External otitis is a skin infection of the ear canal. As noted in a 2006 review article published in "American Family Physician," bacteria causes approximately 90 percent of external otitis; the remaining 10 percent is due to fungal infections. External otitis typically occurs when there is excess moisture in the ear. Because of this, this condition is known as "swimmer's ear." External otitis and its accompanying symptoms can range from mild to severe.
Itching of the Ear Canal
According to the University of Virginia Health System Department of Otolaryngology, itching in the ear canal is often an early symptom of external otitis. As the infection progresses, itching may continue, but pain becomes the more prominent symptom.
Redness of the Outer Ear
External otitis often causes redness of the outer ear structure, the auricle. It may be warm to the touch. The American Academy of Otolaryngology (AAO) notes that both the ear canal and the auricle may be swollen. After a few days, the skin of the auricle may begin to flake and peel.
Fluid or Pus Drainage from the Ear
Fluid commonly drains from the ear canal with external otitis. At first, the fluid is predominantly clear. As the infection progresses, the drainage shifts to an opaque, yellowish fluid that often has a foul odor. The drainage is a mixture of pus and bacteria. "The Merck Manual for Healthcare Professionals" reports the most common causes of external otitis are Pseudomonas aeruginosa, Staphylococcus aureus, Proteus vulgaris and Escherichia coli.
Ear Pain
External otitis frequently evokes an exception level of pain. Pulling or pressing on the auricle is typically exquisitely painful. Aching ear pain is the norm, although the AAO advises the pain may radiate to the face, side of the head or neck.
Hearing Loss
Swelling of the ear canal and the presence of pus therein blocks the normal transmission of sound to the middle ear. The Mayo Clinic notes sounds may seem muffled and hearing sensitivity temporarily decreased in the painful ear. Once the infection resolves, hearing returns to the previous level of acuity.
Swollen Nodes
External otitis often causes swelling of lymph nodes behind the ear. The ear may appear raised from the surface of the head or pushed forward due to this swelling, advises the AAO.
Fever
Fever is not normally a symptom of external otitis. Therefore, if fever develops, it is a warning that the infection may have invaded bone and tissues around the ear canal. This condition is malignant otitis externa. "The Merck Manual for Healthcare Professionals" clarifies that this condition most commonly occurs in older people with diabetes or those with a weakened immune system.
