Otitis Externa (Swimmer's Ear) Identification, Treatment, and Prevention

 Disclaimer.  I am not a licensed health practitioner.  This is just another post on knowledge and understanding you might wish to acquire in advance of a disaster in case no higher care is available.  As long as our society is functioning, you should leave anything more substantial than applying a Band-Aid to the professionals.  No medication, including those available over the counter, should be taken without consulting a physician.  Information shared here is for educational and entertainment purposes only.  It is not medical advice nor a substitute for licensed medical care. 

For the first decade of my life, I lived across the street from a house that had an Olympic-sized swimming pool.  My mother said one of the previous owners had in fact been an Olympic swimmer.  Anyway, I didn't really care about that.  I did care about that pool and was very fortunate that Bill and Janie invited us over to swim often.  I absolutely loved to swim at that age.  I loved diving for pennies and building up my lungs each summer to be able to swim all the way across the pool--lengthwise--and back, underwater without taking a breath.

Invariably, I would get an ear infection at the beginning of each summer.  I don't remember any physical pain associated with it, but there was the excruciating torture of not being able to swim until the infection was resolved, and then being prohibited from going under the water for another week after that.

Swimmer's ear, otitis externa, is an external ear infection of the outer ear canal.  It most commonly afflicts children between the ages of four and fourteen years in the summer, when kids are swimming.[1]  However, otitis externa infections can also develop due to minor trauma to the ear canal.  While often the result of trapped moisture altering the pH of the ear canal, these infections can also be the result of cleaning, over-cleaning, or scratching the ear canal with a foreign object, including Q-tips, fingernails, or bobby pins.[2]

Symptoms of a swimmer's ear infection include:

• Swollen ear canal
• Redness of ear
• Tenderness or itchiness inside the ear
• Touching, pulling, or pressing the ear increases the pain
• Odor
• Watery discharge
• Ringing in the ears (tinnitus)

Otitis externa can be distinguished from a classic otitis media infection by the following:

• Fever and cold symptoms + no tenderness of external ear structures = otitis media
• No fever or cold symptoms + tenderness of external ear structures = otitis externa[3]

Treatment:

• For mild swimmer's ear, treatment may not be necessary as the infection will resolve on its own.  
• For more painful cases, a 1:1 mix of water and white vinegar will help restore the pH level in the ear and thus promote healing.  Some physicians would prescribe a short course of oral steroids like prednisone for severe symptoms, but if your supply is limited you might wish to save them for more serious situations.  
• Oral antibiotics, especially for a true swimmer's ear due to moisture being trapped, are unlikely to be effective, but may work when the infection is due to a trauma.  All medications are taken for 5-10 days.
• Keflex, 250-500 mg, 3-4x per day
• TMP-SMZ DS, 1 tablet 2x per day
• Cipro, 500 mg, 2x per day[4]
• Warm compresses to the ear will help reduce the pain.  Ibuprofen may also be taken for pain.[5]

To prevent future occurrences, especially after swimming or excessive sweating:

• Towel dry the ears thoroughly.[6]
• Lie down with ears to the ground, pulling the ear lobes slightly to facilitate draining, and let water drain.[7]
• Carefully swab the ear canal with a little rubbing alcohol to help dry it out.[doctors debate this one--some say no one should put anything in their ears]

Links to related posts:
Otitis Media Ear Infections
Keflex
Cipro

References:
[1] Joseph Alton, The Survival Medicine Handbook, 436-37.
[2] Cynthia Koelker, Armageddon Medicine, 154-55.
[3] Ibid.
[4] Ibid.
[5] The Survival Medicine Handbook, 436-37.
[6] The Centers for Disease Control, https://www.cdc.gov/healthywater/swimming/swimmers/rwi/ear-infections.html, accessed 19 June 2020.
[7] Ibid. 

19 august 2020