Acute Otitis Externa (Swimmer’s Ear): Complications Acute Otitis Externa (AOE)
Authors: Charmaine Szalay-Anderson Reviewers: Shayan Hemmati Ben Campbell Justin Lui* * MD at time of publication
Spread of P. aeruginosa (most commonly)
in an immunocompromised host or due to antibiotic resistance
Rapid infectious spread through soft tissue to mastoid and/or temporal bone
Malignant (necrotizing) otitis externa *can be life threatening
Inflammation of connective tissue and bony structures
Chronic otitis externa
(>6 weeks) Chronic inflammation Ear canal fibrosis
Ear canal stenosis
Damage or obstruction to ear canal structures
(Inflammation of the outer ear)
Recurrent or non-resolving acute otitis externa Dissemination of infection
Immune reactionà purulent otorrhea (discharge from ear)
Spread to tympanic membrane
Spread to subcutaneous tissue
Spread to connective tissue and cartilage
Systemic spread
Ear canal blockage
(inflammation of tympanic membrane)
Sensation of fullness in the ear
Temporary hearing loss
Tympanic membrane perforation
Periauricular/pinna cellulitis Facial cellulitis
Perichondritis (inflammation of ear cartilage)
Systemic infectious symptoms (ex. fever, malaise, tachycardia)
Erosion of temporal bone decreasing bony sound conduction
Permanent conductive hearing loss
Direct toxicity of pathogens to nerves
Cranial nerve (CN) VII (facial) palsy
(+/- CN X, XI, XII)
Out-of- proportion primary otalgia (ear pain)
Sign/Symptom/Lab Finding
Published December 4, 2022 on