A Man Cleaned His Ears with a Cotton Swab. Then He Got an Infection in His Skull.

A man in England has sworn off cleaning his ears with cotton swabs after developing a life-threatening infection that not only affected his hearing, but also spread to his brain’s lining and caused neurological symptoms, according to a new case report.

The troubles for the 31-year-old man started when a cotton swab’s tip was stuck inside his ear canal, though he told doctors he wasn’t sure exactly how or when it happened. A little cotton left in the ear may sound harmless, but it caused terrible pain in this instance. The man developed a severe bacterial infection that began in his ear canal, advanced into the bone at the base of his skull, and then moved upward into the lining of his brain, the meninges, said lead author Dr. Alexander Charlton, a member of the team of ear, nose and throat specialists involved in the treatment of the patient at Coventry University Hospital in England.

Even though the infection didn’t enter the man’s brain — it didn’t progress beyond the lining — it was clearly causing neurological symptoms. The man was rushed to the emergency room after experiencing a seizure and collapsing, according to the case report.

Charlton told Live Science that he thinks that either toxins from the bacterial infection or pressure on the brain from the infection caused the seizure.

However, according to the report, the symptoms began long before his seizure occurred. He had experienced pain and discharge from his left ear about 10 days before the seizure and had experienced headaches that were so severe on the left side of his head that they made him vomit. He had also begun to have trouble remembering the names of people.

But the man’s ear problems were nothing new; he told doctors that over the past five years he had experienced left ear pain and hearing loss and had been treated twice on the same side for severe ear infections. When he came to the hospital, doctors gave him a CT scan to examine his brain; two abscesses or inflamed areas filled with pus were revealed in the bones at the base of his skull, adjacent to his left ear canal. This signaled to doctors that while the infection may have started inside the ear canal of the man, it has spread beyond that area.

The man was diagnosed with “necrotizing otitis externa,” or an infection in the soft tissue of the external auditory canal. (The external auditory canal is the portion of the ear canal from the outside of the ear to the eardrum.)

The man’s doctors took him through a minor surgery to explore his ear canal; during this operation, they located and removed the cotton swab tip that had gone missing. The swab was impacted and encased by wax and debris, suggesting that it had been there for some time, Charlton stated, adding that it probably contributed to the man’s recurrent ear infections over the years, culminating in the particularly severe episode.

The man had to spend nearly a week in the hospital and needed two months of intravenous and oral antibiotics to cure the infection, but he had no long-term hearing or thinking problems.

And, perhaps unsurprisingly, he was advised to never use cotton swabs in his ears again. “They can only cause problems,” Charlton said, noting that cotton swabs have been linked to ear infections, punctured eardrums and impacted ear wax.

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