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. COMMON
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