Level And Quality Of Evidence
To assess the level of evidence, studies were categorized based on the 2011 Oxford Centre for Evidencebased MedicineLevels of Evidence.9, 10 Level 1 was defined as a systematic review of randomized trials Level 2 was defined as a randomized trial or observational study with dramatic effect Level 3 was defined as a nonrandomized controlled cohort/followup study Level 4 was defined as a caseseries, casecontrol, or historically controlled study.
To assess the quality of each study, a 14item checklist was generated a priori, assessing research design, patient selection, and presentation of outcome data .1). Criteria were chosen based on previous systematic reviews. Studies were assigned one point based on each listed item. Studies with a total score of 10 to 14 points were considered high quality studies with a score of 6 to 9 were considered moderate quality and studies with a score of 0 to 5 were considered low quality.
What Is An Ear Infection
Ear infections can be either bacterial or viral infections. They can occur in your middle ear, the part of your ear just behind your eardrum, as well as the outer and inner ear. They often clear up on their own but can be painful due to inflammation or fluid buildup.
Ear infections can be chronic or acute. Acute ear infections are painful but short in duration. Chronic ear infections either dont clear up or recur many times. They can cause damage to the middle and inner ear, which is infrequently permanent.
Keep reading to learn about ear infections, including causes, symptoms, and treatment options.
Common symptoms of ear infections include:
- mild pain or discomfort inside your ear
- changes in air pressure
Ear infections can also develop from infected adenoids. Your adenoids are glands on the roof of your mouth behind your nose that help protect your body from infections. Infections can spread from these glands to the nearby ends of your Eustachian tubes.
Signs In Young Children
As babies are unable to communicate the source of their discomfort, it can be difficult to tell what’s wrong with them. Signs that a young child might have an ear infection include:
- raised temperature
- pulling, tugging or rubbing their ear
- irritability, poor feeding or restlessness at night
- coughing or a runny nose
- unresponsiveness to quiet sounds or other signs of difficulty hearing, such as inattentiveness
- loss of balance
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Location And Symptoms Of Otogenic Brain Abscess
Of papers identifying otogenic comorbidities in patients presenting with brain abscess , all stated that patients most commonly also suffered from suppurative chronic otitis media, with a prevalence of 43% to 100% . Seven studies also explicitly mentioned the prevalence of cholesteatoma, ranging from 21100% . Two studies, Chun et al. and Fernandes et al., also identified mastoiditis as prevalent in 71% and 62%, respectively, of patients with otogenic brain abscess.
Most papers specifically addressed the intracranial location of abscesses of otogenic infection. Out of 1302 total otogenic abscesses, 55% were found in the temporal lobe and 28% were in the cerebellum. Other locations mentioned included the frontal and parietal lobes, which were implicated in 5% . A total of 156 out of 1302 abscesses did not have an identified location. Across papers, the range of otogenic abscesses in the temporal lobe comprised 11% to 90% , while otogenic abscesses in the cerebellum ranged from 4% to 80% .
Location of otogenic intracranial abscesses across all studies. The location of 905 out of 1302 total otogenic abscesses was specified. Most were located in the temporal lobe or cerebellum . Other includes frontal lobe, parietal lobe and subdural locations . The location of 145 otogenic abscesses was not specified .
Longer Term Effects Of Inner Ear Infections
Generally, the symptoms will clear up as soon as the infection is gone. However, the effects can sometimes last longer.
You might still feel dizzy and off-balance even when the other symptoms caused by the infection have gone. This can be a sign that the balance organs were damaged. Your brain can usually learn to work with these changes, so your sense of balance should usually come back by itself. However, if youre struggling to cope or the problem persists, you should see an ENT specialist. The doctor can check for any underlying causes and may refer you for vestibular rehabilitation therapy to help you to recover your balance.
Inner ear infections can also have a longer term effect on your hearing. This is more likely if you had bacterial infection, so your doctor might recommend a hearing test to check on your ears after the infection.
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Study Extraction Categorization And Analysis
Articles were assessed for variables including study size, location, setting, main outcome measures , and conclusions. Data was subsequently extracted and compiled in an electronic data extraction form. In the event of uncertainty, two independent investigators discussed the relevant finding and determined an outcome based on consensus.
Causes Of Middle Ear Infections
Infections may be caused by a virus or bacteria. Viral infections will not respond to an antibiotic, and clear up without treatment.
Most middle ear infections occur when an infection such as a cold , leads to a build-up of mucus in the middle ear.
This causes the Eustachian tube to become swollen or blocked.
This means mucus can’t drain away properly. This makes it easier for an infection to spread into the middle ear.
An enlarged adenoid can also block the Eustachian tube. The adenoid can be removed if it causes persistent or frequent ear infections.
