Malignant Otitis Externa

By Medically reviewed by Panel Perubatan Hello Doktor


What is malignant otitis externa?

Otitis externa (Swimmer’s ear) is a one of the most popular ear infection that is also known as swimmer’s ear. It develops in the inner ear. In some situations, otitis externa can spread to the outer ear and surrounding tissue which includes the bones of the jaw and face. This infection is known as malignant otitis externa. Although malignant otitis externa shares part of its name with swimmer’s ear, the condition isn’t due to water remaining in the ear canal.

How common is malignant otitis externa?

Malignant otitis externa usually is caused by some bacteria such as Pseudomonas aeruginosa. Over 90 percent of people who develop malignant otitis externa have diabetes. Malignant external otitis is more common in humid and warm climates than in other climates.

However, it can be managed by reducing your risk factors. Please discuss with your doctor for further information.


What are the symptoms of malignant otitis externa?

These signs and symptoms of malignant otitis externa are not difficult to recognize. They may include:

  • Persistent and foul-smelling yellow or green drainage from the ear
  • Ear pain that gets worse when moving the head
  • Hearing loss
  • Persistent itching in the ear canal
  • Fever
  • Difficulty swallowing
  • Weakness in the facial muscles
  • Loss of voice, or laryngitis

If you suspect that you many experience any these signs and symptoms of this condition, please contact your doctor immediately. Early treatment will help you reduce other health complications that result from the infection.

When should I see my doctor?

Early diagnosis and treatment can stop this condition from worsening and prevent another medical emergency, so talk to your doctor as soon as possible to prevent this serious condition.

If you have any signs or symptoms listed above or have any questions, please consulting with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.


What causes malignant otitis externa?

Malignant otitis externa isn’t actually a complication of swimmer’s ear. Typically, the condition occurs when you have other health problems or you are having some treatments that can weaken your immune system or your resistance, including:

  • Diabetes
  • HIV
  • AIDS
  • Chemotherapy treatment

If you have a compromised immune system and serious aggressive bacteria enter your ear canal, your body will have difficulty warding off infection. If the bacteria are the reason causing an infection, the infection can damage the tissue of your ear canal and the bones at the base of your skull. If it is left untreated, the infection can spread to your brain, cranial nerves, as well as other parts of your body.

Risk factors

What increases my risk for malignant otitis externa?

One of the most common factors is swimming, especially in fresh water. Other factors include skin conditions such as eczema and seborrhea, trauma from cerumen removal, use of external devices such as hearing aids, and cerumen buildup.

Diagnosis & Treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.


How is malignant otitis externa diagnosed?

Your doctor will perform a physical exam to determine if he/she suspects that you may experience malignant otitis externa. The exam will include a health history to identify underlying conditions that may have compromised your immune system.

During the examination, your doctor will look into your ear to check if there is an infection. Your doctor will also check over your head and behind your ear. If there is drainage from the ear, your doctor may take a sample, or culture, of the drainage. They will send this sample to a lab for analysis. This will help identify the bacteria causing the infection.

If you have malignant otitis externa, your doctor may order some additional tests to see if the infection has spread, including:

  • A neurological exam
  • A CT scan of the head
  • An MRI scan of the head
  • A radionuclide scan

How is malignant otitis externa treated?        

Based on the condition of your infection, it is assumed that there are two primary treatment options: antibiotic and surgery.

  • Antibiotics: Treatment for malignant otitis externa typically involves antibiotic therapy. The condition can be tough to treat. You may need to remain on antibiotics for several months. You may need antibiotics delivered intravenously, or through a vein in your arm, if your condition is severe. You must continue treatment until tests show that the infection is over.
  • Surgery: If significant tissue damage occurs as a result of the infection, you may also be recommended a surgery. Surgery can remove damaged tissue. Your doctor will tell you if you need surgery. Surgery occurs after the infection has been cured.

Lifestyle changes & Home remedies

What are some lifestyle changes or home remedies that can help me manage malignant otitis externa?

Some recommended home remedies includes:

  • Do not scratch or clean the inside of the ear with cotton swabs, bobby pins, your fingernails, or other objects.
  • Avoid prolonged use of earplugs and in-ear headphones. Like cotton swabs, these can cause irritation and itching and can plug the ear with wax.
  • Keep soap, bubble bath, and shampoo out of the ear canal. These products can cause itching and irritation.
  • Keep your ears dry.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

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Review Date: February 26, 2017 | Last Modified: December 4, 2019

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