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I Have A Question Regarding An Ear Infection From Past 5 Years Currently Extreme Pain With Itching Is This Fungal Infection?
Question: Hello there. I have a question regarding an ear infection.
History: I’ve had chronic outer ear infections for the past 5 years. With a flare up about once a year and general itchy/discomfort all the time. The first time I got it, I used acetic acid with hydrocortisone drops and it went away for a while. But it came back and since then has never fully gone away. I use acetic acid w/hydrocortisone for my flare ups normally. The normal flare ups consist of extreme itchiness with moderate pain and the acetic acid normally stars working within one day.
Current situation: Since three days ago I have had extreme pain in my outer ear. It started with the usual itching but then progressed to a full blown excruciating pain to where it hurts to eat and my jaw and surrounding my ear is very painful. I went to the doctor, she saw white and yellow discharge in ear. She prescribed me ciprodex drops. I took two doses yesterday and one dose today (at 7am) I will take my last dose momentarily.
My question is, I have not started to feel better at all since starting the antibiotic. In fact, my hearing has become more muffled and I am just as miserable as before. Is it normal for the antibiotics to take more than two days to take any effect? I didn’t expect a miracle cure but I thought my pain and discomfort would subside after a few Doses. How soon should I return to the doctor if the antibiotic doesn’t seem to be working? I am currently taking 600 mg of ibuprofen every 6 hours, but in the last two hours before taking another dose, my pain returns and I am miserable. Is there anything else OTC I can take that will last longer or be more effective than ibuprofen?
My concern is that I may have a fungal ear infection or a difficult bacteria infection which will not be cleared by the ciprodex. Would it be okay to use the aretic acid/hydrocortisone in between my doses of ciprodex or will it interact with each other and cause a problem.
Thank you very much for your time sir or ma’am. I know this has been a lot of information but I ask that you will carefully review and give me your best theory.
History: I’ve had chronic outer ear infections for the past 5 years. With a flare up about once a year and general itchy/discomfort all the time. The first time I got it, I used acetic acid with hydrocortisone drops and it went away for a while. But it came back and since then has never fully gone away. I use acetic acid w/hydrocortisone for my flare ups normally. The normal flare ups consist of extreme itchiness with moderate pain and the acetic acid normally stars working within one day.
Current situation: Since three days ago I have had extreme pain in my outer ear. It started with the usual itching but then progressed to a full blown excruciating pain to where it hurts to eat and my jaw and surrounding my ear is very painful. I went to the doctor, she saw white and yellow discharge in ear. She prescribed me ciprodex drops. I took two doses yesterday and one dose today (at 7am) I will take my last dose momentarily.
My question is, I have not started to feel better at all since starting the antibiotic. In fact, my hearing has become more muffled and I am just as miserable as before. Is it normal for the antibiotics to take more than two days to take any effect? I didn’t expect a miracle cure but I thought my pain and discomfort would subside after a few Doses. How soon should I return to the doctor if the antibiotic doesn’t seem to be working? I am currently taking 600 mg of ibuprofen every 6 hours, but in the last two hours before taking another dose, my pain returns and I am miserable. Is there anything else OTC I can take that will last longer or be more effective than ibuprofen?
My concern is that I may have a fungal ear infection or a difficult bacteria infection which will not be cleared by the ciprodex. Would it be okay to use the aretic acid/hydrocortisone in between my doses of ciprodex or will it interact with each other and cause a problem.
Thank you very much for your time sir or ma’am. I know this has been a lot of information but I ask that you will carefully review and give me your best theory.
Brief Answer:
Otitis externa non-responsive to ear drops may require oral steroids...
Detailed Answer:
Hi
Thanks for posting the query
After going through your query, I do understand that you are suffering from recurrent otitis externa. Otitis externa could be bacterial as well as fungal.
Usually, during fungal infection, there would be swelling of the skin of the ear canal with some whitish or creamy discharge and excruciating pain. In this case, the fungal debris has to be cleaned thoroughly followed by instillation of the antifungal ear drops.
Otitis externa secondary to the bacterial infection will have almost all the above symptoms with or without fever. Usually, a wick smeared with antibacterial and steroid cream is placed inside the ear canal for a couple of days. This would eventually reduce the swelling as well as the infection. In conditions where the pain is intolerable, oral steroids for a short course is recommended.
