This past weekend, all across this great nation, something wonderful happened. The pools opened! Memorial Day Weekend is the official start of pool season. That makes this a great time to talk about swimmer's ear.
Swimmer's ear, also known as acute otitis externa, is an infection of the outer ear and ear canal that is usually caused by a combination of bacteria and fungi. Accumulation of water in the ear canal is a major trigger in the development of infection. This infection is associated with a lot of inflammation which, in turn, causes pain and itching. If there is a large amount of wax in the ear, this will increase the pain. (A normal amount of wax actually coats the external ear canal and can prevent infection). The inflammation also causes a purulent discharge (pus) from the ear which can be quite striking in some cases. Some children have a small amount of pain and little or no discharge. Others will have copious amounts of discharge and pain that radiates to the angle of the jaw and down the neck. Wikipedia has a lovely picture, but diagnosis usually requires looking inside the ear canal. For those of you in our concierge medicine practice, this would mean a house call not a telemedicine visit.
Swimmer's ear accounts for a number of outpatient visits every summer and a lot of discomfort. It affects roughly 10% of the population at some point in time. The good news is that it is both treatable and preventable.
Water plays a huge role in the development of swimmer's ear. If your ears never get wet, you will probably never get otitis externa. However, if you never bathe, you won't have many friends. Swimming in pools means spending much more time in the water. This increases your risk of developing this infection. I recommend all swimmers purchase preventative drops to use after swimming. These drops are to be placed in the ears at the end of swimming each day, or at the end of each trip to the pool, lake or ocean. They are heavier than water. They descend to the base of the ear canal, pushing out any water that is present. Then, they evaporate at body temperature, leaving the ear canal dry and clean. There are several companies that make such drops. Ask your physician or pharmacist to assist you in picking one.
Preventative drops are only that, preventative. Once an infection has started, they are no longer helpful. If your child complains of ear pain, with or without itching, that lasts more than a day or so, see a physician. If there is a purulent discharge, that gives you even more reason to see someone and consider starting medication. The medications used are usually drops in the ear. Antibiotics by mouth are seldom needed.
However, many of you who are swimming are also camping and a physician isn't readily available. In such cases, you may want to administer a vinegar solution until you can see a doctor. You can use distilled white vinegar diluted half and half with water. Keep in mind, this is not a substitute for medical care. If your child has fever or blood from their ear, do not use diluted vinegar: see your provider as soon as possible. If you use the diluted vinegar, the dose is 3-4 drops in the ear twice daily. You can use an eye dropper or drip this off your fingertip. If your child has fever, severe ear pain, swelling of the outer ear, blood from the ear canal, or pain radiating to the jaw or neck do not give vinegar. See your provider.
Dr Nan N
House Call Pediatrician, Overland Park, KS
State of the art care for your child in your home.
http://FiresidePediatrics.com
http://PersonalMedicine.com
No comments:
Post a Comment