Malignant otitis externa (spreading ear canal infection)

Overview

It starts like swimmer's ear but spreads into the bone of the skull.

Severe pain, drainage, and face weakness are warning signs.

Symptoms

Common signs:

• Severe ear pain with drainage
• Face weakness
• Fluid or blood draining from the ear, or a burst eardrum

Less common

• Headache

Look up a symptom: Fever

When to get medical care

Causes

Bacteria.

Does it spread or run in families?

• It usually doesn't spread from person to person.
• People get it from: hospitals, clinics, or water.

Who is more likely to get it

• Diabetes
• Older adults

Possible complications

• Facial nerve weakness: If infection spreads

Diagnosis

This is diagnosed in the emergency room or hospital.

The exam

A physical exam.

Tests

Tests, if needed:

• CT:

Treatment

Emergency care is needed. While waiting for help:

Self-care

• Get urgent care
• Control blood sugar

Prevention

To lower your risk or prevent problems:

• Treat ear infections promptly with diabetes

Which doctor treats this

• Emergency doctors treat it first, in the ER.
• They may send you to an ENT doctor (ear, nose, and throat doctor).

Back to school, work, or sports

• Recovery time varies. Ask your care team when you can drive, lift, work, and exercise.

Children, pregnancy, and older adults

• Older adults with diabetes: Highest risk.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Some infections can pass to the baby during pregnancy or birth. Tell your provider if you've been exposed.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

For caregivers

• Go to visits when you can and take notes.
• Keep a list of medicines, allergies, and doctors in one place.
• Learn the warning signs that need fast care.
• Learn CPR. Many hospitals and the Red Cross offer classes.
• Take breaks and ask for help. Caregivers need care too.

Outlook

Long antibiotic courses cure most.

Getting ready for your visit

Bring a list of your symptoms and medicines.

What to bring

• A list of your medicines and supplements
• Notes on when symptoms started and what makes them better or worse

Questions to ask

• What follow-up care do I need?
• How can I prevent this from happening again?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Malignant otitis externa (spreading ear canal infection)