Materiały źródłowe

• #1 Acute otitis externa

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3567906/

  Acute otitis externa, also known as swimmers ear, is a common disease of children, adolescents and adults. […] It is defined by diffuse inflammation of the external ear canal. Primarily a disease of children over two years of age, it is commonly associated with swimming. Local defence mechanisms become impaired by prolonged ear canal wetness. Skin desquamation leads to microscopic fissures that provide a portal of entry for infecting organisms. […] Infection causes the vast majority of AOE cases. The two most commonly isolated organisms are Pseudomonas aeruginosa and Staphylococcus aureus. […] The management of AOE has been the subject of one Cochrane systematic review, one meta-analysis by the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), and one clinical practice guideline (AAO-HNS).

• #2 Otitis Externa – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK556055/

  Otitis externa (OE) is an inflammation, that can be either infectious or non-infectious, of the external auditory canal. […] It is also known as swimmer’s ear as it often occurs during the summer and in tropical climates and having retained water in the ears increases the risk for it. […] The inflammatory response in otitis externa is believed to be caused by a disruption of the normal pH and protective factors within the auditory canal. […] This includes a sequential process of damage to the epithelium, loss of protective wax, and accumulation of moisture that leads to a higher pH and bacterial growth.

• #3 Swimmer’s Ear Treatment, Home Remedies, Symptoms & Causes

  https://www.emedicinehealth.com/swimmers_ear/article_em.htm

  The definition of swimmer’s ear is an infection, inflammation, or pain in the ear caused by water trapped in the ear canal. This condition frequently occurs in swimmers, which is why it’s known as swimmer’s ear but it can occur in anyone, even from showering. […] The main cause of swimmer’s ear is a break in the skin lining of the outer ear or ear canal that allows bacteria or fungi to invade the outer ear. A break in the skin may be caused by scratching the ear area, skin conditions such as seborrheic dermatitis and psoriasis, improperly cleaning your ears with cotton-tipped swabs or other objects inserted in the ear, using devices inserted into the ear (earplugs, hearing aids, headphones, earbuds, and other devices), or chemicals (hair dyes, bleaches, certain shampoos, hair sprays). […] The skin lining the ear canal and outer ear serve as a barrier against infection from bacteria and fungi. The ear is protected against infection because the lining is slightly acidic. The lining is also a physical barrier that protects against excessive moisture.

• #4 Swimmer’s Ear (Otitis Externa): Causes, Diagnosis, Treatment

  https://www.webmd.com/cold-and-flu/ear-infection/understanding-swimmer-ear-basics

  Swimmer’s ear, which has the medical name of otitis externa, is an infection in your ear canal. That’s the tube that runs from the hole on the outside of your ear to your eardrum. […] Usually, swimmer’s ear is caused by bacteria, but it can sometimes be brought on by a virus or fungus. […] Most of the time, your ear fights off the germs that cause swimmer’s ear on its own. You can thank your earwax for that. While it doesn’t get much respect, earwax helps protect the ear canal from damage and makes it hard for germs to grow. […] But if the skin gets scratched, germs can get into your ear canal and cause an infection. […] When water gets stuck in your ear canal after swimming — or after you soak in a hot tub or even take a shower or bath — it can remove some of the earwax and soften the skin, which makes it easier for germs to get in.

• #5 Ear Canal Infection (Swimmer’s Ear) – Ear, Nose, and Throat Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/ear-nose-and-throat-disorders/outer-ear-disorders/ear-canal-infection-swimmer-s-ear

  Bacteria and sometimes fungi can cause acute infection of the skin of the ear canal. […] Ear canal infection is caused by bacteria or, less commonly, fungi. […] Getting water in the ear, particularly while swimming (called swimmer’s ear) […] White vinegar (acetic acid) is helpful because bacteria do not grow as well in an acidic environment. […] Swimmer’s ear may be prevented by putting drops of a solution containing half rubbing alcohol and half white vinegar (acetic acid) in the ear immediately after swimming. This treatment should be done only if the eardrum is intact (that is, has no holes in it). The alcohol helps the water evaporate, and the vinegar alters the acidity of the canal. […] Attempting to clean the canal with cotton swabs or other objects is strongly discouraged because such action interrupts the ear’s normal, self-cleaning mechanism and can push debris and earwax further inward. Also, this action may cause minor damage to the delicate skin of the canal, providing a site for bacteria to infect.

• #6 Acute Otitis Externa (Swimmer’s Ear): Pathogenesis … | GrepMed

  https://grepmed.com/images/8315/pathophysiology-swimmersear-otitisexterna

  Acute Otitis Externa (Swimmers Ear): Pathogenesis and clinical findings […] Pathogens = Pseudomonas aeruginosa (most common opportunistic), Staphylococcus, other gram negatives […] 1. Absence of cerumen – Aggressive washing of cerumen or retention of water – Alkalotic external auditory canal – Decreased production of antibacterial agents (e.g. lysozyme) – Bacterial overgrowth […] 2. Trauma – Microtraumas (e.g. cotton swaps, finger nails, or hair pins) – Injury of external auditory canal soft tissue – Invasion of bacteria into damaged skin […] 3. Obstruction – Cerumen build-up, debris, exostosis, narrow and tortuous auditory canal – Moist, dark, warm environment of the external auditory canal – Pathogen overgrowth

• #7 Swimmer’s ear | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/swimmers-ear

  Swimmer’s ear is an infection that’s usually caused by bacteria. It’s less common for a fungus or virus to cause swimmer’s ear. […] Having swimmer’s ear means the ear’s natural defenses have not worked well. The conditions that often play a role in infection include: Moisture in the ear canal that makes an ideal place for bacteria to grow. Contact with contaminated water. Damage to the skin of the ear canal, which can be an entry point for bacteria. […] Most often, ear drops that have a mix of the following can treat the infection: An acidic solution to help restore the ear’s natural defenses. A steroid to reduce swelling and irritation, called inflammation. An antibiotic to fight bacteria. An antifungal medicine to fight infection caused by a fungus.

