QuestionSBA
QuestionChoice
This is not an appropriate management option as the inflammation can be managed using topical steroids rather than systemic steroids which would be less effective at treating the condition and have a high risk of side effects.
10035038
b
Prescribe oral steroids
QuestionChoice
This is typically only done if topical antibiotics are ineffective.
10035039
c
Prescribe oral antibiotics
QuestionChoice
The tenderness of the tragus, combined with watery discharge and an erythematous auditory canal is a classic history of otitis externa. This is typically managed with topical ciprofloxacin/dexamethasone drops if the symptoms are troublesome.
10035037
a
Prescribe topical combined antibiotic/steroid drops
QuestionChoice
This would be an appropriate strategy for malignant otitis externa, suggested by severe pain which wakes the patient at night as well as cranial nerve palsies. It is more common in older diabetic or immunocompromised patients and does not seem to be suspected in this scenario.
10035040
d
Refer to hospital for IV antibiotics
QuestionChoice
Whilst diabetes is a risk factor for otitis externa, it is reasonable to try basic topical management before investigating the patient further if the basic management is ineffective. Checking the patient’s HbA1c also does not address the patient’s symptoms in the meantime.
10035041
e
Check the patient’s HbA1c
Concept
Chapter
2693
4406
Otitis externa
Topic
186
Ear, Nose and Throat
19411
Otitis externa presents with ear tenderness, discharge, and erythema; initial treatment often involves topical antibiotic-steroid drops for symptom relief.
A 27-year-old male has an itchy right ear with associated watery discharge. He is finding the symptoms incredibly bothersome as he works as a music producer.

On examination, he has tenderness on palpation of his right tragus. His auditory canal is erythematous and the tympanic membrane is intact.

Which of the following is the most appropriate initial management option?
a