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Johns Hopkins Health - All Ears

Summer 2009
Issue No. 5

All Ears

Date: June 24, 2009

kids in pool

Chronic ear infections and swimmer’s ear are common in kids. Understanding the difference can help you know what you can do at home and when it’s time to see the doctor

What are the symptoms, and when do I call the doctor?
Ear pain is the most common complaint with both swimmer’s ear and middle ear infections. The pain from swimmer’s ear usually is made worse if you tug on the outer ear. Middle ear infections may be harder to detect if your child is too young to say she’s in pain. In those cases, you might see her tugging at her ears, crying more than normal, not sleeping, and developing a fever. If symptoms last longer than a couple of days, your child has a fever, or you see a discharge of blood or pus from the ear, you should call your pediatrician or family doctor.

What causes the infection?
Whereas pools are most likely to cause and spread swimmer’s ear, middle ear infections usually begin with a viral infection such as a cold. Babies and young children in group settings are more prone to middle ear infections.

Is there a difference between swimmer’s ear and other ear infections?
Swimmer’s ear is an inflammation of the external ear canal, says Johns Hopkins pediatric otolaryngologist David Tunkel, M.D. Water—usually from swimming, but also from bathing or showering—irritates the skin inside the ear, which may become infected with bacteria or fungi. Another type of ear infection affects the middle ear cavity. These infections, called otitis media, are most common in infants and toddlers. On the other hand, swimmer’s ear happens more frequently in older children.

How are swimmer’s ear and middle ear infections treated?
Parents can use over-the-counter eardrops for water in the ear after swimming or bathing. This can decrease the chance of infection. Middle ear infections usually clear up after a couple of days. It’s important to understand that antibiotics won’t help ear infections caused by viruses. Your pediatrician may recommend an over-the-counter medicine such as acetaminophen or ibuprofen to help with pain and fever. When middle ear infections are chronic and don’t respond to antibiotics or other treatments, your doctor may recommend surgery.?

Learn more about Johns Hopkins Pediatric Otolaryngology at For appointments or consultations, call 877-546-1872.

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