How Is Otitis Media Diagnosed
Making a firm diagnosis of otitis media is not easy. The eardrum is not easy to see, especially in younger children, and the signs of an infection are not always clear.
Your doctor or a nurse will examine your child with an otoscope, an instrument that has a light to allow them to see your childs eardrum. Your child might also have a tympanometry test, which checks how much your childs eardrum moves.
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Where To Get Help
- NURSE-ON-CALL Tel. for expert health information and advice
- Royal Children’s Hospital Tel. 9345 5522
- Your maternal and child health nurse
- Your local hospital emergency or casualty department.
- 24 hour Maternal and Child Health Telephone Service: Tel. 13 22 29 for the cost of a local call throughout Victoria.
Symptoms Of A Middle Ear Infection
In most cases, the symptoms of a middle ear infection develop quickly and resolve in a few days. This is known as acute otitis media. The main symptoms include:
- a lack of energy
- slight hearing loss – if the middle ear becomes filled with fluid
In some cases, a hole may develop in the eardrum and pus may run out of the ear. The earache, which is caused by the build-up of fluid stretching the eardrum, then resolves.
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When To Use A Home Remedy
The best home remedy for an earache depends on the cause. If a cavity is to blame, your earache may not improve until you see a dentist. However, if its an ear infection, using a natural remedy could make the illness bearable as your body fights off the infection.
Many ear infections clear up on their own in about a week or two, with symptoms starting to get better after a few days. Be sure to check with your childs pediatrician if your child has ear pain, especially if they are under 2 years of age.
If your child is running a high fever, or if a fever lasts longer than a day, seek immediate medical care. A high fever for children is defined as:
| Age |
How Are Ear Infections Treated
To treat an ear infection, health care providers consider many things, including:
- the type and severity of the ear infection
- how often the child has ear infections
- how long this infection has lasted
- the child’s age and any risk factors
- whether the infection affects hearing
The type of otitis affects treatment options. Not all kinds need to be treated with antibiotics. Because most ear infections can clear on their own, many doctors take a “wait-and-see” approach. Kids will get medicine for pain relief without antibiotics for a few days to see if the infection gets better.
Antibiotics aren’t routinely prescribed because they:
- won’t help an infection caused by a virus
- won’t get rid of middle ear fluid
- can cause side effects
- usually don’t relieve pain in the first 24 hours and have only a minimal effect after that
Also, overuse of antibiotics can lead to antibiotic-resistant bacteria, which are much harder to treat.
If a doctor does prescribe antibiotics, a 10-day course is usually recommended. Kids age 6 and older who don’t have a severe infection might take a shortened course for 5 to 7 days.
Some children, such as those with recurrent infections and those with lasting hearing loss or speech delay, may need ear tube surgery. An ear, nose, and throat doctor will surgically insert tubes that let fluid drain from the middle ear. This helps equalize the pressure in the ear.
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Do Allergy Medicines Help Ear Infections
No. Allergy medicines such as antihistamines and are often used to dry out excess fluids in the body. The latest clinical guidelines from the American Academy of Family Physicians do not recommend using antihistamines or decongestants for ear infections. Using these allergy medications to treat ear infections provides little benefit and may cause more harm than good.
How Is Otitis Media Treated
If your child is in pain or has a fever, you should give them paracetamol. Your doctor may suggest anaesthetic ear drops. Encourage your child to drink plenty of water. Most kids will feel better within a day or two.
You should see a doctor if your child:
- is still feeling unwell after 48 hours
- has severe pain
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Who Is At Higher Risk For Ear Infections
- Children less than 5 years old, because they have shorter eustachian tubes.
- Children who attend daycare, because they tend to have more colds.
- Children with allergies.
- Children who are exposed to cigarette smoke. Smoke causes inflammation of the eustachian tube, making ear infections more likely.
- Children who were not breastfed. Breast milk has antibodies that help fight infections.
- Babies who are being bottle fed, especially if they swallow milk while lying too flat. Milk can enter the eustachian tube and cause inflammation, which increases the risk of an ear infection. Children should be held upright while drinking a bottle. When they are old enough to hold their own bottle well, they should be taught to drink from a regular cup and no longer given a bottle.
