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Otitis Externa- Swimmer's Ear by Dr Zoran Becvarovski

Acute Otitis Externa

Figure shows an inflamed left osseous meatus due to acute otitis externa.

Another example of swimmer's ear.


Diffused inflammation of ear canal

A diffusely inflamed and narrowed ear canal.  (+) - tympanic membrane.



Otomycosis presents with ear itchiness, blockage, reduced hearing, and pain.  There is superficial inflammation caused by various fungal species including candida and aspergillus.  Fungal hyphae, micelium, and wet-paper appearance of ear canal skin are amongst its typical findings.

 Otomycosis occuring along handle of malleus.


Fungal hyphae with surroundings wet paper appearance.


Mycelium of fungus involving osseous meatus.

Another example of otomycosis with obvious mycelium seen (ellipse).

Severe otomycosis caused by Aspergillus niger.


Frank pus with visible fluffy hyphae without spores in osseous segment of external auditory meatus. 

Otomycosis with visible rim of central perforation at the background.

Otomycosis with co-existing small eardrum perforation.

Appearance of the ear canal after topical antifungal

powder spray applied post-aural toilet.

Inflammatory swellings (x) at handle of malleus and top or osseous auditory canal in a patient witth otomycosis treated a week earlier.

Minute yellowish tufts/grains of otomycosis at it early stage of infection.


Hidden perforation made visible after ear toilet...it's a double perforation of TM!


                              Figure 1                                       Figure 2

 Figure 3

Figure 4


Figure 1: Furunculosis with pointing pus arising from hair-bearing area of ear canal

Figure 2: Diffuse inflammation with ear canal occlusion. Tragal tenderness present.

Figure 3: Furunculosis (circle) which spontaneously burst a day earlier causing purulent discharge with blood stain.  Incision or aspiration is usually not perform due to fear of spreading the infection leading to perichondritis,

Figure 4. A recently burst furuncle (arrow) which responded favourably with oral antibiotic.  (T - tragus).

Ear Abscess Complicating Furunculosis

 Purulent ear discharge from burst furuncle with abscess formation.



An indurated tender swelling involving postero-inferior post auricular and upper neck area with lymphadenitis.  The child responded well to treatment consisting intravenous antibiotic, micro-ear toilet, antibiotic impregnated wick, and suitable anaelgesia.  Pus culture grew Staphylococcus aureus.



Healed lesion 2 weeks later with restored post-auricular sulcus.