EAR INFECTION, MIDDLE- (Otitis Media) |
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EAR INFECTION, MIDDLE- (Otitis Media)
DESCRIPTIONMiddle-ear infection means inflammation or infection in the middle ear. This is not contagious from person to person, but the preceding respiratory infection causing it may be infectious. The middle-ear space where nerves and small bones connect to the eardrum on one side and the eustachian tube on the other side is involved. Middle-ear infections can affect all ages but is most common in infants and children.
Appropriate health care includes:
Physician's monitoring of general condition and medications.
Home care after diagnosis.
Surgery to insert plastic tubes through the child's eardrum to drain pus or fluid from the middle ear (rare).
SIGNS & SYMPTOMS
Irritability.
Earache.
Feeling of fullness in the child's ear.
Hearing loss.
Fever.
Discharge or leakage from the ear.
Diarrhea (sometimes).
Pulling at the ear (small children).
CAUSES
Bacterial or viral infections which spread to the middle ear by way of the eustachian tube. These are usually upper-respiratory virus infections in the child's nose or throat.
Sinus and eustachian-tube blockage caused by nasal allergies or enlarged adenoids in your child.
A ruptured eardrum.
RISK FACTORS
Recent illness, such as a respiratory infection, that has lowered your child's resistance.
Crowded or unsanitary living conditions.
Genetic factors. Some American Indians--especially the Navajo--seem more susceptible.
High altitude.
Cold climate.
Taking a bottle to bed. Fluid pools in the child's throat near the eustachian tube.
PREVENTING COMPLICATIONS OR RECURRENCE
If your child has an ear infection followed by a hearing loss or enlarged adenoids, ask your doctor about using a steroid nasal spray, preventive antibiotics, or decongestants during future respiratory infections. This may prevent fluid accumulation.
Bottle-feed your infant in a sitting position--never lying down.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
POSSIBLE COMPLICATIONS
Eardrum rupture.
Hearing impairment--usually temporary, but sometimes permanent--leading to delay of normal language development in children.
Enlarged adenoids in children from chronic middle-ear infections.
Mastoiditis.
Meningitis.
PROBABLE OUTCOME
Usually curable with treatment.
TREATMENT
HOME CAREApply heat to the area around the child's ears to relieve pain.
MEDICATION
Use ear drops to relieve the child's pain. You may use non-prescription drops or those prescribed for a previous infection. They will not cure the infection.
Use non-prescription nasal sprays or drops to help open the eustachian tube and relieve pressure in the child's middle ear.
Use non-prescription drugs, such as acetaminophen, to reduce the child's pain and fever.
Your doctor may prescribe antibiotics if the infection appears to be bacterial rather than viral. Have your child finish the medication. The infection may remain active for several days after symptoms disappear.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
Your child should rest in bed or reduce activity until fever and pain subside.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?When signs of infection have decreased, appetite returns, and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of a middle-ear infection.
The following occurs during treatment: fever above 102F (38.9C), despite treatment; severe headache; earache that persists longer than 2 days, despite treatment; swelling around the child's ear; convulsions; twitching of the child's face muscles; dizziness.
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