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What causes recurrent outer ear infections? - Online Doctor Chats

Date : 25-Mar-2014
User rating for this question
Very Good Posted in: Ear, Nose and Throat Problems
Answered by

General & Family Physician
Practicing since : 2003
Answered : 1230 Questions
User:Why am I having recurrent outer ear infections with swelling in jaw and moving down neck? I have been on quite a bit of antibiotics seen 3 different ENT.
Labs drawn only showing is positive for mono., cultures negative, run fever up to 104 degrees.
This is the sixth bout of this and each time is worse. I have been on cephalexin for 2 weeks had 2 shots in office and this past weekend sent to ER by ENT for IV of Vancomycin.
Doctor:I have read your query
User:I am generally healthy tested neg for diabetes
Doctor:You seem to be suffering from a rather resistant ear infection
Doctor:Yes, hello sir
User:Yes that is a fact. It is resiliant
Doctor:how can I help you?
User:I would like answers or possible causes. The only other problem I have is athletes feet
User:Are you really a Dr
Doctor:It is difficult to answer the why questions
Doctor:Yes, I am a real doctor
User:What causes this?
Doctor:I did read your question carefully
Doctor:The cause is usually bacterial infections
User:Such as....
Doctor:other possibility is fungal infections
User:How should this be treated
Doctor:Such as, Staphylococcus Aureus
Doctor:Psuedomonas Aeroginosa
User:So how is this cured?
Doctor:there are many bacteria which can cause this type of recurrent ear infections
User:If this was you. How would you proceed?
Doctor:The cure depends on identifying the bacteria or the fungus
User:How would that be done. Other than cultures which came back negative
Doctor:If it were me, I would get a pus culture and sensitivity test done while I was running the fever
Doctor:I understand that the cultures came back negative
User:How would I go about getting this done? Request in ER
Doctor:that is why I will say, you are in a difficult situation
User:I haven't had any visible pus discharge, possibly contained under skin.
Doctor:You should get your ENT to do an X-ray or CT scan of the side affected
User:Are you familiar with this, recurring outer ear infection?
Doctor:I am familiar with recurring outer ear infections
User:I have had a CT done in the ER. Nothing showed up
Doctor:it is commonly seen in young children
Doctor:seldom in adults
User:Would you have any recommendations I can try beside going back to ER
Doctor:I would advise you to speak to your ENT again and ask him/her to get the pus from inside the ear/ mastoid air cells and send that for culture
User:Would you consider this a life threatening condition? Is there possibly an ENT on the staff here
Doctor:I would consider this life threatening as the infection can spread from the outer ear to brain
Doctor:and I am sorry, there are no ENT specialists available for chats
User:I was hoping for a possible diagnosis. Since all labs are negative, except for mono. Is this something that apcan be caused by mono?
Doctor:Mono can not cause such recurrent infection
User:Where is your degree from?
User:Would you be concerned of cancer?
Doctor:I have studied in India
Doctor:Cancer should have been detected on the CT scan
User:Are you a practicing DR in the USA
Doctor:I am a practicing doctor in India
User:Would you put patient on antibiotics for this?
Doctor:I would first confirm the type of infection
Doctor:whether it is bacterial or fungal
User:Thank You
Doctor:ask your ENT to ask for a fungal culture as well
Doctor:If it is fungal infection, I would put you on antifungal medicines
Doctor:The problem usually in such situations is inadequate antibiotics
Doctor:or wrong antibiotics
User:I will is it possible to infect ear in bath if I have athletes feet?
Doctor:yes, it is possible
User:Okay thank you for the suggestions. I will try to get a confirmation of what it is bacterial or fungal.
Doctor:so the best bet would be to go for higher combination antibiotics such as Imepenam with Vancomycin
Doctor:is there anything else I can help you with
User:I have been administered Vancomycin drip this weekend but only one dose.
Doctor:one dose will not suffice
User:Ok I will continue on my search.
Doctor:I would give vancomycin with Imepenam for a period not less than 7 days
Doctor:As I said, the problem usually is inadequate antibiotics
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