Otitis externa
Also known as external otitis and swimmer’s ear, otitis externa is an inflammation of the skin of the external ear canal and auricle. It may be acute or chronic, and it’s most common in the summer. With treatment, acute otitis externa usually subsides within 7 days (although it may become chronic) and tends to recur.
Causes
Otitis externa usually results from bacterial infection with an organism, such as Pseudomonas, Proteus vulgaris, streptococci, or Staphylococcus aureus; sometimes it stems from a fungus, such as Aspergillus niger or Candida albicans (fungal otitis externa is most common in the tropics). Occasionally, chronic otitis externa results from dermatologic conditions, such as seborrhea or psoriasis. Predisposing factors include:
swimming in contaminated water (cerumen creates a culture medium for the waterborne organism)
cleaning the ear canal with a cotton swab, bobby pin, finger, or other foreign objects (irritates the ear canal and may introduce the infecting microorganism)
exposure to dust, hair care products, or other irritants (causes the patient to scratch his ear, excoriating the auricle and canal)
regular use of earphones, earplugs, or earmuffs (traps moisture in the ear canal, creating a culture medium for infection)
chronic drainage from a perforated tympanic membrane.
Signs and symptoms
Acute otitis externa characteristically produces moderate to severe pain that’s exacerbated by manipulation of the auricle or tragus, clenching of the teeth, opening of the mouth, or chewing. Other signs and symptoms include fever, foul-smelling aural discharge, regional cellulitis, and partial hearing loss.
Fungal otitis externa may be asymptomatic, although A. niger
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