• #8 Swimmer’s ear | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20164010/

  The moist environment from water remaining in your ear after swimming or bathing can lead to this infection in the outer ear canal. […] Swimmers ear is an infection in the outer ear canal, which runs from your eardrum to the outside of your head. Its often brought on by water that remains in your ear, creating a moist environment that aids the growth of bacteria. […] Swimmers ear is an infection thats usually caused by bacteria. Its less common for a fungus or virus to cause swimmers ear. […] If you have swimmers ear, your natural defenses have been overwhelmed. The conditions that often play a role in infection include: Moisture in the ear canal that creates an ideal environment for bacterial growth, Exposure to contaminated water, Damage to the sensitive skin of the ear canal that creates an opening for infection.

• #9 Acute Otitis Externa: An Update | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/1201/p1055.html

  Otitis externa, also called swimmer’s ear, involves diffuse inflammation of the external ear canal that may extend distally to the pinna and proximally to the tympanic membrane. […] Several factors may predispose patients to the development of acute otitis externa. One of the most common predisposing factors is swimming, especially in fresh water. […] These factors appear to work primarily through loss of the protective cerumen barrier, disruption of the epithelium (including maceration from water retention), inoculation with bacteria, and increase in the pH of the ear canal. […] In North America, 98 percent of cases of acute otitis externa are caused by bacteria. The two most common isolates are Pseudomonas aeruginosa and Staphylococcus aureus. However, a wide variety of other aerobic and anaerobic bacteria have been isolated.

• #10 Otitis externa

  https://dermnetnz.org/topics/otitis-externa

  Otitis externa, also called external otitis or swimmers ear, is a common inflammatory condition of the external auditory canal (the ear canal). It is characterised by redness, swelling, scaling, and thickening of the ear canal skin lining; and varying degrees of discomfort, itch, ear discharge, and hearing loss. […] Swimming is a key risk factor. […] The breakdown of these protective barriers leads to damage to the epithelial lining of the ear canal, and changes to its pH and the quality and amount of cerumen. This in turn leads to bacterial overgrowth. […] Common causes that encourage bacterial overgrowth in the external ear include: Increased water exposure from swimming, perspiration, and high humidity. […] The most common bacteria involved in otitis externa are Pseudomonas aeruginosa (41%) and Staphylococcus aureus (15%). Up to 10% of cases of infectious otitis externa are caused by fungal infections with Aspergillus (most common) or Candida. Mixed bacterial and fungal infections can also occur.

• #11 Understanding Swimmer’s Ear | UNC Health Talkhealth wellnessstethoscopeStorieshealth wellnessstethoscopeStoriestwitter-iconfacebook-iconpinterest-iconemail-iconhealth wellnessstethoscopeStoriesfacebooktwitteryoutubepinterestinstagramLinkedIn

  https://healthtalk.unchealthcare.org/understanding-swimmers-ear/

  Swimmer’s ear peaks in the summer months, when people are more likely to go swimming, but you can get it without ever going in the water. […] The infection is usually caused by one of two types of bacteria, Pseudomonas aeruginosa or Staphylococcus aureus. Water left in the ear canal after swimming provides an environment that is favorable for these bacteria to grow, but there are other ways for the germs to take root in the ear, says Christine DeMason, MD, an ear, nose and throat physician at UNC Medical Center in Chapel Hill. […] Any water, sand or other debris that gets into the ear canal and stays there can cause the infection. […] Sometimes people try to clean their ears with cotton swabs. This can cause damage or irritation to the lining of the ear canal, and that gives bacteria a way to get in and cause an infection.

• #12 Acute Otitis Externa: An Update | AAFP

  https://www.aafp.org/pubs/afp/issues/2012/1201/p1055.html

  Approximately one-third of cases are polymicrobial. […] Fungal pathogens, primarily those of the Aspergillus and Candida species, occur more often in tropical or subtropical environments and in patients previously treated with antibiotics. […] Inflammatory skin disorders and allergic reactions may cause noninfectious otitis externa, which can be chronic.

• #13 Otitis externa – Wikipedia

  https://en.wikipedia.org/wiki/Otitis_externa

  Otitis externa, also called swimmer’s ear, is inflammation of the ear canal. […] The most common cause of otitis externa is bacterial. […] The two factors that are required for external otitis to develop are (1) the presence of germs that can infect the skin and (2) impairments in the integrity of the skin of the ear canal that allow an infection to occur. […] If there are chronic skin conditions that affect the ear canal skin, such as atopic dermatitis, seborrheic dermatitis, psoriasis or abnormalities of keratin production, or if there has been a break in the skin from trauma, even the normal bacteria found in the ear canal may cause infection and full-blown symptoms of external otitis. […] Another causative factor for acute infection is prolonged water exposure in the forms of swimming or exposure to extreme humidity, which can compromise the protective barrier function of the canal skin, allowing bacteria to flourish, hence the name „swimmer’s ear”. […] The majority of cases are due to Pseudomonas aeruginosa and Staphylococcus aureus, followed by a great number of other gram-positive and gram-negative species. […] Candida albicans and Aspergillus species are the most common fungal pathogens responsible for the condition.

• #14 Swimmer’s ear | Health Library | Memorial Health System

  https://www.mhsystem.org/health-library/con-20164010/

  Factors that can increase the risk of swimmers ear include: Excess moisture in your ear canal from heavy perspiration, prolonged humid weather or water remaining in the ear after swimming, Exposure to high bacteria levels in contaminated water, Cleaning the ear canal with cotton swabs, hairpins or fingernails, which can cause scratches or abrasions, Ear devices, such as earbuds or hearing aids, which can cause tiny breaks in the skin. […] The goal of treatment is to stop the infection and allow your ear canal to heal. […] For most cases of swimmers ear, your doctor will prescribe eardrops that have some combination of the following ingredients, depending on the type and seriousness of your infection: Acidic solution to help restore your ears normal antibacterial environment, Steroid to reduce inflammation, Antibiotic to fight bacteria, Antifungal medication to fight infection caused by a fungus.

