OpenHealth Q&A

Ear Infection Overview

A 27-year-old woman, standing 5 feet 7 inches tall and weighing 129 pounds, presents with multiple health concerns including Major Depressive Disorder (MDD), Attention Deficit Hyperactivity Disorder (ADHD), Ehlers-Danlos Syndrome (EDS), vitiligo, vasculitis, alopecia areata, and a history of anemia, kidney stones, septic shock, recurrent urinary tract infections, and recurrent ear infections. Her current medication regimen consists of 300 mg of Effexor XR daily, 40 mg of Mydayis typically three days per week, a daily intake of Nutrafol (an over-the-counter hair growth supplement) on various days, and 70 units of Ozempic administered biweekly. The patient has experienced otitis media in her right ear since June 4. She initially sought medical attention at an urgent care facility on June 6 due to ear pain accompanied by low-grade fevers and chills, where she received an ear irrigation and was prescribed Ciprofloxacin and dexamethasone ear drops. However, she forgot to use the medication until a week later, from June 11 to June 23. She suspects she may have perforated her eardrum on June 13, possibly while performing an ear lavage with a kit purchased from Walgreens or while using saline solution on her nasal passages. During this process, she reported a sudden, painful screeching noise in her ear and the sensation of air and moisture escaping through her ear canal. Notably, she removed a sizable object resembling a bent baby carrot, which was cream-colored and had a white tip with dark spots. She has refrained from using cotton swabs for about two years based on advice from a different urgent care doctor regarding her prior ear infection. On June 23, due to ongoing pain rated between 2 and 3 out of 10, escalating to 5 out of 10 intermittently, coupled with hearing difficulties and a sensation of fullness in her ear, she contacted an Ear, Nose, and Throat (ENT) specialist to secure the earliest available appointment for July 28. On June 24, she returned to urgent care, where the physician discovered pus in her ear canal and removed what appeared to be compressed cotton. The ear drum wasn't clearly visible, and further flushing wasn't attempted to minimize additional discomfort. She was prescribed a week-long course of amoxicillin-clavulanate, which she is set to complete tomorrow. At this moment, she is experiencing heightened pain (baseline of 4-5 out of 10, spiking to 7-8 out of 10 intermittently, unresponsive to Aleve), worsened hearing loss, and purulent drainage. Additionally, she has developed a sore throat two days ago. She seeks guidance on whether to contact her ENT for an earlier appointment, revisit urgent care, or simply endure the symptoms. Unfortunately, she does not have a primary care physician after transitioning from pediatric care, partly due to a lack of motivation. As a bedside nurse, she finds it challenging to work effectively due to the pain, especially since wearing a stethoscope is currently uncomfortable for her.

Answers (1)

7/2/2025, 12:40:52 AM

OpenHealth AI

It sounds like you are dealing with a painful and complicated situation involving an ear infection, and it's understandable to feel overwhelmed given your health history and current symptoms. Your situation warrants careful attention, particularly since you are experiencing increased pain, hearing loss, and drainage.

Key Points:

1. Severe Symptoms: You are experiencing heightened pain, purulent drainage, and hearing loss, which suggest the need for prompt medical evaluation.
2. Current Medication and Treatment: You have been on antibiotics, but the worsening symptoms indicate that the infection may not be adequately controlled.
3. Need for Timely Intervention: Given your work as a bedside nurse, managing your symptoms is essential to perform your duties effectively.

Explanation:

Infections of the ear, especially when accompanied by significant pain and drainage, can sometimes lead to more serious complications, particularly if the eardrum is or has been perforated. The presence of pus and ongoing symptoms after a course of antibiotics indicates that the initial treatment may not have been fully effective, which could necessitate either a stronger antibiotic or further intervention by a specialist.

Next Steps:

1. Contact Your ENT Specialist: Reach out to your ENT’s office as soon as possible and explain your current symptoms, including the increased pain and hearing loss. Request an expedited appointment. Emphasize the impact these symptoms have on your daily life and work as a nurse.

2. Urgent Care Visit: If getting a quicker appointment with your ENT isn’t feasible (or is delayed), consider returning to an urgent care clinic. Explain that your symptoms have worsened, and ask to be evaluated for the potential need for different treatments, which may include additional antibiotic options or referrals for further care.

3. Self-Care Suggestions:

   • Pain Management: Since Aleve isn’t effective, you might try alternating with acetaminophen (Tylenol) for more substantial relief, but check the recommended dosages and avoid exceeding the daily limits for both medications.
   • Avoid Water in Ear: Be cautious with water exposure in your ear, avoiding swimming and showering without protection.
   • Head Position: Try to keep your affected ear facing downward when lying down to allow drainage and reduce pressure.

By taking these steps, you can work towards resolving your current ear infection and manage your symptoms more effectively. Please keep me updated on your progress, and let me know if you have any questions or need further support!