Swimmer's Ear Infection
(External Otitis)
Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR
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Make Swimming Pools Safer
Medical Editor: Melissa Conrad Stöppler, MD
 Nine people drown per day in the US. That's the
average. It does not even include drownings from boat accidents. According to
the CDC (Centers for
Disease Control and Prevention), drowning rates have
declined over the years, but drowning is still the second–leading cause of
injury–related deaths of children.
While most drownings of infants under a year
of age occur in bathtubs, buckets, or toilets, most drownings of children one to
four
years of age occur in residential swimming pools. The facts surrounding the
drownings of young children in residential pools can send a chill down any
parent's spine:
- Most children who drowned in pools were last seen in
the home.
- Most young children who drowned in pools had been out of sight for less than
five minutes.
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What is "swimmer's ear" or acute external otitis?
External otitis or "swimmer's ear" is an infection of the skin covering the outer ear and ear canal. Acute external otitis is commonly a bacterial infection caused by streptococcus, staphylococcus, or pseudomonas types of bacteria. The swimmer's ear infection is usually caused by excessive water exposure. When water collects in the ear canal (frequently trapped by wax), the skin will become soggy and serve as an inviting culture media for bacteria. Cuts or abrasions in the lining of the ear canal (for example, from cotton swab injury) can also predispose to bacterial infection of the ear canal.
What are the symptoms of swimmer's ear?
The first symptom of infection is that the ear will feel full, and it may itch. Next, the ear canal will swell and ear drainage will follow. At this stage the ear will be very painful, especially with movement of the outside portion of the ear. The ear canal can swell shut, and the side of the face can become swollen. Finally, the glands of the neck may enlarge, making it difficult or painful to open the jaw. People with swimmer's ear may experience a decreased capacity for hearing in the affected ear.
What is chronic swimmer's ear?
Chronic (long-term) swimmer's ear can be caused by a bacterial infection, a skin condition (eczema or seborrhea), fungus (Aspergillosis), chronic irritation (such as from the use of hearing aids, insertion of cotton swabs, etc), allergy, chronic drainage from middle ear disease, tumors (rare), or it may simply follow from a nervous habit of frequently scratching the ear. In some patients, more than one factor may be involved. For example, a patient with eczema may subsequently develop black ear drainage. This would be suggestive of an accompanying fungal infection.
The standard treatments and preventative measures, as noted below, are often all that is needed to treat even a case of chronic otitis externa. However, in people with diabetes or those with suppressed immune systems, chronic swimmer's ear can become a serious disease (malignant external otitis). Malignant external otitis is a misnomer because it is not a tumor or a cancer, but rather an aggressive bacterial (typically Pseudomonas) infection of the base of the skull.
Next: What is the treatment for swimmer's ear? »
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