• #15 Swimmer’s ear – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/swimmers-ear/symptoms-causes/syc-20351682

  Swimmer’s ear is an infection that’s usually caused by bacteria. It’s less common for a fungus or virus to cause swimmer’s ear. […] Having swimmer’s ear means the ear’s natural defenses have not worked well. The conditions that often play a role in infection include: Moisture in the ear canal that makes an ideal place for bacteria to grow. Contact with contaminated water. Damage to the skin of the ear canal, which can be an entry point for bacteria. […] Swimmer’s ear usually isn’t serious if treated quickly. But complications that can happen include: Long-term infection, called chronic otitis externa. This involves symptoms of outer ear infection that last for more than three months. Chronic infections are more common if treatment is hard. Treatment can be hard when there is a rare strain of bacteria, an allergic skin reaction, an allergic reaction to antibiotic ear drops, a skin condition such as dermatitis or psoriasis, or a combined bacterial and fungal infection.

• #16 Preventing Swimmer’s Ear | Healthy Swimming | CDC

  https://www.cdc.gov/healthy-swimming/prevention/preventing-swimmers-ear.html

  Swimmers ear is a bacterial infection caused by water that stays in the outer ear canal for a long period of time, providing a moist environment for bacteria to multiply. […] Swimmer’s ear (also known as acute otitis externa) is a bacterial infection. It is typically caused by water that has stayed in the outer ear canal for a long time. This wears down protective wax and skin and provides a moist environment for bacteria to multiply. […] Swimmer’s ear can be treated with antibiotic ear drops.

• #17 Understanding Swimmer’s Ear | UNC Health Talkhealth wellnessstethoscopeStorieshealth wellnessstethoscopeStoriestwitter-iconfacebook-iconpinterest-iconemail-iconhealth wellnessstethoscopeStoriesfacebooktwitteryoutubepinterestinstagramLinkedIn

  https://healthtalk.unchealthcare.org/understanding-swimmers-ear/

  People who wear hearing aids are at risk of developing swimmer’s ear because hearing aids can break down the natural protective barrier of the skin and trap moisture. […] In most cases, swimmer’s ear can be treated with a careful cleaning of the ear canal (which should be done by a health care professional) and prescription eardrops that inhibit bacterial or fungal growth and reduce inflammation. […] If left untreated, swimmer’s ear can lead to more serious problems, such as a deep tissue infection called cellulitis, or to bone and cartilage damage. […] Your risk of swimmer’s ear is higher when you swim in natural bodies of water, such as rivers, lakes or the ocean, compared with swimming in a chlorinated swimming pool, Dr. DeMason adds. That’s because natural bodies of water are more likely to have higher levels of bacteria. […] For people with eczema, who are also prone to swimmer’s ear, the problem is the opposite: The skin is too dry, which can lead to infection in the ear canal.

• #18 Swimmer’s Ear (Otitis Externa) | Boston Medical Center

  https://www.bmc.org/patient-care/conditions-we-treat/db/swimmers-ear

  An infection of the outer ear structures caused when water gets trapped in the ear canal leading to a collection of trapped bacteria is known as swimmers ear or otitis externa. […] In this warm, moist environment, bacteria multiply causing irritation and infection of the ear canal.

• #19 Swimmer’s ear (otitis externa, infection of the external ear canal) – Dermatology Advisor

  https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/swimmers-ear-otitis-externa-infection-of-the-external-ear-canal/

  Swimmers ear is caused by overgrowth of bacteria, specifically P. aeruginosa. Many other bacteria (second most common being Staphlococcous aureus) and fungi can be present and play a role in disease formation. […] Moisture retention: This in turn is directly related to the amount of time one spends in water. Swimmers are 5 times more likely to develop otitis externa than non-swimmers. Factors that lead to moisture retention include: abnormalities in the anatomy of the external auditory canal, excessive buildup of cerumen, and chronic dermatoses (such as psoriasis) due to the buildup of scale which is able to retain moisture. […] Bacteria: Bacteria are present normally within the external ear canal, and when moisture retention occurs they are able to proliferate, invade the epithelial lining of the canal and cause disease. The normal acidic nature of the ear canal (pH 4-5) inhibits bacterial growth under normal circumstances. During moisture retention, and a build up of cerumen and epithelial debris, the pH increases significantly and thus innate protection is decreased. […] Swimmers are more prone to developing otitis externa as they introduce more bacteria into the ear canal along with moisture allowing for the perfect growth environment. […] Trauma: Any damage to the lining of the ear canal can increase the likelihood of developing otitis externa.

• #20 Otitis Externa – What To Do For Swimmer’s Ear | familydoctor.org

  https://familydoctor.org/condition/otitis-externa-swimmers-ear/

  Swimmer’s ear is an irritation, swelling, or infection in your ear. It’s often caused by swimming a lot or swimming in unclean water. It can occur suddenly. It’s common in children and young adults but can happen to anybody. The medical name for swimmer’s ear is otitis externa. […] Swimmer’s ear infects the outer ear or ear canal. Because those areas are dark and warm, bacteria and fungus can grow there to create an infection. Note this type of infection is different than an inner ear infection. […] Several things can cause swimmer’s ear, including: Swimming in unclean water. Swimming and showering too much. Water can accumulate in the ear canal, which allows germs to grow. Excessive cleaning of your ears. Earwax helps to flush germs from the ear. Removing too much may allow germs to spread and start an infection. Injuring the skin in the ear canal. This can happen by putting your finger or an object (such as a cotton swab) in your ear. Some skin conditions. If you have conditions such as eczema and psoriasis in other places on your body, they can occur in the ear canal, too. This can cause an infection. Bacteria from products used in your hair, such as hairspray or hair dye. These products can get trapped in your ear canal.

