The ear is a small part of the body. But infection and inflammation of it causes much morbidity and suffering to the sufferer. There is pain and discomfort and many of these infections tend to be chronic and resistant to treatment.

There may be pain, pruritis, discharge from the affected ear. Labyrinthine system (part of the balancing system of the body) is located within the ear. Chronic or recurrent inflammation within the ear also affects the labyrinthine apparatus thus causing vertigo. Because of the anatomical closeness, nose and throat also tend to get affected by an ear infection and vice versa.

Acute or chronic sinusitis i.e. inflammation of the air cells of the brain can develop because of ear infections. This becomes the cause for frontal headache and also puts the individual at risk of developing brain infections.

Infections of the ears are dangerous, because if they are persistent, then through the blood stream, microbes can easily travel to the lungs causing pneumonia. If they reach the brain they can cause brain abscess, and meningitis i.e. inflammation of the coverings of the brain. Various kinds of neurological disturbances can occur depending on the part of the brain affected but commonly the temporal lobe is affected by ear infections causing epilepsy and abnormal behavior. Long standing ear infections can impair ones hearing ability.

Infections of the external ear are the same as any other part of the body. Localised infection of the soft tissues can occur causing cellulitis. Commonly this is caused by staphylococcus aureus. This would manifest as an abscess, due to which the individual would suffer from pain and swelling at the site of infection. These respond readily to treatment by a suitable antibiotic and anti – inflammatory medicine but infections of the bone or mastoid process are resistant to treatment and take longer to heal. Acute diffuse infection of the external ear is commonly caused by pseudomonas or other organisms. There is severe pain and inflammation with a white clumpy discharge.

Chronic infection of the external ear can occur due to persistent discharge from middle ear infections causing pruritis and pain. Dermatitis in the external ear can also get infected leading to similar symptoms.

Malignant or necrotising otitis externa is a potentially fatal condition developing in diabetic or immune depressed subjects. It progresses insidiously over weeks to months, causing severe pain, discharge and marked redness of the ear. It can spread to the brain and meninges.

Infection of the middle ear and the tube connecting nose and ears commonly occurs in people suffering from recurrent cold. People suffer from itching and pain inside the ears due to it. Tinnitus also occurs due to ear infections, along with severe pain, discharge and fever. Long standing infection of the ear can lead to erosion of the underlying bone needing surgical correction. Fungal infections of the inner ear are resistant to treatment given and take much longer to resolve.

Thus those suffering from recurrent, "grip”, should take care to avoid allergy producing substances to avoid secondary infections. Avoid putting in needles, e.t.c. in ears as this can induce trauma and introduce germs. Ears have a natural cleaning mechanism. Ear buds if at all used for cleaning, should be put in very cautiously and that too not frequently.

While swimming or taking a shower, one should cover his ears, otherwise water entering the ears becomes a potential source of infection. Women wearing artificial ear rings ought to see that they do not have allergy to the material used in the ear rings or its catch. Allergy occurring due to the material can lead to secondary infection in the ears externally.

Any pain, itching or secretions from the ears should never be ignored, as it could be beginning of an infection.

Dr Rachna Pande,

Specialist, internal medicine