Otitis externa epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.; Tarek Nafee, M.D. [2]

Overview

The annual incidence of acute otitis externa is approximated to be 801 per 100,000 individuals in the U.S. and 140 per 100,000 individuals in the Netherlands. The annual prevalence of acute otitis externa in the United Kingdom is approximately 24 per 100,000 individuals. The annual case fatality rate for malignant necrotizing otitis externa is approximately 10-20%. The majority of acute otitis externa cases occur in adults between 65 and 74 years old. The majority of malignant otitis externa patients are aged 50 and older; this is due to the primary cause of immunocompromise resulting in maligant otitis externa being diabetes mellitus. Acute otitis externa is approximately 1.1 times more likely to occur in females than males of all age groups.

Incidence

  • The incidence of acute otitis externa is usually high:
    • In the U.S. the incidence is approximately 801 per 100,000 individuals.[1]
    • In the Netherlands the incidence is approximately 140 per 100,000 individuals.[2]
  • The incidence of acute otitis externa is greater in climates that experience more year-round humidity which is more conducive to bacterial and fungal colonization.[3][4]

Prevalence

  • A study of acute otitis externa patients in the United Kingdom revealed that the disease prevailed for 12-months in approximately 24 per 100,000 individuals.[5][6]

Case Fatality Rate

Age

  • The majority of acute otitis externa cases occur in adults between 65 and 74 years old.[6]
  • There is an increase in acute otitis externa among children between 5 and 14 years old.[8]
  • The majority of malignant otitis externa patients are aged 50 and older; this is due to the primary cause of immunocompromise resulting in maligant otitis externa being diabetes mellitus.[9][10]

Gender

  • Acute otitis externa is approximately 1.1 times more likely to occur in females than males of all age groups.[6]
    • Males are more likely to have a recurrent acute otitis externa episode after initial infection.

Race

  • There is no racial predisposition to otitis externa.

References

  1. "Estimated Burden of Acute Otitis Externa --- United States, 2003--2007".
  2. van Balen, F. A M (2003). "Clinical efficacy of three common treatments in acute otitis externa in primary care: randomised controlled trial". BMJ. 327 (7425): 1201–1205. doi:10.1136/bmj.327.7425.1201. ISSN 0959-8138.
  3. Martin TJ, Kerschner JE, Flanary VA (2005). "Fungal causes of otitis externa and tympanostomy tube otorrhea". Int. J. Pediatr. Otorhinolaryngol. 69 (11): 1503–8. doi:10.1016/j.ijporl.2005.04.012. PMID 15927274.
  4. Ramos GP, Rocha JL, Tuon FF (2013). "Seasonal humidity may influence Pseudomonas aeruginosa hospital-acquired infection rates". Int. J. Infect. Dis. 17 (9): e757–61. doi:10.1016/j.ijid.2013.03.002. PMID 23639485.
  5. "Population, total | Data | Table".
  6. 6.0 6.1 6.2 Rowlands S, Devalia H, Smith C, Hubbard R, Dean A (2001). "Otitis externa in UK general practice: a survey using the UK General Practice Research Database". Br J Gen Pract. 51 (468): 533–8. PMC 1314044. PMID 11462312.
  7. Bhandary S, Karki P, Sinha BK (2002). "Malignant otitis externa: a review". Pac Health Dialog. 9 (1): 64–7. PMID 12737420.
  8. McWilliams CJ, Smith CH, Goldman RD (2012). "Acute otitis externa in children". Can Fam Physician. 58 (11): 1222–4. PMC 3498014. PMID 23152458.
  9. Handzel O, Halperin D (2003). "Necrotizing (malignant) external otitis". Am Fam Physician. 68 (2): 309–12. PMID 12892351.

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