Swimmer’s Ear [Acute Bacterial Otitis Externa]

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What Is Swimmer’s Ear?

During the summer when children are swimming, they are prone to develop a painful bacterial infection involving the external auditory canal called “Swimmer’s Ear”. At Southampton Urgent Medical Care, I am currently seeing about ten cases a day. Swimmer’s Ear is a common problem for Hampton’s families and can be a debilitating infection. It is effectively treated with topical suspensions or solutions. Pseudomonas aeruginosa and Staphylococcus aureus are the main bacterial pathogens [in clinical terms].

Prolonged water exposure, high humidity, and a breach in the integrity of the skin overlying the external canal are predisposing factors in developing SE. Prevention is the best policy. The ear canal should be dried with a hair dryer following swimming. Cerumen or ear wax is protective and should not be removed. Do not ‘instrument’ the ear canal with any object that may disrupt the canal’s protective barrier. Dilute 2% Acetic acid solution, Burow’s solution, and ‘Swim Ear’ are effective in preventing SE. Ill- fitting ear plugs may actually damage the canal and should be used cautiously.

SIGNS & SYMPTONS: Ear ache pain or discomfort is the predominant symptom elicited by tugging on the ear lobe. Itchiness may precede the pain followed by discharge and decreased hearing due to a swollen, obstructed and infected ear canal. The infection oftentimes spreads to the outer ear, face, and neck accompanied by a fever and lymphadenopathy(swollen glands).

TREATMENT: Many topical ear suspensions or solutions may treat SE. A mild SE is self-limiting and may not require medicine, only avoidance of swimming. I prescribe CIPRODEX which contains the antibiotic Ciprofloxacin and steroid Dexamethasone, which treats the inflammation. A completely occluded canal may require wick insertion to insure penetration of the drops into the canal. If the infection spreads to the outer ear oral Ciprofloxacin is indicated. Again, the patient may not swim until the infection is eradicated..

*A visit to SUMC is warranted for persistent earache, discharge, or an extension of the infection to the outer ear.