question-icon

Taking Cipro for ear infection. Causes itching. Is this likely to resolve with current treatment?

default
Posted on Mon, 24 Sep 2012
Question: Hi, my husband (64yrs) had what appeared to be an infection rapidly ascending up his eustachian tube 2 1/2 weeks ago with muffled hearing. He was prescribed Amoxicillin. After the course of antibiotics, he improved a bit and then almost immediately ear pain returned. he saw his GP who noted debris blocking the view of his eardrum. The GP syringed the ear resulting in a diffuese and excruciatingly painful otitis externa. his ear can almost swelled shut. he was precribed Cipro HC drops and told to take NSAIDs (he declined to take Hydrocodone). Now 4 days into treatment with the drops the ear canal is responding and no longer intensely painful but his neck, jaw and temple are sensitive to touch. Hearing which cleared after the syringing event (when white cheeselike material/debris were removed) quickly became muffled again and feels like debris or fluid may be causing it. The pain is mostly gone but the Cipro now causes intense itching. He is afraid of returning to the GP as he does not want the ear syringed again fearing a recurrence of the OE. The blood vessels in the affected temple feel quite painful to touch now too. Is thismlikely to resovlve with current treatment and hearing return or should he see an ENT specialist for removal of more debris? This is the first time he has experienced an event like this. There is no apparent cellulitis surrounding the affected ear.
doctor
Answered by Dr. Sumit Bhatti (3 hours later)
Hi,

Thank you for your query.

1. You need to get a his ear cleaned again to rule out a fungal infection (in addition to a bacterial infection) since there is a cheesy white discharge and intense itching. The better the cleaning, the faster will be the recovery.

2. The neck, jaw and temple pain is refereed pain since there is no apparent cellulitis surrounding the affected ear.

3. I would recommend an ear swab for antibiotic culture and sensitivity.

4. Once the ear heals, the eardrum must be examined to rule out a foreign body or an unsafe ear disease such as a cholesteatoma (also has a cheesy white foul smelling discharge).

5. Painkillers are equally necessary for their anti inflammatory action as they are for pain reduction.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Sumit Bhatti (16 hours later)
Thank you so much for the reply.
I described the material removed by irrigation as whiteish and cheesy looking ...the difference was there was no odor associated with it and the intense itching has only presented since the Cipro HC drops have begun to reduce the inflammation in the ear canal. Does this reduce the likelihood of a cholesteatoma?
default
Follow up: Dr. Sumit Bhatti (13 minutes later)
Lastly...what is the likelihood of keratosis obturans being the causative problem and could that have led to a bacterial and or fungal infection under the blocking debris (which was removed by irrigation)? Our own GP declined to consider the possibility of a fungal infection stating that black spores would be seen in the debris but I had understood that Candida albicans could be present without black spores being noted.
doctor
Answered by Dr. Sumit Bhatti (17 hours later)
Hi,

Thank you for writing back.

1. A Cholesteatoma can only be ruled out if the entire eardrum is visible. A Cholesteatoma has a characteristic fishy odor. There is a new MRI Scan technique for Cholesteatoma that I have co-authored a paper on in December 2011. You may see the abstract at the following link: WWW.WWWW.WW
2. Itching is also a sign of healing similar to the itching that occurs after scabs form on healing wounds. Anti-histamines help control itching.

3. Keratosis Obturans involves a massive build-up of wax and debris in the ear canal with infection. It has to be confirmed and treated (cleaned) under a microscope often under local or general anesthesia as it is very painful.

4. Candida is white in color. Aspergillus has black fungal spores. Both may co-exist leading to the wet newspaper look of the ear debris.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2662 Questions

premium_optimized

The User accepted the expert's answer

Share on
Taking Cipro for ear infection. Causes itching. Is this likely to resolve with current treatment?

Hi,

Thank you for your query.

1. You need to get a his ear cleaned again to rule out a fungal infection (in addition to a bacterial infection) since there is a cheesy white discharge and intense itching. The better the cleaning, the faster will be the recovery.

2. The neck, jaw and temple pain is refereed pain since there is no apparent cellulitis surrounding the affected ear.

3. I would recommend an ear swab for antibiotic culture and sensitivity.

4. Once the ear heals, the eardrum must be examined to rule out a foreign body or an unsafe ear disease such as a cholesteatoma (also has a cheesy white foul smelling discharge).

5. Painkillers are equally necessary for their anti inflammatory action as they are for pain reduction.

Hope I have answered your query. If you have any follow up queries I will be available to answer them.

Regards.