  are primarily pain, itching, and swelling of the ear canal. Symptoms of malignant necrotizing<unk>  include severe ear pain, facial paralysis, difficulty opening mouth, and difficulty swallowing. Laboratory findings consistent with diagnosis of all forms of<unk>  include evidence of bacterial or fungal infection. CT imaging is essential in establishing a diagnosis of malignant necrotizing<unk>  by revealing the extent of infection past the ear canal and spread into temporal and intracranial bones. They reveal the extent of damage and inflammation of the bones and soft tissue, demonstrating the cause for facial palsy due to the inflammatory influence on the cranial nerves. Other imaging findings to facilitate accurate diagnosis of malignant necrotizing<unk>  includes Technetium-99m and Gallium Citrate Ga 67 scintigraphical nuclear imaging. The mainstay of therapy for acute<unk>  (AOE) includes cleaning of the<unk> l auditory meatus and treating the infection.  Topical therapy is recommended as the initial therapy for diffuse, uncomplicated acute<unk> .  Systemic antimicrobials should be reserved for infections extending outside the<unk> l canal or patients with specific host factors.  Analgesics such as Acetaminophen or Nonsteroidal anti-inflammatory drugs are administered, either alone or in combination with an opioid. Preventing<unk>  primarily revolves around preventing epithelial damage to the ear canal that predisposes infection or dermatitis. The prognosis of<unk>  varies based on the presence of complications from the spread of the infectious pathogen. Without treatment, the prognosis of acute<unk>  is usually good and it is self-limited. Malignant<unk>  that results in palsies, osteitis of the skull base, and osteomyelitis of the temporal bone have particularly poor prognoses if left untreated. With treatment, acute and chronic<unk>  have good prognoses. The prognosis of malignant necrotizing<unk>  with treatment will vary depending on the severity of resultant complications. Complications of<unk>  include reactions to infection, as well as adverse reactions to the spread of the pathogen past the ear canal. This includes cerebral abscess, osteomyelitis of the skull base, cellulitis of the ear canal, perforated tympanic membrane and Sigmoid sinus thrombosis.
Otitis externa
Otitis media
Otitis interna
Q fever
Chondritis
Cervicitis
Rhinorrhea
Gonorrhea