Which symptom is most characteristic of otitis externa?

• A. Hearing loss
• B. Tragal pain
• C. Fever
• D. Ear pressure

Answer: (B)

Pain when the tragus or the ear is touched is the hallmark of otitis externa. The external auditory canal is inflamed, so moving or pressing on the tragus irritates the inflamed skin and underlying nerves, producing sharp ear pain. Hearing loss, fever, or a sense of fullness can occur, but they’re less specific: fever isn’t typical in uncomplicated cases, and fullness or mild hearing changes can happen with any swollen canal. So the standout feature that best identifies otitis externa is tragal tenderness.