Monday, November 28, 2005

But does it itch?

Ear pain. We've all had it, but I'd hazard a guess that we haven't all had the symptoms one patient was experiencing today. Last month, she was treated for otitis externa and has been using cortisporin otic drops. Steroid-containing drops. Her pain was intensifying over the past three days so she returned for follow-up care. In addition to her otalgia, she also had tender pre-auricular lymphadenopathy. Her past medical history is negative for diabetes, FYI.

Good ear looks good. Textbook, one might say. Affected ear on the other hand... I carefully looked in her ear and thought, "Now, if I were looking in a vagina, I would be quite certain that I was seeing yeast." Now, I do not come home to peruse Gray's Anatomy every evening, but I am confident that I know an ear from a vagina. But yeast? In the ear? Another first for newFNP. It was all I could do not to laugh as I used a vaginal wet mount swab to grab a culture of the ear funk. Ah, improv.

I treated her with Diflucan under the philosophy of what's good for the south is good for the north. I can't wait to get that ear wet mount back.

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