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Otitis externa: Otitis externa, or swimmer's ear, is an infection of the outer ear structures. It typically occurs in swimmers, but the since the cause of the infection is water trapped in the ear canal, bathing or showering may also cause this common infection. When water is trapped in the ear canal, bacteria that normally inhabit the skin and ear canal multiply, causing infection and irritation of the ear canal. If the infection progresses it may involve the outer ear. Swimmer's ear is sometimes confused with otitis media (middle ear infections), especially when there is drainage from the ear (otorrhea). In middle ear infections, drainage only occurs if the tympanic membrane (ear drum) has either a perforation (hole) or bulges in the membrane. Otitis media with effusion: When fluid forms in the middle ear, the condition is known as otitis media with effusion. This occurs in a recovering ear infection or when an ear infection is starting. Fluid can remain in the ear for weeks to months. When a discharge from the ear persists or repeatedly returns, this is sometimes called chronic middle ear infection. Fluid can remain in the ear up to three weeks following the infection. If not treated, chronic ear infections have potentially serious consequences such as temporary or permanent hearing loss. All children with middle ear infection or fluid have some degree of hearing loss. The average hearing loss in ears with fluid is 24 decibels, equivalent to wearing ear plugs. If a child has a hearing loss, they should be examined by an ear, nose, and throat specialist at the earliest opportunity. Hearing loss can be temporary, lasting only a few days, to permanent in severe infections. Suppurative otitis media: A condition called chronic suppurative otitis media (an ear infection with drainage lasting more than two weeks) can develop from repeat ear infections. Otitis interna: Otitis interna, or inner ear infection, is inflammation of the inner ear. It is among the most common ear infections and is usually caused by water trapped inside the ear by earwax. Labyrinthitis is a type of inner ear infection that typically results in severe vertigo (dizziness) lasting for one or more days. It is thought to be caused by a viral inflammation of the vestibular labyrinth (the part of the inner ear responsible for balance). Individuals usually complain of a sudden onset of severe whirling vertigo (dizziness), nausea, and vomiting. The symptoms can be so severe and disabling that people frequently go to the emergency room for care and require drugs to help regain balance, such as meclizine (Antivert®). Symptoms typically subside over a few days, but may leave the individual with slight imbalance that slowly improves over weeks or months. Hearing loss rarely accompanies the vertigo
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