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Otitis Externa (Swimmer's Ear); causes, risk factors, signs and symptoms, management, complications

 It is an inflammation of part or whole of external auditory meatus or canal. Otitis externa can be acute or chronic.

Causes of Otitis Externa

  1. Bacterial infection
  2. Fungal infection(otomycosis)
  3. Allergies
  4. Autoimmune disorders eg systemic lupus erythematosus, psoriasis, etc.

Risk factors

  1. Swimming in an infected water
  2. Trauma to the canal e.g. from cleaning, poking the ear with the fingers, pens, broom stick, etc
  3. Hearing aids or ear plugs
  4. Dermatitis

Signs and Symptoms

  • Meatal tenderness
  • Tragal tenderness
  • Irritation/itching
  • Discharge (scanty)
  • Deafness
  • Pain, moderate to severe
  • Moist debris from the canal
  • Oedema of the meatal walls
  • Tinnitus or ringing in the ear


  1. Full Blood Count (FBC)
  2. Swab for culture and sensitivity test

Mode of Diagnosis

  • Using signs and symptoms
  • Microbial culture


  1. Aural toileting is very necessary where there is discharge. This will ensure successful treatment. Once discharge or debris is in the canal treatment will not be effective.
  2. Ear drops may be necessary in the treatment of otitis externa together with other supportive medications.
  3. Ear packing
  4. Education on the mode of medication is necessary to ensure effective treatment.
  5. Ensure that patient is reviewed to monitor treatment progress where possible. 


  1. Narrowing of the auditory canal
  2.  Formation of abscesses
  3. Malignant otitis externa
  4. Inflamed eardrum
  5. Conductive hearing loss due to inflamed canal
  6. Chondritis of the auricle due to spread of acute otitis externa to the pinna
  7. Lymphadenitis

Serious Advice

  1. Avoid putting sharp objects into the canal
  2. Do not put local preparations into the canal
  3. Report early to a health facility when you notice pain in the canal or when you feel your ear canal is blocked.
  4. Avoid over-the-counter self-medications, etc

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