Ear Infections

Ear infection could be divided to external ear infection and middle ear infection. The border separating the two would be tympanic membrane. Infection occur outside the tympanic membrane and over the ear canal is called otitis external. Meanwhile, infection occurs medial or deeper than tympanic membrane is called otitis media.

Otitis External could be very painful because of rich sensory innervation of the skin overlying the ear canal. Ear pain could be radiate to the face, head and even the throat. Chewing and eating may aggravate the pain. The discharge may be more serous and less compare to middle ear infection. Meanwhile in otitis media, the pain is much lesser and usually its associated with more mucoid discharge. In middle ear infection, it very common for the patient to suffered from the nasal problem such as nasal blockage, rhino rhea, post nasal drip and facial pain. When pulling the pinna or pressing on tragus would aggravate the pain in otitis external. 

Otitis external could be due to the fungal or bacteria infection. Otomycosis is also known as fungal infection of external ear characterized by blackish spore like growth (aspergillum sp.) over the external ear or whitish curd like debris (candida albicans). The treatment mainly is to clean up the ear and application of topical fungal oinment or fungal ear drop. Ear flushing or ear syringing with water should be avoided to clean up the infection as it might created a very moist and wet environment for the fungal to continue growing and expanding.

fluffy cotton like mass with hair like protrusion with black-brownish fungal spore at the end

Fungal infection of external ear. Candida species.

Meanwhile in bacteria infection, the ear canal appeared very swollen and inflamed. The usual cause of external ear infection is due to water went into the ear canal and get trapped especially after some sports activity such as swimming, diving, kayaking, surfing or even after bathing. Ear toilet is needed and topical ear drop could be instilled to treat the infection.

Furunculosis

Furunculosis is the infection of the hair follicle of external ear canal. It usually causes severe pain to the patient and the pain is worse during chewing and eating as movement of the jaw might cause the movement to the external ear canal. Sometimes the furuncle might progress to a local abscess which might need a minor drainage or aspiration of pus from the lesion. Simple furuncle could be treated with oral and topical antibiotic.