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Ear Infections/Acute Otitis Media

One of the most common problems pediatricians see is ear infection. Almost half of all children will have at least one middle-ear infection during their first year and by age three, two-thirds of all children will have had a middle-ear infection.

Bacteria entering the middle ear from the nose or throat are the major culprit. When these germs multiply, fever occurs, pus accumulates and pressure builds up behind the eardrum, causing pain that ranges from mild to severe. Nasal congestion, cough and conjunctivitis or "pinkeye" - signs associated with a viral infection - often precede the ear infection.

Symptoms include ear pain, fever, irritability or, in older children, dizziness. Parents should also look for subtle signs, too, like decreased activity or appetite, or head shaking in infants or young children.

Occasionally, the pressure in the middle ear will build up to a point where the eardrum bursts, resulting in pus and blood drainage from the ear.

As alarming as this seems, this generally results in a decrease in the fever and pain. The tear in the eardrum allows the infected inner ear contents to drain and the hole usually heals within a few days after antibiotics are started.

Ear infections rarely require emergency medical attention unless the pain is severe and persists for several hours, or the child exhibits excessive drowsiness, extreme irritability or a lack of response to his or her environment.

Acetaminophen generally provides temporary relief of the fever and ear pain and can be administered until a physician evaluates the child.

Parents sometimes stop giving prescribed medication when the fever disappears or the child says the pain is gone. Although the "ache" often goes away in hours to days, it may take several weeks for antibiotics to rid the ear of infection.

Ear infections are not in themselves contagious. However, the viral infections that often accompany them can be transmitted to other people. Once antibiotic therapy is started, the child may return to school or day care if the fever is gone.

Unfortunately, a number of children have recurrent middle-ear infections; however, there is no way to predict in which children this will occur. Children who have repeated middle-ear infections generally have abnormalities of their Eustachian tube, the passage between the throat and the middle ear. Most of the time, these abnormalities are temporary and resolve by school age. In other cases, surgery to insert drainage tubes into the ears is required.

 

 

 

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