Otitis Externa
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Otitis Externa is also referred to as Swimmer’s ear and is a fairly common ear infection amongst children, adolescents, and young adults. The inflammation, swelling, and infection of Otitis Externa presents in the outer ear and ear canal. Otitis Externa can be acute, meaning that it happens every now and then, or chronic, which means it is a nearly constant infection.


The symptoms of Otitis Externa include ear pain which may worsen when downward pressure is applied the ear canal, such as pulling on the ear, itching inside the ear or itching in the ear canal, and typically a yellowish green drainage from the ear that smells quite foul and looks a lot like pus. Fevers may or may not accompany Otitis Externa.


Otitis Externa can be caused by a variety of factors. Swimming in water that has bacteria is the most common way to contract Swimmer’s ear, hence the name. Bacteria enters the ear canal and infests the ear. Scratching inside the ear, or even trying to clean wax from the ear with an object such as a cotton swab or a pen can scratch the ear and lead to infection. Sometimes an object gets trapped in the ear, such as a particle of an ear plug, and created Otitis Externa.
Otitis Externa
Image: Otitis Externa


There are no definitive risk factors for Otitis Externa with the exception of the cleanliness of the water that one chooses to swim in. Of course in many cases it can be almost impossible to tell whether or not the water has bacteria that may be harmful or not.


Diagnosis of Otitis Externa is rather simple. The physician may have a difficult time being able to view the ear drum due to the swelling and inflammation associated with Otitis Externa. The sensitivity of the ear will usually increase when the outer ear is moved or touched. Draining the infected ear canal can not only alleviate some pressure, but can often allow the physician to identify the bacteria or fungus. The ear canal may appear to have scaly shedding skin, almost like eczema.

The risk of complications from Otitis Externa is fairly small with treatment. Without treatment however, the patient may develop Otitis Externa as a chronic condition, the infection may spread to other areas of the body, or over time malignant Otitis Externa may develop.
Swimmer’s ear
Image: Swimmer’s ear


Treating Otitis Externa may require draining the ear of infectious fluid. This can be a painful but necessary process to relieve the patient of the pressure and allow medication to work effectively. Once the ear canal has been drained, the physician typically prescribes antibiotic ear drops to fight infection. The physician may also prescribe a pain relieving ear medication to assist with pain relief during the healing stages. Because the ear drops need to reach the end of the ear canal, the drops should be used in abundance and in the event of excessive swelling, a wick may be inserted into the ear to allow the medication to reach its destination. Although it is rare, a pill form of antibiotic may be used in cases of excessive swelling.

During treatment it is important to protect the ear from further damage. Keeping the ear dry during shower, bathing, and swimming is important in allowing it to heal. Keeping all objects out of the ear is vital, even if the ear begins to itch or feel as though it is draining inside the ear canal. A warm compress can often help alleviate some pain. A physician should be notified if the infection does not begin to clear up within 2 or 3 days, or if the infection worsens after treatment begins.


Drying the ear thoroughly, avoiding polluted water when swimming, the use of earplugs when swimming, and applying a solution of alcohol and white vinegar to the ear canal after exposure to water can help prevent future cases of Otitis Externa. It is recommended that the patient use care when entering a cold temperature. Changes in temperature, particularly from warm to cold, can cause the ear significant pain. During the first few days of treatment, drainage may occur during sleep which may stain fabrics such as pillow cases. The patient should be urged to contact a physician immediately if new symptoms appear.
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