- Children with cleft palates, as their eustachian tubes are often inflamed.
- Children of First Nations and Inuit descent, though its not clear why.
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Otitis Externa Treatment And Management
Most people with otitis externa or ear infections are given treatment without having any tests, as the diagnosis is usually clear from examination of the ear. If you recognise the condition yourself you could try some ear drops for otitis externa. These are available without prescription, such as those containing 2% acetic acid.
Ear drops are usually enough to cure a bout of short-lasting otitis externa. However, other treatments are sometimes added. This is more likely to be necessary if you notice any of the following:
- Your ears are particularly painful or swollen.
- Your ears are completely blocked .
- Your otitis externa keeps coming back or has become persistent .
It is also very important that you take steps to help things settle down, as if the conditions that caused the otitis externa in the first place are unchanged, it may well come back.
Middle Ear Infection Treatment
Witha middle ear infection, it’s best to have a provider examine your ear with an otoscope to look for signs of infection or blockages. For this reason you should be seen in person at urgent care, at a convenient care or walk-in clinic, or at your primary care clinic. If your providerbelieves that bacteria may have caused the infection, she’ll prescribe an antibiotic. However, if a virus is causing the infection, an antibiotic won’t help, and you’ll have to treat the pain and wait for the infection to get better on its own.
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Oral Antibiotics Have Risks
- Oral antibiotics are more likely to cause resistant bacteria outside the ear. When that happens, these medicines will not work as well in the future. Illnesses will be harder to cure and more costly to treat.
- Antibiotic eardrops kill the bacteria faster and more completely than oral antibiotics. Drops dont go into the bloodstream, so more medicine reaches the infection.
Return To The Doctor Or Nurse If Things Don’t Settle
Very occasionally, the germs which infect the ear canal are resistant to some antibiotic ear drops. A change to a different type of ear drop may be helpful. Sometimes a small sample of the discharge is taken and sent to the laboratory to identify which germ is causing the infection. If the infection is severe, antibiotic tablets may be needed in addition to drops.
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How Middle Ear Infections Are Treated
Proper treatment of an ear infectionalso known as acute otitis media will greatly reduce the amount of ear pain that you are experiencing, as well as decrease your risk of other complications from an untreated infection. Options include over-the-counter therapies and prescription medications that your doctor can prescribe.
Verywell / Brianna Gilmartin
Explore these treatments for both pain and fighting the infection, as well as other treatments that you may want to understand.
What Are The Types Of Middle
Infections can affect the middle ear in several ways. They are:
-
Acute otitis media. This middle-ear infection occurs suddenly. It causes swelling and redness. Fluid and mucus become trapped inside the ear. You can have a fever and ear pain.
-
Otitis media with effusion. Fluid and mucus build up in the middle ear after the infection goes away. You may feel like your middle ear is full. This can continue for months and may affect your hearing.
-
Chronic otitis media with effusion. Fluid remains in the middle ear for a long time. Or it builds up again and again, even though there is no infection. This type of middle-ear infection may be hard to treat. It may also affect your hearing.
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Why Do Kids Get Ear Infections
Kids get ear infections more than adults do for several reasons:
- Their shorter, more horizontal eustachian tubes let bacteria and viruses find their way into the middle ear more easily. The tubes are also narrower, so more likely to get blocked.
- Their adenoids, gland-like structures at the back of the throat, are larger and can interfere with the opening of the eustachian tubes.
Other things that can put kids at risk include secondhand smoke, bottle-feeding, and being around other kids in childcare. Ear infections are more common in boys than girls.
Ear infections are not contagious, but the colds that sometimes cause them can be. Infections are common during winter weather, when many people get upper respiratory tract infections or colds .
Types Of Middle Ear Infections
Middle ear infections are called otitis media. When otitis media is accompanied by fluid in the middle ear, ear infections are referred to as serous otitis media, or otitis media with effusion.
Middle ear infections often occur after a cold virus or upper respiratory infection. They are also more common in individuals who suffer from allergies or enlarged adenoids , which can inhibit proper functioning of the auditory tube.
Bacteria, viruses, or fungi often enter through the auditory tube, which can then become swollen and blocked with mucus, preventing drainage and ventilation of the middle ear.
