This blog is part of a series of blog posts designed to serve as a quick reference guide. Each will focus on a sudden injury or illness and is designed to help you make an informed decision on a plan of action when the unexpected happens.
An ear infection is an inflammation of the middle ear that occurs when fluid builds up behind the eardrum. Ear infections are usually caused by bacteria. Although adults can get ear infections, they are far more common in children, and five out of six children will have at least one ear infection by their third birthday. Ear infections are the most common reason children visit the doctor’s office. Otitis media is the scientific name for an ear infection.
What are the different types of ear infections?
The most common type of ear infection is known as acute otitis media (AOM) in which parts of the middle ear are infected and fluid is trapped behind the eardrum. This causes ear pain and sometimes fever.
Sometimes, an ear infection can run its course, but fluid can stay trapped behind the eardrum. This is known as otitis media with effusion (OME). The most common symptom of OME is hearing loss. There may be a sensation of fullness in the ear, but usually there is no pain. A doctor will be able to see the trapped fluid with a special instrument. If this fluid remains in the middle ear or returns again and again, it is known as chronic otitis media with effusion (COME). A referral to an ear, nose, and throat surgeon may be needed, as this can lead to language and behavioral problems.
How can I tell that my child has an ear infection?
Many ear infections occur in young children that are unable communicate ear pain verbally. In this case, look for the following symptoms.
- Tugging and pulling at the ear(s)
- Fussiness and crying
- Trouble sleeping
- Fever (especially in infants and younger children)
- Fluid draining from the ear
- Balance problems
- Trouble hearing
What causes ear infections?
Ear infections usually begin after a child has had an upper respiratory infection such as a cold or sore throat but can also be caused by allergies. Bacterial upper respiratory infections can spread to the middle ear; viral upper respiratory infections (often colds) can lead to bacterial secondary infections in the middle ear. Once the middle ear becomes infected, fluid builds up behind the eardrum.
Why are children more likely than adults to get ear infections?
The eustachian tubes connecting the upper part of the throat to the middle ear are smaller in children than in adults. These small passageways supply fresh air to the middle ear and drain fluid. Smaller eustachian tubes are not as effective at draining fluid, especially when they are swollen or blocked with mucus because of recent respiratory illness. Children also have less effective immune systems and therefore are more likely to have infections in general.
How is an ear infection diagnosed?
A doctor can quickly and easily check for an ear infection using a lighted instrument called an otoscope to look at the eardrum. The eardrum will appear red and bulging if an ear infection is present.
How is an acute middle ear infection treated?
Often your child’s doctor will prescribe an oral antibiotic to be taken for 7-10 days. He or she may also recommend an over-the-counter pain reliever such as acetaminophen or ibuprofen to help with fever and pain. If your doctor can’t make a definite diagnosis of an ear infection, especially if your child doesn’t have a fever, he or she may ask you to wait a day or two to see if the ear pain subsides to avoid prescribing antibiotics unnecessarily.
How long will it take my child to get better?
Your child should start feeling better within a few days after visiting the doctor. If the condition worsens, call your doctor; a different antibiotic may be needed.
What happens if my child keeps getting ear infections?
If ear infections continue to return and antibiotics aren’t helping, your child’s doctor may recommend a surgical procedure that places small ventilation tubes in the eardrum to prevent fluid backup in the middle ear. The most commonly used tubes stay in place six to nine months before falling out. If ear infections continue after tube placement, a doctor may consider removing the adenoids to prevent the spread of infections to the eustachian tubes.
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