• #21 Swimmer’s Ear (Otitis Externa) Explained: Causes and Treatments in Ansonia, CT | Naugatuck Valley Ear, Nose, and Throat Associates (NVENTA)

  https://naugatuckvalleyent.com/blog/swimmers-ear-otitis-externa-explained-causes-and-treatments-in-ansonia-ct/

  Skin Conditions: Conditions like eczema or seborrhea can affect the skin in the ear canal, leading to a higher risk of infection. […] Ear Devices: Ill-fitting hearing aids or contaminated earbuds can also cause or exacerbate swimmers ear. […] Antibiotic or antifungal drops are commonly prescribed to treat the infection and reduce inflammation. […] For more severe infections, a healthcare provider may insert a wick into the ear canal to help administer eardrops more effectively. […] If left untreated, swimmers ear can lead to serious complications, including: Chronic Otitis Externa: Recurrent infections that require ongoing treatment. […] Malignant Otitis Externa: A severe infection that can spread to the bones and cartilage of the ear, skull, or brain, particularly in older adults, diabetics, or individuals with weakened immune systems.

• #22 Swimmer’s Ear (Otitis Externa) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/swimmers-ear

  Otitis externa is commonly known as swimmer’s ear. It’s the inflammation of the external ear canal. Swimmer’s ear is caused by fungi or bacteria. Water that remains trapped in the ear canal (when swimming, for example) may provide a source for the growth of bacteria and fungi. […] Many different factors can increase your child’s chance of developing swimmer’s ear. As the name implies, one of the factors is excessive wetness as with swimming, although it can occur without swimming. Other possible causes include: Being in warm, humid places, Harsh cleaning of the ear canal, Trauma to the ear canal, Dry ear canal skin, Foreign body in the ear canal, Lack of cerumen (ear wax), Eczema and other forms of dermatitis. […] Swimmer’s ear may be diagnosed with a complete medical history and physical examination by your child’s physician. Your child’s physician may use an otoscope, a lighted instrument that helps to examine the ear and to aid in the diagnosis of ear disorders. This will help your child’s physician know if there is also an infection in the middle ear, called otitis media. Although this infection usually does not occur with swimmer’s ear, some children may have both types of infections. Your child’s physician may also take a culture of the drainage from the ear to help determine proper treatment.

• #23 Patient education: External otitis (including swimmer’s ear) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/external-otitis-including-swimmers-ear-beyond-the-basics/print

  External otitis is a condition that occurs when the ear canal becomes irritated. The ear canal is the part of the ear that leads from the outer ear to the ear drum. External otitis can develop as a result of an infection, allergy, or skin problem. „Swimmer’s ear” is the name for external otitis that occurs in a person who swims frequently. […] This article will discuss external otitis that is caused by an infection, as well as ways to prevent future episodes of external otitis. More detailed information is available by subscription. (See „Acute otitis externa in adults: Pathogenesis, clinical features, and diagnosis.”) […] Several factors can increase your risk of developing external otitis. […] Swimming on a regular basis removes some of the ear wax, allowing water to soften the skin. Bacteria, which normally live in the ear canal, can then enter the skin more easily.

• #24 Patient education: External otitis (including swimmer’s ear) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/external-otitis-including-swimmers-ear-beyond-the-basics

  In some cases, your health care provider will flush out your ear with water and hydrogen peroxide before you begin treatment; this speeds healing by removing dead skin cells and excess ear wax. […] If you swim frequently, experts recommend the following tips to reduce the chance of developing external otitis. […] Use ear drops after swimming to prevent ear infections; these are available at most pharmacies without a prescription. […] Acute otitis externa in adults: Pathogenesis, clinical features, and diagnosis.

• #25 Chronic Swimmer’s Ear: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/swimmers-ear-chronic

  Chronic swimmers ear is when the outer ear and ear canal become infected, swollen, or irritated, on a long-term or recurring basis. Water trapped in your ear after swimming often causes this condition. The ears structure and the water left in the ear after swimming combine to create a damp, dark space where bacteria and fungi can thrive and cause infection. […] The medical term for chronic swimmers ear is chronic otitis externa. […] Swimmers ear can occur when you dont have enough earwax in your ear. Without the protection of adequate earwax, bacteria can enter your ear and cause an infection. […] An acute case of swimmers ear may become chronic if the physical structure of the ear makes treatment difficult, the bacterium (or fungus) is a rare strain, you have an allergic reaction to antibiotic eardrops, or the infection is both bacterial and fungal.

• #26 Swimmer’s Ear: Causes, Symptoms, and Effective Treatments – BuzzRx

  https://www.buzzrx.com/blog/what-is-swimmers-ear-and-treatment-for-an-infection

  Chemicals in shampoos, hairsprays, or hair dyes can enter the ear canal and can cause irritation and inflammation. […] Sometimes, otitis externa infection occurs when an infection spreads from the middle ear (this is called otitis media). […] People with diabetes (high blood sugar) have more alkaline earwax, which promotes the growth of bacteria and fungi. […] People with narrowed ear canals have less effective ear drainage and are more prone to swimmer’s ear (otitis externa). […] A skin condition such as eczema or psoriasis can increase the risk of ear infections. […] Swimmer’s ear (otitis externa) is usually treated with ear drops containing antibiotics to kill bacteria and corticosteroids to reduce swelling. […] Swimmer’s ear does not go away by itself and must be treated with antibiotics. Leaving an outer ear infection untreated can result in complications such as temporary hearing loss, chronic otitis externa (long-lasting infection), damage to the bone and cartilage, and more widespread infection.

• #27 Swimmer’s ear | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/swimmers-ear

  Swimmer’s ear is an infection or inflammation of the canal between the eardrum and the outer ear. […] The infection can be caused by fungi or bacteria. […] Some of the causes and risk factors include: […] Water – dirty water can deliver bacteria to the ear canal. A wet ear canal is also prone to dermatitis. Tiny cracks or splits in the skin can allow bacteria to enter. […] Mechanical damage – attempts to clean the ears using fingernails, cotton buds or other objects may cut the delicate tissues of the ear canal and lead to infection. […] Chemical irritation – hairsprays, shampoos and hair dyes may get into the ear canal and irritate the tissues. […] Middle ear infection (otitis media) – an infection within the middle ear can trigger an infection or inflammation in the ear canal.

