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Everyone must stay at home to help stop the spread of coronavirus. Advice for clinicians on COVID-19 (coronavirus) is here. If you are a member of the public looking for health advice, visit the NHS website or North Yorkshire Public Health. And if you are looking for the latest travel information, and advice about the government response to the outbreak, go to the website.

Last updated: 30 March, 2020 15:59pm

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Otitis Externa (Swimmer’s Ear) – Information for GPs

Referral criteria / commissioning position

Consider referral to ENT if:

  • treatment within general practice has not settled the symptoms in 7-10 days

Red flag symptoms

  • Severe unremitting pain, cranial nerve palsy, or fever may represent malignant otitis externa (osteomyelitis of the temporal bone caused by Pseudomonas aerognosa)
  • More common in diabetic or immunocompromised patients
  • Spreading infection could be mastoiditis, periaural cellulitis, or perichondritis

Investigations prior to referral

Ear swab

Information to include in referral letter

  • History and duration of complaint
  • Outline treatments already advised and tried including their effects
  • Past medical/surgical history
  • Current regular medication
  • Smoking status
  • Alcohol consumption

Patient information leaflets


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