Otitis Media a.k.a Middle Ear Infection

OTITIS MEDIA

This week KMC Clinic will discuss about ear infection again. We discussed Otitis Externa at the beginning of our website launch, and now we kindly present Otitis Media as discussion topic. Otitis media is an infection of the middle ear that causes inflammation (redness and swelling) and a build-up of fluid behind the eardrum. Anyone can develop a middle ear infection but infants between six and 15 months old are most commonly affected. It's estimated that around one in every four children experience at least one middle ear infection by the time they're 10 years old.

SYMPTOM

Children

Signs and symptoms common in children include:

• Ear pain, especially when lying down
• Tugging or pulling at an ear
• Trouble sleeping
• Crying more than usual
• Fussiness
• Trouble hearing or responding to sounds
• Loss of balance
• Fever of 100 F (38 C) or higher
• Drainage of fluid from the ear
• Headache
• Loss of appetite

Adults

Common signs and symptoms in adults include:

• Ear pain
• Drainage of fluid from the ear
• Trouble hearing

Risk factors

Risk factors for ear infections include:

Age. Children between the ages of 6 months and 2 years are more susceptible to ear infections because of the size and shape of their Eustachian tubes and because their immune systems are still developing.

Group child care. Children cared for in group settings are more likely to get colds and ear infections than are children who stay home. The children in group settings are exposed to more infections, such as the common cold.

Infant feeding. Babies who drink from a bottle, especially while lying down, tend to have more ear infections than do babies who are breast-fed.

Seasonal factors. Ear infections are most common during the fall and winter. People with seasonal allergies may have a greater risk of ear infections when pollen counts are high.

Poor air quality. Exposure to tobacco smoke or high levels of air pollution can increase the risk of ear infections.

Cleft palate. Differences in the bone structure and muscles in children who have cleft palates may make it more difficult for the Eustachian tube to drain.

Prevention

The following tips may reduce the risk of developing ear infections:

• Prevent common colds and other illnesses. Teach your children to wash their hands frequently and thoroughly and to not share eating and drinking utensils. Teach your children to cough or sneeze into the crook of their arm. If possible, limit the time your child spends in group child care. A child care setting with fewer children may help. Try to keep your child home from child care or school when ill.
• Avoid secondhand smoke. Make sure that no one smokes in your home. Away from home, stay in smoke-free environments.
• Breast-feed your baby. If possible, breast-feed your baby for at least six months. Breast milk contains antibodies that may offer protection from ear infections. If you bottle-feed, hold your baby in an upright position. Avoid propping a bottle in your baby's mouth while he or she is lying down. Don't put bottles in the crib with your baby.
• Talk to your doctor about vaccinations. Ask your doctor about what vaccinations are appropriate for your child. Seasonal flu shots, pneumococcal and other bacterial vaccines may help prevent ear infections.

What a diagnosis means

Acute otitis media. The diagnosis of "ear infection" is generally shorthand for acute otitis media. Your doctor likely makes this diagnosis if he or she sees signs of fluid in the middle ear, if there are signs or symptoms of an infection, and if symptoms started relatively suddenly.

Otitis media with effusion. If the diagnosis is otitis media with effusion, the doctor has found evidence of fluid in the middle ear, but there are presently no signs or symptoms of infection.

Chronic suppurative otitis media. If the doctor makes a diagnosis of chronic suppurative otitis media, he or she has found that a long-term ear infection resulted in tearing of the eardrum. This is usually associated with pus draining from the ear.

Treatment

Some ear infections resolve without antibiotic treatment. What's best for your child depends on many factors, including your child's age and the severity of symptoms.

A wait-and-see approach

• Children 6 to 23 months with mild middle ear pain in one ear for less than 48 hours and a temperature less than 39 C
• Children 24 months and older with mild middle ear pain in one or both ears for less than 48 hours and a temperature less than 39 C

Some evidence suggests that treatment with antibiotics might be helpful for certain children with ear infections. On the other hand, using antibiotics too often can cause bacteria to become resistant to the medicine. Talk with your doctor about the potential benefits and risks of using antibiotics.

Managing pain

Your doctor will advise you on treatments to lessen pain from an ear infection.

Antibiotic therapy

Antibiotics aren't routinely used to treat middle ear infections, although they may occasionally be prescribed if symptoms persist or are particularly severe.

Source:

1. https://www.mayoclinic.org/diseases-conditions/ear-infections
2. https://www.nhsinform.scot/illnesses-and-conditions/ears-nose-and-throat