Integrated Inflammatory and Hematological Signatures in Pediatric Otitis Externa: Exploring the Diagnostic Role of CRP, ESR, and Blood Cell Indices

Noor Mohammed Al-Dhafiri; Intisar Khlaif Fliafel

doi:10.51699/cajmns.v7i3.3237

Authors

Noor Mohammed Al-Dhafiri Department of Nursing, Technical Institute of Babylon, Al-Furat Al-Awast Technical, University (ATU), Iraq
Intisar Khlaif Fliafel Department of Nursing, Technical Institute of Babylon, Al-Furat Al-Awast Technical, University (ATU), Iraq

DOI:

https://doi.org/10.51699/cajmns.v7i3.3237

Keywords:

Pediatric Otitis Externa, CRP, ESR, Hematological Indices, Bacterial Isolates

Abstract

Pediatric otitis externa is an inflammatory disorder of the external ear canal, often related with bacterial infection and environmental exposures, and behavioral risk factors. The purpose of this study was to explore both inflammatory and hematological biomarkers of pediatric otitis externa and to determine the most common bacterial isolates in relation to the disease. A case–control study was conducted between March 2025 and February 2026 in Al-Nasiriyah Maternity and Children Hospitals and outpatient clinics in Nasiriyah, Iraq. There were 90 children participants (60 patients with otitis externa and 30 healthy controls). A clinical examination, hematological analysis, evaluation of inflammatory biomarkers and microbiological tests were conducted. Findings revealed no significant differences in age, sex, or BMI among groups (P > 0.05) and that swimming exposure and poor ear hygiene were significantly greater in patients (P < 0.05). Hematological examination showed that there is a substantial increase in white blood cell count and neutrophil percentage and a subsequent reduction in lymphocyte percentage in patients as compared to controls (P < 0.001). Patients had a higher inflammatory level, as evidenced by C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) (P < 0.001). The most common pathogens were Pseudomonas aeruginosa (35.0%) and Staphylococcus aureus (28.3%). Correlation analysis revealed that there were significant positive relationships between CRP and WBC as well as neutrophils but negative relationships with lymphocytes. In conclusion, pediatric otitis externa is characterized by significant inflammatory and hematological alterations, with distinct bacterial profiles. The integrated assessment of CRP, ESR, and blood cell indices provides valuable diagnostic insight and may improve clinical management strategies.

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