Cause
An infection of the ear canal—the opening that carries sound from the outside to the eardrum—otitis externa can be caused by several types of bacteria and fungi.
Symptoms
The major symptom is severe ear pain that gets worse when the ear is pulled. Sometimes there is an itching sensation in the ear before the pain begins. The outer ear may also become reddened. There may be a slight fever or a greenish-yellow discharge from the ear opening, and hearing may be decreased. Otitis externa usually occurs in children whose ears are exposed to persistent moisture, especially when swimming. Chlorinated water can dry out the skin of the ear canal and make it easier for germs to attack. It can also occur when a child’s ear canal has been scratched by a sharp object.
How It Spreads
It is not contagious.
Incubation Period
There is no set incubation period for an enfection of the ear canal, but ear pain often develops gradually over hours after the ear canal has been exposed to moisture, such as during swimming.
How Long Symptoms Last
Pain may continue to increase for the first 12 to 24 hours after treatment begins. If treated with medication, it is usually cured within 7 to 10 days, but the child may have to stay out of the water longer than this.
When to Call Your Child’s Doctor
Call your child’s doctor if there is pain in the ear with or without fever, loss of hearing, or discharge from the ear.
How the Diagnosis Is Made
Your child’s doctor will make a diagnosis by examing the ear with an otoscope.
Treatment
For milder infections, your child’s doctor will prescribe eardrops containing antibiotics, which fight infection, and sometimes corticosteroids, which reduce swelling. Eardrops are usually given several times a day for 7 to 10 days. If the opening of the ear canal is narrowed, the doctor may insert a cotton wick into the canal to help carry the drops into the canal. For more severe infections, oral antibiotics may be given.
Home Treatment
Acetaminophen (Tylenol) or ibuprofen may be given to relieve pain. To protect the infected ear, the doctor will usually advise keeping your child’s head out of water for 10 to 14 days, including covering the ear while bathing or showering. Shower caps or cotton earplugs coated with petroleum jelly—removed after bathing or showering—can be used for this purpose.
Prevention
Children (and adults) should avoid putting straight stiff objects like cotton-tipped applicators or bobby pins in their ears. If your child doesn’t have ear tubes or a hole in the eardrum, acid alcohol drops like SwimEar can be used after swimming to help keep the ear canal dry. Soft earplugs that easily mold to the shape of your child’s ear canal can also be used while your child is swimming.
Complications
Untreated, an infection can spread to the surrounding cartilage and bone.