• #28 Swimmer’s Ear (Otitis Externa) – ENT Health

  https://www.enthealth.org/conditions/swimmers-ear-otitis-externa/

  Swimmers ear (also called acute otitis externa) is a painful condition that affects the outer ear and ear canal that is caused by infection, inflammation, or irritation. […] A common source of the infection is increased moisture trapped in the ear canal from baths, showers, swimming, or moist environments. When water is trapped in the ear canal, bacteria that normally inhabit the skin and ear canal multiply, causing infection of the ear canal. Swimmers ear needs to be treated to reduce pain and eliminate any effect it may have on your hearing, as well as to prevent the spread of infection. […] Bone and cartilage damage (malignant otitis externa) are also possible due to untreated swimmers ear. If left untreated, ear infections can spread to the base of your skull, brain, or cranial nerves. Diabetics, older adults, and those with conditions that weaken the immune system are at higher risk for such dangerous complications.

• #29 Otitis Externa: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/994550-overview

  OE is a superficial infection of the skin in the EAC. […] The processes involved in the development of OE can be divided into the following four categories: Obstruction (eg, cerumen buildup, surfers exostosis, or a narrow or tortuous canal), resulting in water retention. […] If moisture is trapped in the EAC, it may cause maceration of the skin and provide a good breeding ground for bacteria. This may occur after swimming (especially in contaminated water) or bathing hence the common lay term swimmers ear. […] Once infection is established, an inflammatory response occurs with skin edema. Exudate and pus often appear in the EAC as well. […] Necrotizing (malignant) OE is a rare complication that occurs in patients who are immunocompromised or in those who have received radiotherapy to the skull base. In this condition, bacteria invade the deeper underlying structures of the soft tissues and cause osteomyelitis of the temporal bone. This is a life-threatening disorder with an overall mortality that historically has approached 50%.

• #30 What doctors wish patients knew about swimmer’s ear | American Medical Association

  https://www.ama-assn.org/delivering-care/population-care/what-doctors-wish-patients-knew-about-swimmer-s-ear

  Swimmers ear is an infection of the ear canalthe space that leads from the ear seen on the outside of the body to the middle ear behind the ear drum, echoed Dr. Eisert. It differs from other ear infections as it does not usually affect the middle ear like other infections do. […] We always see a surge of swimmers ear over the summer, Dr. Spence said, noting that the ear canal produces cerumenwhich is waxand that provides water protection, similar to the wax on your car. […] A change in pH balance to an alkaline environment also sets up conditions in which bacteria and other germs like to live. This process can break down the skin of the canal and creates the symptoms of swimmers ear. […] The idea is that water gets trapped in the ear and then usually bacteriasometimes fungusbreeds in the ear after that and turns the area red, swollen, inflamed and pretty uncomfortable, she said.

• #31 Otitis externa

  https://dermnetnz.org/topics/otitis-externa

  Due to disruption of the skin barrier, often these conditions can become complicated by superimposed infection. […] The clinical features of otitis externa may vary according to the cause: […] Significant swelling of the ear canal is common. […] The diagnosis of otitis externa is based on history and physical examination. […] Common topical treatments include: Acetic acid 2% solution inexpensive and effective against most infections but can be irritating to the inflamed canal. […] Topical drops that have a combination of antibiotics and steroids may help to reduce inflammation and resolve symptoms more quickly. […] Those with an acute episode of infectious otitis externa treated with antibiotic/steroid ear drops tend to notice resolution in symptoms within 710 days.

• #32 Chronic Swimmer’s Ear: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/swimmers-ear-chronic

  The condition is considered chronic if the symptoms occur repeatedly, as multiple sequential episodes, or if the symptoms persist for more than three months. […] Complications of untreated chronic swimmers ear include hearing loss, infection of the surrounding skin, and cellulitis (an infection that affects the deep tissues of the skin). […] Serious complications that affect other parts of the body include malignant otitis externa, an infection that spreads to the base of your skull and is more likely to affect older adults and people with diabetes or immune deficiencies. […] Your doctor may also take a sample of ear discharge or debris for laboratory analysis. This allows them to determine the organism causing the recurring infection. […] For most cases of chronic swimmers ear, treatment will begin with antibiotic eardrops to cure a bacterial infection.

• #33 Swimmer’s Ear (Otitis Externa): Symptoms & Care

  https://my.clevelandclinic.org/health/diseases/8381-swimmers-ear-otitis-externa

  Swimmers ear complications are rare, especially if you treat your symptoms quickly. But they can still happen. Possible issues include chronic (long-term) ear infections. If you have swimmers ear for more than three months, providers call it a chronic ear infection. This can happen if you have a combination of a bacterial and fungal infection. […] A provider will examine your ears for redness, swelling or other signs of damage. If you have drainage coming from your ears, providers may take a sample of the fluid to determine what caused the infection. This is valuable information because bacterial infections and fungal infections require different treatments. […] In most cases, healthcare providers prescribe ear drops to eliminate the infection. Depending on your situation, your provider might recommend these medications for otitis externa: antibiotic ear drops to fight bacteria, antifungal ear drops to fight fungi, steroid ear drops to reduce inflammation.

• #34 Swimmer’s ear – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/swimmers-ear/symptoms-causes/syc-20351682

  Bone and cartilage damage, called early skull base osteomyelitis. This is a rare complication of swimmer’s ear. It happens if the infection spreads to the firm tissue of the outer ear, called cartilage, and bones of the lower part of the skull. This causes severe pain that gets worse. Being older or having diabetes or a weakened immune system raises the risk of this complication.

• #35 Otitis Externa: Symptoms, Causes and Treatment | Ada

  https://ada.com/conditions/otitis-externa/

  Malignant otitis externa is a serious but very rare complication. It occurs when the infection spreads to the bone surrounding the ear canal. People with weakened immune systems, such as people diagnosed with HIV, people undergoing chemotherapy treatment and people with diabetes, especially older people with poor glucose control, are most at risk.

