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Pediatr Integral 2025; XXIX (6): 465
M. Gómez de Pablos Romero*, M. Sánchez Martín**
*Adjunto de Pediatría de la Clínica Universidad de Navarra (Pamplona),
**Adjunto de Pediatría del Hospital Universitario La Paz
44. Acute otitis externa. Outpatient visit
Doctor: Mónica Gómez de Pablos Romero. Adjunto de Pediatría de la Clínica Universidad de Navarra. Pamplona
Mother: María Sánchez Martín. Adjunto de Pediatría del Hospital Universitario La Paz. Madrid
Doctor: Good afternoon Mrs. Harper. What brings you here today?
Mother: Good afternoon Dr. López. I’m here with James because he has been complaining of earache since yesterday. I have given him ibuprofen, but he says it is still hurting.
Doctor: OK. James is 7 years old, and he is a healthy boy, correct?
Mother: That is correct, yes.
Doctor: Has he had any fever or cold symptoms? Any ear discharge?
Mother: No. He hasn’t had any fever or cold symptoms, and we haven’t noticed any ear discharge.
Doctor: Have you been to the pool or to the beach these days?
Mother: Yes, he has been going to the pool all week.
Doctor: Perfect. Let’s take a look.
I see the ear canal swollen, erythematous, and macerated with discharge present. The tympanic membrane is normal. James also shows tenderness of the tragus.
All of this points to otitis externa, or outer ear infection. This is an inflammation of the external auditory canal (the part of the ear that goes from the outer ear to the eardrum). This condition is also known as swimmer’s ear, since water exposure is one of the most common risk factors. Most cases are caused by bacteria, so he will have to use ear drops with antibiotic.
Mother: I understand.
Doctor: I will prescribe a ciprofloxacin otic suspension. You will have to administer 4 drops twice daily during a week. You can also give him ibuprofen for the pain, as you have been doing.
Mother: Alright. Can James still go to the pool?
Doctor: He should avoid the pool for 7 to 10 days. After that, if the pain has disappeared and he doesn’t show any other symptoms, he can attend the pool again.
Mother: Should he use ear plugs?
Doctor: There is no need for ear plugs right now, since this is the first time this happens. If he has more episodes like this, we’ll talk about it then.
Mother: Thank you, doctor.
Doctor: You’re welcome. Have a good day.
KEY WORDS
Acute: aguda.
Otitis externa/outer ear infection: otitis externa.
Earache: otalgia (dolor de oído).
Ear discharge: supuración ótica.
Ear canal/external auditory canal: conducto auditivo externo.
Erythematous: eritematoso.
Tenderness of the tragus: dolor en la zona del trago (signo del trago positivo).
Eardrum: tímpano.
Risk factors: factores de riesgo.
Ear drops: gotas óticas.
Ear plugs: tapones para oídos.
Neurocutaneous syndromes