Younger children are particularly vulnerable to middle ear infections as:
- the Eustachian tube is smaller in children than in adults
- a child’s adenoids are much larger than an adults
Certain conditions can also increase the risk of middle ear infections, including:
- having a cleft palate a type of birth defect where a child has a split in the roof of their mouth
- having Down’s syndrome
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When Should I Go To The Doctor For An Ear Infection
While many ear infections can be treated at home, some need medical attention. Youll want to talk to a doctor or nurse if:
- Your baby has a fever, especially if they are younger than 3 months old, or if your older babys temperature is above 102 degrees Fahrenheit.
- The ear infection symptoms arent getting better after a couple of days.
- Theres fluid draining from the ear.
- You or your child is experiencing changes or loss of hearing.
- The infection has lasted for more than six weeks.
- You or your child is experiencing frequent or recurrent ear infections.
When To Seek Medical Advice
Most cases of otitis media pass within a few days, so there’s usually no need to see your GP.
However, see your GP if you or your child have:
- symptoms showing no sign of improvement after two or three days
- a discharge of pus or fluid from the ear some people develop a persistent and painless ear discharge that lasts for many months, known as chronic suppurative otitis media
- an underlying health condition, such as cystic fibrosis or congenital heart disease, which could make complications more likely
Read more about diagnosing middle ear infections
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What Are Recurrent Ear Infections
People of all ages can get frequent ear infections, but they are especially common in children about 25% of children experience repeat ear infections. If you or your child has three or more ear infections in a six-month period or four within one year, its a good idea to talk to your doctor about treatment options.
Are recurrent ear infections curable?
Your doctor may recommend ear tube surgery to make it less likely for you or your child to get future ear infections.
Your doctor may also suggest a tonsillectomy to remove infected tonsils and adenoids. This surgery involves removing lumps of tissue from the back of your nose and throat. Getting a tonsillectomy may make it easier for fluid to drain from your ears, reducing the chance of trapped fluid that can cause an ear infection. A tonsillectomy is usually only recommended when antibiotics and ear tubes dont work.
What Should I Do About An Ear Infection
If its only been a couple of days and the only symptom has been ear pain, you dont need to head to the doctor right away. Because many ear infections go away on their own, its likely your doctor will want to wait and see how the symptoms improve before providing prescription medicines.
In the meantime, focus on getting lots of rest. Sleeping strengthens the immune system and helps the body fight off infections and other sickness.
If the ear infection is causing pain or discomfort, there are treatments for ear infections you can try at home. One of the simplest is using a warm compress to dull the pain. Just soak a washcloth in warm water, wring out the excess water and then hold it against the infected ear for up to 20 minutes. If it helps, reapply the compress throughout the day.
If your child is over 3 months old, an over-the-counter medication like acetaminophen can also help with the pain just make sure youre using an age-appropriate dose. If you have questions, contact your doctor or nurse line.
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How Middle Ear Infections Are Treated
Make sure any painkillers you give to your child are appropriate for their age. Read more about giving your child painkillers.
Antibiotics aren’t routinely used to treat middle ear infections, although they may occasionally be prescribed if symptoms persist or are particularly severe.
Read more about treating middle ear infections
Infection From Another Area Of The Body
If an infection occurs somewhere else in the body, the infectious organisms can travel through the bloodstream, bypass the blood-brain barrier, and enter and infect the brain.
Between 9 and 43 percent of abscesses result from pathogens that traveled from another part of the body.
Many bacterial brain abscesses stem from a lesion somewhere else in the body. It is crucial to find that primary lesion, or there may be a repeat infection in the future.
A person with a weakened immune system has a higher risk of developing a brain abscess from a bloodborne infection.
A person may have a weakened immune system if they:
- are using long-term steroid medication
- have had an organ transplant and take immunosuppressant drugs to prevent organ rejection
The most common infections known to cause brain abscesses are:
- endocarditis, an infection of the heart valve
- pneumonia, bronchiectasis, and other lung infections and conditions
- abdominal infections, such as peritonitis, an inflammation of the inner wall of the abdomen and pelvis
- cystitis, or inflammation of the bladder, and other pelvic infections
Earaches And Ear Infections
Earaches and ear infections can have a variety of causesviral, bacterial and fungaland can affect different parts of the ear. Common infections include inner ear, middle ear and outer ear infections .
Ear infections also can be caused by scratching the ear canal when cleaning their ear, especially if a cotton-tipped applicator or dangerously sharp small object, such as a hair clip, is used. In other cases, a middle ear infection can cause an external infection to develop through the draining of pus into the ear canal through a hole in the eardrum.