• #36 What doctors wish patients knew about swimmer’s ear | American Medical Association

  https://www.ama-assn.org/delivering-care/population-care/what-doctors-wish-patients-knew-about-swimmer-s-ear

  Without medical care once the symptoms begin, it is not going to get better on its own, Dr. Eisert said, emphasizing that ignoring this can lead to significant pain and complications. […] Untreated, swimmers ear can lead to infection of the surrounding tissues including the skin or skull, he said. One condition called cellulitis occurs when infection spreads to the skin beyond the ear canal. This can cause fever and significant pain. […] If infection spreads to the surrounding bone of the skull, it can be a very serious condition that requires hospitalization given the proximity to the brain.

• #37 Otitis Externa (Swimmer’s Ear) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/swimmers-ear-otitis-externa

  Swimmer’s ear, also called (otitis externa) is an irritation of the external ear canal. Otitis externa is caused by fungi or bacteria. Water that remains trapped in the ear canal (when swimming, for example) may provide a source for the growth of bacteria and fungi. […] Your child’s provider may also take a swab culture of the drainage from the ear and send it to the lab to help determine what type of bacteria or fungus is causing the infection.

• #38 Swimmer’s ear | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/swimmers-ear

  Folliculitis – an infected hair follicle within the ear canal can trigger a generalised infection. […] Malignant otitis externa is the spread of infection to the bones of the ear canal and lower part of the skull. This may cause structural damage in severe cases. Without treatment, the infection may reach the cranial nerves and the brain. […] Swimmer’s ear is diagnosed by physical examination. The skin of the ear canal will appear red, scaled and peeling when examined using an otoscope. […] Microscopic examination of the discharge in the ear canal will, in most cases, tell the doctor whether the infection is caused by bacteria or fungi. […] Treatment depends on the degree of bone infection (osteomyelitis), but is generally lengthy and involves prolonged courses of antibiotics.

• #39 Acute otitis externa

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3567906/

  It is clear that topical antimicrobials are effective in mild-to-moderate AOE. […] Clinical response should be evident within 48 h to 72 h, but full response can take up to six days in patients treated with antibiotic and steroid drops. […] In patients who are immunodeficient or who have insulin-dependent diabetes, special measures should be taken to rule out malignant otitis externa. This invasive infection of the cartilage and bone of the canal and external ear may present with facial nerve palsy and pain as a prominent symptom. […] Targeting typical causal culprits of AOE, such as moisture and trauma, seems prudent.

• #40 Patient education: External otitis (including swimmer’s ear) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/external-otitis-including-swimmers-ear-beyond-the-basics

  External otitis is a condition that occurs when the ear canal becomes irritated. The ear canal is the part of the ear that leads from the outer ear to the ear drum. External otitis can develop as a result of an infection, allergy, or skin problem. „Swimmer’s ear” is the name for external otitis that occurs in a person who swims frequently. […] This article will discuss external otitis that is caused by an infection, as well as ways to prevent future episodes of external otitis. More detailed information is available by subscription. […] Several factors can increase your risk of developing external otitis. […] Swimming on a regular basis removes some of the ear wax, allowing water to soften the skin. Bacteria, which normally live in the ear canal, can then enter the skin more easily. […] Treatment of external otitis aims to reduce pain and eliminate the infection. Most people with external otitis can be treated at home.

• #41 Swimmer’s ear | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/swimmers-ear?content_id=CON-20164010

  Swimmer’s ear is an infection in the outer ear canal. The outer ear canal runs from the eardrum to the outside the head. Swimmer’s ear is often brought on by water that stays in the ear. The moisture helps bacteria grow. […] Having swimmer’s ear means the ear’s natural defenses have not worked well. The conditions that often play a role in infection include: Moisture in the ear canal that makes an ideal place for bacteria to grow. […] Swimmer’s ear is an infection that’s usually caused by bacteria. It’s less common for a fungus or virus to cause swimmer’s ear. […] Cleaning the outer ear canal helps ear drops get to all infected areas. A healthcare professional will use a suction device or ear curet to clean away discharge, clumps of earwax, flaky skin and other debris. […] Most often, ear drops that have a mix of the following can treat the infection: An acidic solution to help restore the ear’s natural defenses. […] If the infection is more advanced or ear drops don’t clear it up, your healthcare professional might prescribe antibiotics that you take by mouth.

• #42 Swimmer’s Ear

  http://www.drrobertoliver.com/what-we-do/pediatrics/swimmers-ear

  Mildly acidic solutions containing boric or acetic acid are effective for early infections. […] For more severe infections, your doctor may prescribe antibiotics to be applied directly to the ear. […] Topical antibiotics are effective for infection limited to the ear canal. Oral antibiotics may also be prescribed if the infection goes beyond the skin of the ear canal.

• #43 Swimmer’s Ear Treatment, Home Remedies, Symptoms & Causes

  https://www.emedicinehealth.com/swimmers_ear/article_em.htm

  Any break in the skin lining can lead to infection, allowing bacteria or fungi to invade the outer ear. […] Excessive moisture in the ear canal from showering or swimming alters the acidic environment of the ear canal and allows for the invasion of bacteria or fungi. This is the reason this condition happens mainly in the summer months and is called swimmer’s ear. […] The most common bacteria responsible for outer ear infection are Staphylococcus aureus and Pseudomonas aeruginosa. Other bacteria are less common. In less than 10% of cases fungus causes of swimmer’s ear. […] Acidifying agents are effective because the common bacteria responsible for outer ear infection cannot survive in a very acidic environment. Examples include acetic acid (vinegar), hydrochloric acid, salicylic acid, boric acid, sulfuric acid, and citric acid solutions. […] Anti-inflammatory agents help with inflammation and may reduce pain. Some studies have shown the combination of anti-inflammatory and acidifying agents was superior to acidifying agents alone in reducing the duration of symptoms and providing pain relief for swimmer’s ear.

