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Swimmer's Ear

more about Swimmer's Ear


OE or otitis externa



  • This condition is an infection of the external ear canal that often occurs during the summer months.  The ear has two canals, the external and internal ear canal.  The middle ear and inner ear structures separate the two canals.  The skin covering the canal normally protects it against foreign invaders such as bacteria.

  • Pain around the ear
  • Itching
  • Hearing loss
  • Plugged ear
  • Movement of the ear is painful
  • Discharge of yellowish-greenish thick liquid from the affected ear
  • Redness and tenderness around the ear and the surrounding tissue
  • Wisdom teeth may be painful
  • With the spread of infection to the surrounding bone, a severe infection called malignant Otitis Externa (MOE) can occur and contain the following:
    1. Fever if the infection is severe
    2. Neurological symptoms (i.e., confusion, headaches, balance problems, weakness or paralysis on one side) due to a spread of infection to the temporal bone and/or the base of the skull.  The temporal bone is one of the skull bones near the ear.

  • Bacteria such as Pseudomonas aeruginosa (normally lives in the external canal), Staphylococcus aureus, and Enterobacter species are common causes
  • Trauma or Injury to the ear canal
  • Fungi such as yeast, aspergillus, and penicillin, can also cause OE.
  • Pseudomonas and other bacterial OE can last for more than a few weeks, and become a chronic infection.
  • Skin conditions such as eczema, seborrhea, neurodermatitis, and Allergic Reactions to medications and other elements can irritate the external canal, which can then become infected.

  • Physical exam of the ear and a general exam must be done.  The ear and surrounding area is observed and palpated.  The physician will need to look inside the ear using an otoscope.
  • Cultures or samples of the discharge might be sent to laboratory for analysis.
  • A blood analysis is done if the patient is very sick (i.e., elderly, diabetic) or has other severe illnesses.
  • Other tests such as CAT scan or other X-rays may need to be done if the physician suspects MOE, and the spread of infection to the skull and the brain.  Cultures will be done in the case of MOE.

  • Swimmers
  • Hot and humid air
  • Elderly diabetics
  • Immunocompromised individuals (i.e., people whose natural body defenses are weak such as patients with aids, cancer, poorly controlled diabetics, those with liver or kidney failure, patients on chemo-therapy or other drugs, or addicts)
  • Hearing aids or headphones
  • Skin diseases

  • In the case of a mild infection, the patient will receive painkillers such as Tylenol and antibiotic drops such as Cortisporin (3-4 drops every eight hours for one week to 10 days, or until the laboratory results become available).
  • In cases where there is potential for worsening of the infection, antibiotics by mouth are given for up to 14 days with a follow up visit.
  • Topical anti-fungal drops can also be used for fungal OE.
  • Eczema and other skin conditions may need drops such as aluminum acetate, steroid cream, or lotions and antibiotics.
  • If there is a fever and the patient appears very sick, he or she is admitted to the hospital for intravenous antibiotics and further work, and possible surgical cleaning or drainage of the ear and affected areas.
  • Intravenous treatment may be necessary for 4-6 weeks if there has been a severe case of MOE or if the patient is immunocompromised.
  • Tylenol or aspirin can help with pain and fever.
  • Insert a cotton or soft-edged gauze wick for swelling of the ear canal, if the physician advises it.

  • If your child has ear pain or discharge, call your doctor as soon as possible.  If your child is very sick or has a fever, seek medical attention immediately, especially if your child has some other underlying disease.




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