If the diagnosis of fungal infection is confirmed, then, usage of antibiotic + steroid ear drops is not recommended. Usage of the above drops can aggravate the condition.
Finally, we need to identify the cause of recurrent ear infection. The recurrent external ear infection could be due to shampoo, excess sweating, diabetes, usage of earbuds, etc. which needs to be identified and avoided.
Hope this answers your query; I will be available for the follow-up queries.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Otitis externa non-responsive to ear drops may require oral steroids...
Detailed Answer:
Hi
Thanks for posting the query
After going through your query, I do understand that you are suffering from recurrent otitis externa. Otitis externa could be bacterial as well as fungal.
Usually, during fungal infection, there would be swelling of the skin of the ear canal with some whitish or creamy discharge and excruciating pain. In this case, the fungal debris has to be cleaned thoroughly followed by instillation of the antifungal ear drops.
Otitis externa secondary to the bacterial infection will have almost all the above symptoms with or without fever. Usually, a wick smeared with antibacterial and steroid cream is placed inside the ear canal for a couple of days. This would eventually reduce the swelling as well as the infection. In conditions where the pain is intolerable, oral steroids for a short course is recommended.
If the diagnosis of fungal infection is confirmed, then, usage of antibiotic + steroid ear drops is not recommended. Usage of the above drops can aggravate the condition.
Finally, we need to identify the cause of recurrent ear infection. The recurrent external ear infection could be due to shampoo, excess sweating, diabetes, usage of earbuds, etc. which needs to be identified and avoided.
Hope this answers your query; I will be available for the follow-up queries.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by :
Dr. Remy Koshy
How do I determine whether it is fungal or bacterial? Do I ask for a culture?
I am in a lot of pain. Will it be okay to stop my ear drops and wait until the weekend is over to get the culture done? It may take a few days and I am worried the infection might spread or become worse.
Should I take my acetic acid drops in the meantime and discontinue the ciprodex antibiotic?
How should I ask my physician to help me? Every time I have a suggestion she is dismissive.
Thanks again
I am in a lot of pain. Will it be okay to stop my ear drops and wait until the weekend is over to get the culture done? It may take a few days and I am worried the infection might spread or become worse.
Should I take my acetic acid drops in the meantime and discontinue the ciprodex antibiotic?
How should I ask my physician to help me? Every time I have a suggestion she is dismissive.
Thanks again
Brief Answer:
Antibiotic ear drops would suffice if there is a bacterial infection...
Detailed Answer:
Hi
Thanks for writing back and sincere apologies for the delayed reply.
1. If there is no fungal infection the antibiotic ear drops would be fine. But, a short course of oral steroids would definitely alleviate your problems. If there is a fungal infection, then, the above drops can worsen your condition.
2. Unless we are sure there is no fungal infection either acetic acid ear drops or antibiotic ear drops would be fine.
3. Yes, please request your physician to help you out with this problem. If the doctor is not obliging, then, request any of your friends or relatives to have a look in the ear. If there is any white/blackish debris, it is a sign of fungal infection. Or else, you can google and look for the images of otomycosis and show it to the one who wants to help you. If there is a fungal infection, then, the entire protocol changes.
Hope this clarifies your doubts. WIsh you a speedy recovery.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Antibiotic ear drops would suffice if there is a bacterial infection...
Detailed Answer:
Hi
Thanks for writing back and sincere apologies for the delayed reply.
1. If there is no fungal infection the antibiotic ear drops would be fine. But, a short course of oral steroids would definitely alleviate your problems. If there is a fungal infection, then, the above drops can worsen your condition.
2. Unless we are sure there is no fungal infection either acetic acid ear drops or antibiotic ear drops would be fine.
3. Yes, please request your physician to help you out with this problem. If the doctor is not obliging, then, request any of your friends or relatives to have a look in the ear. If there is any white/blackish debris, it is a sign of fungal infection. Or else, you can google and look for the images of otomycosis and show it to the one who wants to help you. If there is a fungal infection, then, the entire protocol changes.
Hope this clarifies your doubts. WIsh you a speedy recovery.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
Dr. Naveen Kumar Nanjasetty
Otolaryngologist / ENT Specialist
Practicing since :2001
Answered : 2540 Questions
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