Swimmer’s ear
IT’S been said that swimming is the perfect exercise. But all that aquatic play has its risks of course, among them an infection of the ear that can appear in just a few days after exposure to contaminated water.
Doctors call it otitis externa. But it is commonly known as “swimmer’s ear.” It is the infection or inflammation of the lining of the outer ear and the ear canal.
Causes and risk factors. An infectious organism, as mentioned, can be present in swimming water (this being of the least concern to children swan diving into Manila Bay or the Pasig river). Moisture in the ears can also persist from too much bathing or living in a humid environment. Otitis externa can be the result of abrading the ear from too much scratching or rubbing with anything from a cotton swab, a pencil, or to the wire ends of eyeglasses. Sometimes bacteria multiplies from exposing the ears to hair sprays and dyes.
As a rule, swimmer’s ear is more common in pre-school and school-age children. However, diabetic patients with impaired body defense mechanisms have increased risk of developing ear infection. There can also be a simultaneous infection of the middle ear (otitis media) and spills out if the eardrum is perforated. Swimmer’s ear can also be associated with an ongoing upper respiratory infection such as the common cold.
Signs and symptoms. ear is characterized by:
• Exquisite pain while tugging on the outer ear (pinna) or pushing on the small bump in front of the ear (tragus). • Outer ear itching. • Muffled hearing. • Draining pus from ear. • Ear swelling or small lumps around the neck (enlarged lymph nodes).
• Usually one sided (only one ear involved). • Reddish ear. • Scaly skin. Swimmer’s
Diagnosis. Visit your favorite family doctor or the ear specialist. While it may not be difficult to make a diagnosis on clinical findings alone, the good doctor will want to look into your ear with a lighted instrument called the otoscope. If there is some drainage, a quick swab of the pus is done and sent to the lab for the organism check.
Treatment. The doctor may want to clean the canal to allow medication to enter easily. A suction device is usually used. This does mean that cleaning your own ear at this time is not advisable. You may irritate it further and prolong the agony. Eardrops prescribed contain steroids to decrease the swelling and antibiotics to treat the infection. Again, if the ear canal is too swollen, the doctor can introduce a wick through which the medication is dropped. It will certainly help to use oral antibiotics and pain killers (non-steroidal anti-inflammatory drugs or NSAIDs). Finally, NO SWIMMING until the infection clears! For mild infection without drainage, or before seeing the doctor, you can start self-care. To reduce pain, take over-the-counter pain-killers and intermittently apply a warm heat pad over the ear.
Complications. While otitis externa is not way up there with heart attacks and strokes, it does have its miserable complications. While the infection festers, hearing may be diminished. Untreated, swimmer’s ear can become necrotizingotitis externa in which bone and cartilage at the base of the skull may be destroyed. The infection becomes life-threatening if, it begins to involve the cranial nerves and brain.
Prevention. Wasn’t Mom always right? We were told to dry our ears after bathing. This is in fact the first preventive step – to always keep the outer ears dry using a soft towel. When swimming, it’s wise to use ear plugs. If you have earwax (cerumen), do not attempt to clean out the ear by using a paper clip or a hairpin. The ear canal is easily injured and earwax is generally pushed inward by these objects rather than scooped out. The ear specialist has the equipment and expertise to do this.
Swimmer’s ear is easily recognized, treated, but above all – prevented.