• #44 External Otitis (Acute) – Ear, Nose, and Throat Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/ear-nose-and-throat-disorders/external-ear-disorders/external-otitis-acute

  External otitis may manifest as a localized furuncle or as a diffuse infection of the entire canal (acute diffuse external otitis). The latter is often called swimmers ear; the combination of water in the canal and use of cotton swabs is the major risk factor. […] Attempts to clean the ear canal with cotton swabs can cause microabrasions of the delicate skin of the ear canal (these microabrasions act as portals of entry for bacteria) and may push debris and cerumen deeper into the canal. These accumulated substances tend to trap water, resulting in skin maceration that sets the stage for bacterial infection. […] In mild or moderate acute external otitis, topical antibiotics and corticosteroids are effective. […] Severe external otitis or the presence of cellulitis extending beyond the ear canal may require systemic antibiotics, such as cephalexin 500 mg orally 4 times a day for 10 days or ciprofloxacin 500 mg orally 2 times a day for 10 days.

• #45 Chronic Swimmer’s Ear: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/swimmers-ear-chronic

  Other treatments for chronic swimmers ear include corticosteroids to lessen inflammation, vinegar eardrops to help restore your ears normal bacterial balance, antifungal eardrops for infections caused by fungi, and acetaminophen or ibuprofen to relieve pain or discomfort. […] High doses of IV antibiotics treat cases of chronic swimmers ear with malignant otitis externa, especially in older adults or people with diabetes. […] You can reduce your risk of developing chronic swimmers ear by following these practices: Don’t remove earwax, don’t put anything in your ears, including cotton swabs, fingers, liquids, or sprays, and consider wearing earplugs if you swim often. […] Treatment for chronic swimmers ear is usually successful. However, depending on the severity of your infection, your treatment may take some time.

• #46 External Otitis (Acute) – Ear, Nose, and Throat Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/ear-nose-and-throat-disorders/external-ear-disorders/external-otitis-acute

  Fungal external otitis requires thorough cleaning of the ear canal and application of an antimycotic solution (eg, gentian violet, cresylate acetate, nystatin, clotrimazole, or even a combination of acetic acid and isopropyl alcohol). However, these solutions should not be used if the tympanic membrane is perforated because they can cause severe pain or damage the inner ear. Repeated cleanings and treatments may be needed to fully eradicate the infection. […] External otitis often can be prevented by applying a few drops of a 1:1 mixture of rubbing alcohol and white vinegar or acetic acid drops (as long as the eardrum is intact) immediately after swimming. The alcohol helps remove (evaporate) water, and the vinegar alters the pH of the canal. Use of cotton swabs or other implements in the canal should be strongly discouraged.

• #47 Swimmer’s Ear – What You Need to Know

  https://www.drugs.com/cg/swimmer-s-ear.html

  Swimmer’s ear, also called otitis externa, is an infection in the outer ear canal. This canal goes from the outside of your ear to your eardrum. Swimmer’s ear most often occurs when water remains in your ear after you swim. This creates a moist area for bacteria to grow. Scratches or damage from your fingers, cotton swabs, or other objects can also cause swimmer’s ear. […] Ear drops help fight infection and decrease redness and swelling. […] An ear wick may be used if your ear canal is blocked. A wick (small tube) made of cotton or gauze is placed in your ear. The wick helps pull extra fluid out of your ear canal. Wicks also help draw medicine into your ear canal.

• #48 Otitis Externa – What To Do For Swimmer’s Ear | familydoctor.org

  https://familydoctor.org/condition/otitis-externa-swimmers-ear/

  Your doctor may take a sample of fluid from the ear to send to a lab. The lab is checking for bacteria or fungus. […] Your doctor will clean the drainage or pus from your ear. They will likely prescribe antibiotic ear drops to make your infection go away and may prescribe oral antibiotics if your case is severe. They may also prescribe other medicine to help with itching. Over-the-counter medicine can relieve pain. Ask your doctor what type you should take. […] Swimmer’s ear usually isn’t serious if it’s treated early. Most symptoms will go away as the infection clears up. In rare cases, the infection can spread and cause damage to skin tissue, bone, and cartilage. Older adults, people with diabetes or weakened immune systems are most at risk for more widespread infection.

• #49 Patient education: External otitis (including swimmer’s ear) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/external-otitis-including-swimmers-ear-beyond-the-basics/print

  In some cases, your health care provider will flush out your ear with water and hydrogen peroxide before you begin treatment; this speeds healing by removing dead skin cells and excess ear wax. […] If you swim frequently, experts recommend the following tips to reduce the chance of developing external otitis. […] Use ear drops after swimming to prevent ear infections; these are available at most pharmacies without a prescription. […] Acute otitis externa in adults: Pathogenesis, clinical features, and diagnosis.

• #50 What Causes Swimmer’s Ear? The Ultimate Guide from an ENT | Ochsner Health

  https://blog.ochsner.org/articles/staying-safe-from-swimmers-ear

  Swimmers ear is a bacterial or fungal infection of the outer ear, which runs from your eardrum to the outside of your ear canal. […] It is also called otitis externa. While excessive wetness in the ear canal is a common cause, trauma to the ear canal, like a scratch from a fingernail or irritation from a Q-tip, can be culprits. […] Treatment will typically include: Suctioning the ear canals (debridement is often necessary a few times to fully clear the infection) […] Antibiotic, antifungal, and steroid ear drops […] Antibiotic, antifungal and steroid topical powders placed in the ear canal […] Keeping the ear dry, as directed by your child’s healthcare provider. […] A good way to help dry out your ear canal is to hold a hair dryer at arms length from your ear, and place it on the cool setting. The extra airflow will help dry you ear canal and prevent that moisture buildup that can cause otitis external.

