Swimmer’s ear and differential diagnoses

Peer Reviewed

Feature Article Ear, nose and throat medicine

Melville Da Cruz

Recent articles on:
Ear infections

Abstract

Swimmer’s ear (acute diffuse otitis externa) is a common problem in clinical practice and treatment is based on simple principles.

Key Points

Acute diffuse otitis externa or swimmer’s ear is a common problem in general and specialist practice.
Underlying causes of acute diffuse otitis externa are most often bacterial or fungal infections of the external canal following water exposure.
Most infections can be resolved promptly with simple ear toileting techniques and local application of antibiotic drops and ointments in conjunction with waterproofing.
Ear swabs are reserved for patients with recurrent otitis externa, those who are treatment resistant or at-risk patients (those who have diabetes, are immunocompromised or have had previous ear surgery or irradiation).
At-risk patients and those with increasing pain, bleeding or failure to respond to simple treatment require referral for specialist assessment.
Although cancer of the ear canal is rare, the symptoms are similar to those of otitis externa. A high degree of awareness is therefore required, particularly in patients who respond poorly to treatment for otitis externa.