Swimmer’s Ear – Otitis Externa

Swimmers-Ear-Otitis-Externa

(left) Image by James Heilman, MD (CC BY 3.0)
(right) Image by Grook Da Oger (CC BY-SA 3.0)

Otitis externa is commonly known as swimmer’s ear, and is an infection of the ear canal. The most common cause is retained water in the ear canal, while other causes include irritating the ear canal with a cotton bud or similar object, badly fitting hearing aids, excess ear wax, sweating in dirty and dusty conditions, and dermatitis in the ear canal.

Bacteria normally live in the outer ear, but if the canal remains constantly wet, the bacteria can invade tissue to cause an infection. If a fungus is the cause it is called otomycosis or tropical ear. These infections are more common in children because their narrower ear canals retain water easily, but they can be prevented by using drying drops in the ear after each period of swimming, or inserting ear plugs before swimming. Sea water is less likely to be a problem than fresh water.

The outer ear canal and the outer surface of the eardrum become excruciatingly painful. The onset is often very rapid, and as the infection progresses a discharge from the ear usually develops. The infection can injure the eardrum and repeated attacks may cause permanent damage. Untreated infections can spread through the eardrum and cause a more serious middle ear infection (otitis media).

In most cases, no investigations are necessary, but if the infection is persistent, swabs may be taken so that the responsible bacteria and fungi can be identified.

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