| Ear pain |
Yes |
Yes, often improved when discharge commences |
| Discharge |
Scanty |
Mod/severe Mucopurulent |
| Hearing |
Later onset muffled |
Early onset |
| Preceding URTI |
No |
Often |
| Tender ear canal |
Yes, very |
No |
| Periauricular swelling |
Yes in severe secondary to soft tissue cellulitis |
No unless mastoiditis |
| Canal swelling |
Yes |
No |
| Ear drum |
Can be difficult to visualise due to canal debris |
Red bulging, oedematous, perforated with mucopus pulsating through |
| Associated with intracranial complications |
No (unless immuno- compromised) |
Yes |