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Otitis Externa - Otitis Externa symptom, treatment, causes

Otitis Externa is an infection of the skin lining the outer ear canal. Otisis externa (also called swimmer's ear) is usually caused by bacteria and/or fungi. The external ear is normally protected from infection by the strong waterproof surface of its lining skin and by ear wax, which helps to prevent the skin softening when water gets into the canal and also traps dirt andgerms that then drain away with the wax. The micro-organisms that cause otitis externa are nor-mallypresent in the canal, but only cause problems if its defences are down, as they are when the surface is broken by injury, usually from trying to clean the ear with rigid objects, or softened by constant dampness (hence the prevalence in swimmers).

Otitis externa commonly known as swimmer's ear is an infection of the ear canal, the tubular opening that carries sounds from the outside of the body to the eardrum. Acute external otitis is commonly a bacterial infection caused by streptococcus, staphylococcus, or pseudomonas types of bacteria. It usually develops in teens and young adults whose ears are exposed to persistent, excessive moisture. People who get external otitis often have been diving or swimming for long periods of time, especially in polluted lakes, rivers, or ponds (although sometimes something as simple as water from the shower can cause it). Swimming in chlorinated pool water also can cause external otitis because chlorinated water can make it easier for bacteria and fungi to penetrate the skin of the ear canal. External otitis occurs most often in warm climates and during the summer months when more people are participating in water activities. Anything that causes a break in the skin of the ear canal can lead to an infection. Dry skin or eczema , scratching the ear canal, vigorous ear cleaning with cotton-tipped applicators, or inserting foreign objects like bobby pins or paper clips into the ear can all increase the risk of developing otitis externa. Sometimes, in a child with a middle ear infection , pus collected in the middle ear can drain into the ear canal through a hole in the eardrum and cause otitis externa to develop.

Otitis externa is inflammation  of the ear canal, the tube going from the outer ear to the ear drum. It is characterised by redness, swelling, scaling and thickening of the canal skin lining and is accompanied by varying degrees of discomfort, itch, deafness and discharge. It may involve the entire ear canal (which is about 2.5 cm long) or it may affect just one small portion. It is associated with swelling, which in severe cases can cause extreme narrowing of the ear canal. Symptoms include itch, ear discharge, temporary dulled hearing, and pain. It is usually caused by an infection, allergy or an irritant such as shampoo or water that gets inside the ear. Anyone can get otitis externa, and you may not even realise why. It can be treated with ear drops and there are simple steps you can follow to prevent it happening again (see prevention section).

Symptom of Otitis Externa

Itching, pain and discharge are the main symptoms. If the canal becomes narrowed by , swelling or blocked by debris, hearing may be reduced. Some Symptoms of Otitis Externa :

• Pain around the ear.
• Itching.
• Redness and tenderness around the ear and the surrounding tissue.
• Discharge of yellowish-greenish thick liquid from the affected ear.
• Plugged ear.
• Hearing loss.
• Fever.

Causes of Otitis Externa

The common Causes of Otitis Externa :

• Fungi such as yeast, aspergillus, and penicillin, can also cause OE.
• Trauma or injury to the ear canal.
• Skin conditions such as Eczema , Seborrhea, Neurodermatitis, and allergic reactions to medications and other elements can irritate the external canal, which can then become infected.
• Pseudomonas and other bacterial OE can last for more than a few weeks, and become a chronic infection.
• Some people have a reaction to some sprays, such as hair spray, causing the skin to swell and be more likely to become infected.
• Bacteria such as Pseudomonas Aeruginosa (normally lives in the external canal), Staphylococcus Aureus, and Enterobacter species are common causes .
• This type of infection often happens when children spend a lot of time swimming (especially in dirty water).
• Water can get into the ear at other times, such as when a child's hair is washed or during a bath.

Diagnosis and Treament of Otitis Externa

Otitis externa is diagnosed by examining the ear canal and the eardrum, to make sure that the discharge is not comingfrom MIDDLE EAR INFECfION. Swabs of the discharge may be taken to identify the causative organism. Treatment is by clearing debris from the canal (this should be done by your doctor) and use of appropriate antibiotic or antifungal drops or ointments. It is important to finish any prescribed course of treatment, even when symptoms settle early. Repeated otitis externa can lead to chronic inflammation of the canal, causing persistent itching, injury to the canal lining by scratching, and further otitis externa - a vicious circle.

Prevention of Otitis Externa

To help prevent otitis extema, keep ears as dry as possible (wear ear-plugs for swimmingnd shampooing) and do not use cotton-wool swabs or any other rigid object to clean or dry the ear canal: healthy ears are self-cleaning, If chronic itchis a problem, ask your doctor for something to relieveit (corticosteroid applications help).

• In cases where there is potential for worsening of the infection, antibiotics by mouth are given for up to 14 days with a follow up visit.
• If the pain is bad you may need to take pain killers (analgesics) such as paracetamol, or anti inflammatory drugs in addition. Usually the infection settles quite quickly.
• Intravenous (via the blood) treatment may be necessary for 4-6 weeks if there has been a severe case of MOE or if the patient is Immunocompromised.
• Sometimes the ear canal needs more attention. This may involve seeing a specialist, and perhaps having the ear cleaned out, or a dressing inserted temporarily.
• Topical anti fungal drops can also be used for fungal OE.
• Eczema and other skin conditions may need drops such as Aluminum acetate, steroid cream, or lotions and antibiotics.
• If there is a fever and the patient appears very sick, he or she is admitted to the hospital for Intravenous antibiotics and further work, and possible surgical cleaning or drainage of the ear and effected areas.
• Tylenol or aspirin can help with pain and fever.