• #51 Risk Analysis of Otitis Externa (Swimmer’s Ear) in Children Pool Swimmers: A Case Study from Greece

  https://www.mdpi.com/2073-4441/14/13/1983

  There are factors that boost the rapid growth of P. aeruginosa. Such factors include long periods of exposure to moisture with an increased risk of cerumen loss, and increased water temperatures. […] The main microbial agent responsible for external otitis media in children using swimming pools is Pseudomonas aeruginosa. […] This germ can form biofilms on all surfaces and survive in treated water with residual chlorine levels < 1 mg/L. [...] Our study results showed a statistically significant factor (p = 0.021) for otitis incidents and the frequency of swimmers’ use of the pool. [...] This can be explained by the fact that humans are not aquatic beings, so prolonged use of the pool seems to affect susceptibility to otitis due to the increase in the humidity in the outer auditory canal.

• #52 Swimmer’s Ear (Otitis Externa): Symptoms & Care

  https://my.clevelandclinic.org/health/diseases/8381-swimmers-ear-otitis-externa

  Swimmers ear usually isnt serious when you get treatment. In most cases, you can expect the infection to go away in about a week. Without treatment, complications like the spread of infection can occur. These complications usually require stronger antibiotics or antifungals. […] No, it wont. Swimmers ear is an infection in your ear canal that wont go away unless you treat it. Left untreated, a swimmers ear infection may spread to the base of your skull, your brain or your cranial nerves.

• #53 Swimmer’s Ear (Otitis Externa): Causes, Diagnosis, Treatment

  https://www.webmd.com/cold-and-flu/ear-infection/understanding-swimmer-ear-basics

  Germs like a warm, wet place to grow, so moisture trapped in your ear is perfect for them. […] Long-term swimmer’s ear (chronic otitis externa). This is when swimmer’s ear doesn’t go away within 3 months. It can happen if you have hard-to-treat bacteria, fungus, allergies, or skin conditions like psoriasis or eczema. […] Sometimes, the bacteria can spread deeper into your skin or to other parts of your body. One rare condition is malignant otitis externa, which happens when the infection moves into bone and cartilage in your head.

• #54 Outer Ear Infection (Swimmer’s Ear)

  https://www.healthline.com/health/otitis-externa

  If a fungus is the cause of the outer ear infection, your doctor will prescribe antifungal ear drops. This type of infection is more common in people with diabetes or a depleted immune system. […] Long-term outer ear infections can cause narrowing of the ear canal. Narrowing can affect the hearing and, in extreme cases, cause deafness. It needs to be treated with antibiotics. […] In rare cases, necrotizing (malignant) otitis externa occurs. This is an extremely serious complication where the infection spreads to the cartilage and bone that surrounds your ear canal. […] The best way to prevent swimmers ear is to keep your ears as dry as possible.

• #55 Swimmer’s ear – Symptoms and causes | American Hospital Dubai

  https://www.ahdubai.com/blogs/swimmer-s-ear

  Swimmer’s ear is the infection in the outer ear canal that runs from the eardrum to the outside of the headcaused due to water that remains in the ear, forming a moist environment, leading to bacteria’s growth. […] Bacteria causes swimmer’s ear infection and, in some unfamiliar conditions, results from a fungus or virus. The outer ear canals have natural defenses that help keep the ears clean and limit infection. When the natural defenses are defeated, disease occurs. Factors like moisture in the ear canal may form a perfect environment for bacterial growth; exposure to contaminated water and damage to the ear canal’s sensitive skin creates an opening for infection. […] The condition isn’t severe when treated immediately; complications occur when left untreated, like: – a temporary hearing loss – muffled hearing that usually gets better after the infection clears. – long-term infection (chronic otitis externa) occurs when the symptoms persist for over a month. Chronic illnesses are more common when certain conditions make treatment difficult, like a rare strain of bacteria, an allergic skin reaction or reaction to antibiotic eardrops, skin conditions like dermatitis or psoriasis, or a combination of bacterial and bacterial and a fungal infection. – deep tissue infection (cellulitis) is a rare complication resulting in the spread into deep layers and connective tissues of the skin. – bone and cartilage damage (early skull base osteomyelitis) is another rare complication that lets the infection spread to the cartilage of the outer ear and bones of the lower part of the skull, causing increasingly severe pain. Older adults, people with diabetes, or weakened immune systems are prone to risk. – When swimmer’s ear grows into advanced skull base osteomyelitis, the infection spreads and affects other sections of the body, like the brain or nearby nerves, which may be life-threatening.

• #56 Swimmer’s ear : MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000622.htm

  Swimmer’s ear is inflammation, irritation, or infection of the outer ear and ear canal. The medical term for swimmer’s ear is otitis externa. […] Swimming in unclean water can lead to swimmer’s ear. Bacteria commonly often found in water can cause ear infections. Rarely, the infection may be caused by a fungus. […] Long-term (chronic) swimmer’s ear may be due to allergic reaction to something placed in the ear or chronic skin conditions, such as eczema or psoriasis. […] The health care provider will look inside your ears. The ear canal area will look red and swollen. The skin inside the ear canal may be scaly or shedding. […] The infection may spread to other areas around the ear, including the skull bone. In older people or those who have diabetes or a condition that weakens the immune system, the infection may become severe. This condition is called malignant otitis externa. This condition is treated with high-dose antibiotics given through a vein.

• #57 Swimmer’s Ear | University Hospitals

  https://www.uhhospitals.org/health-information/health-and-wellness-library/article/diseases-and-conditions/swimmers-ear

  Swimmer’s ear is a redness or swelling (inflammation), irritation, or infection of your outer ear canal. […] When water stays in the ear canal, germs can grow. This causes an infection. […] One of the main causes of swimmers ear is too much wetness in the ear. This can happen when you swim. […] It’s more likely if you do things that remove the protection from the skin. Losing this protection lets germs into the skin. […] If left untreated, swimmer’s ear may cause other problems, such as: Hearing loss from a swollen and inflamed ear canal. Hearing often returns to normal when the infection clears up. […] Preventing moisture and irritation can prevent swimmer’s ear.

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