Summary about Disease
Otitis externa, commonly known as swimmer's ear, is an inflammation or infection of the outer ear canal, the tube between the eardrum and the outside of the head. It's frequently caused by bacteria or fungi. While often associated with swimming, any activity that leaves moisture in the ear canal can create a breeding ground for these organisms.
Symptoms
Ear pain (often severe)
Itching in the ear canal
Redness and swelling of the ear canal
Tenderness when touching the ear
Drainage of pus or fluid from the ear
Feeling of fullness in the ear
Decreased hearing or muffled hearing
Swollen lymph nodes in the neck (in severe cases)
Causes
Bacteria: Most common cause, especially Pseudomonas aeruginosa* and *Staphylococcus aureus*.
Fungi: Can be caused by Aspergillus or *Candida* species.
Excess Moisture: Swimming, sweating, or showering can trap moisture.
Injury: Scratching the ear canal, using cotton swabs aggressively, or wearing earbuds can damage the skin.
Irritants: Hair spray, hair dye, or other chemicals can irritate the ear canal.
Skin Conditions: Eczema or psoriasis can increase susceptibility.
Medicine Used
Antibiotic Ear Drops: Used for bacterial infections. Examples include ofloxacin, ciprofloxacin, or neomycin/polymyxin B/hydrocortisone combinations.
Antifungal Ear Drops: Used for fungal infections. Examples include clotrimazole or miconazole.
Acidic Ear Drops: Acetic acid solutions can help restore the ear's normal pH and inhibit bacterial growth.
Corticosteroid Ear Drops: Used to reduce inflammation and itching. Often combined with antibiotics or antifungals.
Pain Relievers: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain. In severe cases, prescription pain medication may be needed.
Oral Antibiotics: May be necessary if the infection has spread beyond the ear canal or in cases of severe infection.
Is Communicable
Otitis externa itself is generally not communicable from person to person. However, the underlying bacteria or fungi that cause the infection can potentially be spread in rare circumstances, but transmission via direct contact is not a primary concern.
Precautions
Keep Ears Dry: Dry ears thoroughly after swimming or showering. Use a towel or a hair dryer on a low, cool setting.
Use Earplugs: When swimming.
Avoid Scratching: Resist the urge to scratch the ear canal.
Avoid Cotton Swabs: Do not insert cotton swabs or other objects into the ear canal.
Tilt Head to Drain Water: After swimming or showering, tilt your head to each side to help drain water.
Avoid Irritants: Limit exposure to hair spray, hair dye, and other chemicals that may irritate the ear canal.
Properly Clean Hearing Aids or Earbuds: Follow manufacturer's instructions for cleaning.
How long does an outbreak last?
With appropriate treatment, otitis externa typically resolves within 7 to 10 days. However, symptoms may begin to improve within a few days of starting treatment. If left untreated or if the infection is severe, it can last longer and potentially lead to complications.
How is it diagnosed?
Medical History: The doctor will ask about your symptoms and activities (like swimming).
Physical Examination: The doctor will examine the ear canal with an otoscope, a lighted instrument for viewing the ear.
Culture: If the infection is severe or doesn't respond to treatment, the doctor may take a sample of the discharge to identify the specific bacteria or fungi causing the infection.
Timeline of Symptoms
The timeline of symptoms can vary, but a typical progression might look like this:
Day 1-2: Mild itching and discomfort in the ear canal.
Day 3-5: Increased pain, redness, and swelling. Drainage may begin.
Day 5-7: Pain becomes more severe, and drainage may increase. Hearing may be affected.
Day 7-10 (with treatment): Symptoms begin to improve. Pain and swelling decrease. Drainage subsides.
Beyond 10 days (without treatment or if severe): Symptoms may persist or worsen. Complications may develop.
Important Considerations
Complete the Full Course of Medication: Even if symptoms improve, finish all prescribed medication to ensure the infection is completely eradicated.
Keep the Ear Canal Dry: It is crucial to keep the ear canal dry during treatment.
Follow-Up: If symptoms don't improve within a few days of starting treatment, or if they worsen, contact your doctor for a re-evaluation.
Avoid Self-Treating: See a doctor for proper diagnosis and treatment. Using the wrong medication can worsen the condition.
Underlying Conditions: If you have eczema, psoriasis, or other skin conditions, work with your doctor to manage these conditions to reduce your risk of otitis externa.