Ear Infections

(Otitis externa and Otitis media)

Otitis externa.jpg
 
635-acute-otitis-media-springer-high.jpg

Acute otitis externa (ear canal infections) is common. The symptoms include:

  • itching

  • muffled hearing

  • ear discharge (may be bloody or smelly)

  • severe pain

  • fever

  • redness (cellulitis/perichondritis) of the ear itself.

Common causes are swimming or minor trauma to the skin of the ear canal (eg cotton buds). Treatment involves removal of infected debris in the ear canal (microsuction/aural toilet), keeping water out of the ear, and antibiotics. Usually antibiotic ear drops are most effective, but for resistant or severe cases, antibiotics may need to be given by mouth as well.

Occasionally people develop an infected spot (furuncle) at the entrance to the ear canal, which can be excruciatingly painful and may require lancing with a needle.

Infections of the outer ear (pinna cellulitis/perichondritis) can be serious and usually need treatment with antibiotics by mouth or intravenously.

 

Acute otitis media (middle ear infection) is also common, especially in children. Adults may also sometimes develop it, especially after a cold or sinusitis.

Typically, patients get hearing loss, ear pain and are unwell with a temperature. You can see in the picture to the left that pus has built up behind the ear drum making it red and bulging. As the pressure continues to build, the pain increases until the eardrum bursts, there is a flood of blood/pus from the ear and the pain settles. The hearing then usually returns gradually.

Usually the infection will settle with antibiotics by mouth (or as drops down the ear if there is discharge) and the hole in the ear drum heals up. Occasionally, the infection and discharge persist so the hole in the eardrum cannot heal up and may need repairing surgically.