The main symptoms of middle ear infections include:
- Ear pain, which may be worse in the morning or cause difficulty sleeping
- Trouble hearing
A healthcare provider can diagnose a middle ear infection based on symptoms and an examination, which involves looking at the eardrum with an otoscope.
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How Do I Know If I Have An Ear Infection
Bacteria, viruses, or fungi can cause ear infections. But because you cant see inside your ear with the naked eye, your symptoms may be the only way to suspect if you have one. And they can vary depending on the area of the ear thats infected.
If you or your child have symptoms like these, an ear infection could be a possibility. To confirm an ear infection, a healthcare provider typically needs to look inside your ear using a medical device called an otoscope. They can also check to see if a bacteria, virus, or something else is causing your infection.
Keep in mind that more serious symptoms can also develop that require prompt medical attention. More on these later.
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Otitis Media In Adults
Otitis media is another name for a middle ear infection. It means an infection behind your eardrum. This kind of ear infection can happen after any condition that keeps fluid from draining from the middle ear. These conditions include allergies, a cold, a sore throat, or a respiratory infection.
Middle ear infections are common in children, but they can also happen in adults. An ear infection in an adult may mean a more serious problem than in a child. So you may need additional tests. If you have an ear infection, you should see your healthcare provider for treatment. If they happen repeatedly, you should see an otolaryngologist or an otologist .
What are the types of middle ear infections?
Infections can affect the middle ear in several ways. They are:
Who is more likely to get a middle ear infection?
You are more likely to get an ear infection if you:
- Smoke or are around someone who smokes
- Have seasonal or year-round allergy symptoms
- Have a cold or other upper respiratory infection
What causes a middle ear infection?
The middle ear connects to the throat by a canal called the eustachian tube. This tube helps even out the pressure between the outer ear and the inner ear. A cold or allergy can irritate the tube or cause the area around it to swell. This can keep fluid from draining from the middle ear. The fluid builds up behind the eardrum. Bacteria and viruses can grow in this fluid. The bacteria and viruses cause the middle ear infection.
Infections Inside The Ear
Antibiotics are not usually offered because infections inside the ear often clear up on their own and antibiotics make little difference to symptoms, including pain.
Antibiotics might be prescribed if:
- an ear infection does not start to get better after 3 days
- you or your child has any fluid coming out of the ear
- you or your child has an illness that means theres a risk of complications, such as cystic fibrosis
They may also be prescribed if your child is less than 2 years old and has an infection in both ears.
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Should I Use Antibiotics For An Ear Infection
Antibiotics are a medicine prescribed by your doctor. If youre dealing with an ear infection caused by bacteria, youll likely need antibiotics. They are the best way of quickly getting rid of a bacterial infection and preventing it from spreading to other parts of the body.
The catch is that antibiotics dont work against viruses if you use antibiotics on a viral ear infection, it can actually make the infection worse. Overuse of antibiotics can lead to a condition called antibiotic resistance, which means that the medicine becomes less effective at fighting off bacteria.
Thats why doctors are careful about using antibiotics wisely and may not immediately prescribe them for ear infections.
When Should I Call The Doctor
Very rarely, ear infections that don’t go away or severe repeated middle ear infections can lead to complications. So kids with an earache or a sense of fullness in the ear, especially when combined with fever, should be seen by their doctors if they aren’t getting better after a couple of days.
Other things can cause earaches, such as teething, a foreign object in the ear, or hard earwax. Your doctor can find the cause of your child’s discomfort and treat it.
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What Are The Symptoms Of Outer Ear Infection
Often only one ear is affected. Symptoms affect your ear and surrounding area, including:
- ear pain or pain when moving your ear or jaw
- itchiness and irritation in or around the ear canal
- swelling and redness of the ear canal and surrounding area
- peeling skin inside and around the outside ear
- fluid from your ear, often with a bad smell
A very rare but dangerous complication is malignant otitis externa. This is the spread of infection to the bones of your ear canal and lower part of your skull. If you have an outer ear infection and experience strange symptoms, such as dizziness or muscular weakness in your face, seek immediate medical help.