Infections of the inner ear usually result from viral illnesses, such as influenza, and can cause vertigo , dizziness, nausea, imbalance, difficulty concentrating, tinnitus , reduced hearing and other symptoms. These symptoms also may be caused by head injuries, drug reactions, allergies, underlying medical disorders or aging. If you have these symptoms, you should see a physician evaluation to make the diagnosis and to begin appropriate treatment.
If the symptoms are caused by a virus, the infection usually improves on its own. However, a doctor may recommend taking prescription or over-the-counter anti-nausea medications or receiving an injection to control the symptoms. Recurrent symptoms may indicate Menieres disease, a disorder in which fluid builds up in the inner ear and causes vertigo and balance problems.
Symptoms of middle ear infections include:
Symptoms of swimmers ear include:
When Is An Ear Infection Considered To Be Chronic
If an ear infection lasts for more than three months, its considered chronic. If chronic ear infections arent treated, it can lead to hearing loss and other serious problems. In children, chronic ear infections can affect their ability to achieve developmental milestones, like walking and talking.
Is a chronic ear infection curable?
If your child has an ear infection for a few months and its affecting their ability to hear, your doctor may recommend a minor surgery to put in ear tubes for chronic ear infections.
During ear tube surgery, an ear, nose and throat doctor inserts small plastic or metal tubes into the eardrum. These tubes help drain the built-up fluid that can cause ear infections. Ear tubes usually fall out on their own within about a year.
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What Are The Symptoms Of A Middle
Common symptoms of a middle-ear infection in adults are:
Pain in 1 or both ears
Drainage from the ear
You may also have a fever. Rarely, your balance can be affected.
These symptoms may be the same as for other conditions. Its important totalk with your health care provider if you think you have a middle-earinfection. If you have a high fever, severe pain behind your ear, orparalysis in your face, see your provider as soon as you can.
How Is Mastoiditis Diagnosed
If you have symptoms of an ear infection, your doctor will examine your ears and head to determine if the infection has spread to your mastoid bone.
The mastoid bone is located in your inner ear and may not be visible due to the infection. Your doctor may perform other tests to confirm the diagnosis. These include:
- a white blood cell count to confirm the presence of an infection
- a CT scan of your ear and head
- an MRI scan of your ear and head
- an X-ray of your skull
If the tests confirm a diagnosis of mastoiditis, your doctor may also perform a lumbar puncture, or spinal tap. This test will allow your doctor to determine if the infection is present in your spinal column.
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Risk Factors For Ear Infections
Ear infections occur most commonly in young children because they have short and narrow Eustachian tubes. About of children develop an acute ear infection at some point.
Infants who are bottle-fed also have a higher incidence of ear infections than their breastfed counterparts.
Other factors that increase the risk of developing an ear infection are:
- altitude changes
- Take OTC decongestants like pseudoephedrine .
- Avoid sleeping on the affected ear.
Virtual Appointment With Your Primary Care Doctor
You can also schedule a virtual appointment with the doctor that usually cares for you or your child. Theyll have the best information about your familys health and what treatments may be appropriate. If necessary, your childs primary care doctor can prescribe antibiotics and recommend additional treatments.
Keep in mind that if its only been a couple days since the ear infection started, you may not get a prescription for antibiotics. Your doctor will likely recommend treating the ear infection with OTC pain relievers and scheduling another appointment after a week or so. Its also possible that the doctor may want to see you or your child in person.
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Causes Of A Brain Abscess
There are 3 main ways a brain abscess can develop. These are:
- an infection in another part of the skull such as an ear infection, sinusitis or dental abscess, which can spread directly into the brain
- an infection in another part of the body for example, the infection that causes pneumonia spreading into the brain via the blood
- trauma, such as a severe head injury that cracks open the skull, allowing bacteria or fungi to enter the brain
However, in some cases, the source of the infection remains unknown.
Read more about the causes of a brain abscess.
How Long Does An Ear Infection Last
In many cases, ear infections clear up in a couple of weeks without treatment. But some ear infections can last for months.
So why do some ear infections last longer than others? The reasons include your health, the location of the infection and whats causing the infection. Inner ear infections tend to stick around longer than infections of the middle or outer ear. And infections caused by bacteria usually last longer than ones caused by viruses.
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Symptoms Of Tooth Infection Spreading To The Brain
A dental abscess can also travel to the brain, leading to the development of another abscess. If the infection reaches your brain, it can be life-threatening.
Since a brain abscess is so dangerous, the condition requires a visit to the hospital or emergency room for urgent treatment. A brain abscess is relatively rare but can occur if the dental infection is left untreated.
Symptoms of a brain abscess :
- Going in and out of consciousness
Dental abscesses can lead to brain abscesses . This is why you should never leave them untreated. Vision changes and body weakness on one side are common with brain abscesses.