Untreated External Otitis with Purulent Discharge in Young Adult

Case at a Glance

A 29-year-old female presents with external otitis characterized by ear canal inflammation and purulent bloody discharge, seeking guidance on natural resolution versus treatment compliance due to financial constraints.

Patient's Story

The patient developed symptoms consistent with external otitis (swimmer's ear) with visible inflammation of the ear canal and purulent bloody discharge. Despite the concerning appearance of the infection, she reports no significant pain. She has been prescribed topical antibiotic drops and oral antibiotics by her healthcare provider but is hesitant to fill the prescriptions due to financial hardship and lack of health insurance coverage.

Initial Assessment

Physical examination revealed inflamed ear canal with active purulent and bloody discharge, consistent with bacterial external otitis. The patient's lack of pain was noted as somewhat unusual for this condition. No signs of middle ear involvement or systemic infection were documented at initial presentation.

The Diagnostic Journey

The diagnosis was straightforward based on clinical presentation of ear canal inflammation with purulent discharge. The healthcare provider appropriately prescribed both topical and oral antibiotic therapy. However, patient compliance became a concern due to socioeconomic factors.

Final Diagnosis

External otitis (otitis externa) with bacterial superinfection

Treatment Plan

Prescribed regimen included topical antibiotic ear drops and oral antibiotics. Healthcare team provided patient education regarding cost-effective alternatives, including generic formulations, pharmacy price comparison, prescription discount programs, and consultation with pharmacists regarding treatment prioritization if unable to afford both medications. Patient was advised that topical treatment is typically more critical than oral antibiotics for localized external otitis.

Outcome and Follow-up

Patient was counseled on the historical significance of untreated ear infections as a cause of hearing loss and complications. Cost-effective treatment options were explored, including telemedicine consultations ($40-50), urgent care cash visits (<$100), community free clinics, and prescription assistance programs. Generic medications were estimated at $20-50 for drops and under $30 for oral antibiotics. Patient was advised to prioritize at minimum the topical antibiotic drops if financial constraints prevented full treatment compliance.