On descent, a preeure differential develops between the ambient water and the interior of this space, and this can cause swelling and haemorrhagic blistering of the canal. Treatment is usually analgesics and topical steroid eardrops. Complications may include local infection. This form of barotrauma is usually easily avoided. Middle ear
Middle ear barotrauma (MEBT) is an injury caused by a difference in pressure between the external ear canal and the middle ear. It is common in underwater divers and usually occurs when the diver does not equalise sufficiently during descent or, less commonly, on ascent. Failure to equalise may be due to inexperience or eustachian tube dysfunction, which can have many possible causes. Unequalised ambient pressure increase during descent causes a pressure imbalance between the middle ear air space and the external auiditory canal over the eardrum, referred to by divers as ear squeeze, causing inward stretching, serous effusion and haemorrhage, and eventual rupture. During ascent internal over-pressure is normally passively released through the eustachian tube, but if this does not happen the volume expansion of middle ear gas will cause outward bulging, stretching and eventual rupture of the eardrum known to divers as reverse ear squeeze. This damage causes local pain and hearing loss. Tympanic rupture during a dive can allow water into the middle ear, which can cause severe vertigo from caloric stimulation. This may cause nausea and vomiting underwater, which has a high risk of aspiration of vomit or water, with possible fatal consequences.
Wash hands and forearms thoroughly with soap and running water after cleaning the tank, even if gloves were worn. Ensure regular and adequate chlorination of swimming pools to kill any bacteria that may be present. Treatment
Treatment involves the use of antibiotics. Since M. marinum has a high tendency for multi-drug resistance, treatment by one particular drug will not be effective. Often, up to six different antimicrobial regimes may be needed before the infection responds to a particular drug combination. This combination of antibiotics is based on the results of the culture and skin biopsy. The treatment can take up to several months.Surgery may also be needed to remove dead tissue if the lesions do not clear with antibiotics. This helps the wound to heal. Epidemiology
Mycobacterium marinum infection is not contagious; it is not spreading from person to person. It is also not transmitted in hospitals like other common bacteria. See also
Skin lesion
List of cutaneous conditions

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