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EAR
INFECTION (Otitis Media) DEFINITION An
ear infection is a bacterial infection of the middle ear (the space behind the
eardrum). It usually is a
complication of a cold, occurring after the cold blocks off the eustachian tube
(the passage connecting the middle ear to the back of the throat).
The pain is due to pressure and bulging of the eardrum from trapped,
infected fluid. Almost
half of all children will have an ear infection during the first year of life.
Some will be prone to recurrence, particularly those with a parent or
sibling who had the same problem during childhood. Another risk
factor is attendance at a day care center during the first two years of life. EXPECTED
COURSE Pain
is the most common symptom of middle ear infections.
In some cases it is very mild; in others, it is severe enough to make the
child cry or scream, although usually for less than half an hour.
Other children usually complain of fullness, hearing loss or a sharp
stabbing pain in the affected ear(s). Infants
may be fussy or out of sorts, tug at their ear(s) and sleep restlessly. One-third
to one-half of children with middle ear infections will develop fever,
occasionally as high as 104° F. Elevated
temperature is more common in infants and toddlers than in older children.
Symptoms of a cold such as nasal congestion, cough and conjunctivitis
("pink eye") often accompany ear infections. In
5% to 10% of children, the pressure in the middle ear causes the eardrum to
rupture and drain. This small tear
usually heals over the next week. It
is uncommon to have a lasting hole
in the eardrum or prolonged hearing loss as a result of ear infection. The peak age range
for ear infections is 6 months to 2 years, but they continue to be a common
childhood illness until 8 years of age. CONTAGIOUSNESS Ear
infections are not contagious, although the viral colds which frequently precede
them can be transmitted to other children.
Children with ear infections may return to school or day care centers
when they feel well and have no fever. TREATMENT We
may or may not initially recommend antibiotics. Some ear infections will clear
on their own. There
are several antibiotics which can be used for treating middle ear infections.
Your doctor will choose one based on his/her experience, the cost of the
medicine, taste of the suspension, and possible side effects such as rashes or
upset stomach. Treatment
is usually prescribed for ten to fourteen days.
Even though ear pain may be completely gone after two or three doses of
the medicine, infection is still present and the
full course should be completed to reduce the likelihood of relapse or
recurrence. Acetaminophen (Tylenol)
or Ibuprofen (Advil) provides temporary relief of mild to moderate
earache. More severe pain usually
requires prescription medications such as acetaminophem with codeine.
Use of a heating pad or hot-water bottle can also be helpful. FOLLOW
UP VISIT Your child may have been given a return appointment in ten to fourteen days. At that visit we will look at the eardrum to be certain that the infection is cleared up and more treatment isn't needed. We may also want to test your child's hearing. Follow-up exams are very important in children under 2 years of age and particularly if the ear drum is perforated. CALL
OUR OFFICE Immediately
if:
During
Regular Office Hours if:
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