Ear infection is inflammation of the ear, and it occurs especially often in children. Three out of four children have at least one episode by their third birthday. It is useful for parents to know how to recognize the illness and when a doctor is needed.
What ear infection is and why it often occurs in children
Most often the infection affects the middle ear — this condition is called otitis media. The middle ear cavity is connected to the nasopharynx by the Eustachian tube, and it is through this tube that the infection travels upward.
Acute otitis media is usually preceded by a respiratory infection. The virus disrupts the protective and transport function of the mucous membrane of the auditory tube, and pathogenic flora enters the tympanic cavity. The tubal route is the main one; hematogenous and transtympanic routes are less common.
Types of ear infection: external, middle, internal
Otitis externa affects the ear canal — the tube between the auricle and the tympanic membrane. It is caused by irritants such as eczema, water, or earplugs, as well as fungal or bacterial infection; both children and adults are affected.
Otitis media affects the area behind the tympanic membrane and usually occurs in children. Internal ear infection affects the labyrinth and vestibular system, can lead to labyrinthitis, and occurs in people of any age.
Main symptoms of ear infection in a child
Symptoms start quickly: pain inside the ear, high temperature, difficulty hearing, discharge from the ear, a feeling of pressure or fullness. Itching and irritation, peeling of the skin around the ear, are possible.
A baby who does not yet speak pulls or tugs at the ear, does not respond to some sounds, is restless, eats worse, and loses balance. Most episodes resolve within three days; sometimes symptoms persist for up to a week.
- Pain and pressure in the ear
- High temperature
- Discharge from the ear
- Hearing deterioration
- Restlessness and loss of balance in babies
Purulent ear infection in children: signs
The inflammatory process in the middle ear is, as a rule, purulent. Purulent exudate fills the air-containing spaces, limits the mobility of the auditory ossicles, and presses on the tympanic membrane.
When the membrane perforates, otorrhea appears — discharge from the ear — and the pain may ease. The appearance of bloody discharge is possible if the membrane ruptures.
How ear infection is diagnosed
The doctor examines the ear with an otoscope — a device with a lamp and a magnifying glass. Some otoscopes deliver a small puff of air to check patency and signs of effusion.
The diagnosis of acute otitis media is made based on the clinical picture: pain began within 48 hours, the membrane bulges, and children have signs of fluid on pneumatic otoscopy. Culture of ear discharge, except for fluid from myringotomy, is usually not done.
Possible complications and when to see a doctor
Acute ear infection with inadequate treatment sometimes becomes chronic. Among the forms of chronic otitis media, mesotympanitis, epitympanitis, and mesoepitympanitis are distinguished. Children with frequent infections sometimes need surgery — placement of tubes in the ears.
A child under 12 months with suspected ear infection is examined by a doctor; examination is also needed if the pain does not resolve within three days or infections recur. Urgent consultation is needed for very high temperature, swelling around the ear, discharge, hearing deterioration, nausea, vomiting, or dizziness.
Ear inflammation by itself is not a reason to call an ambulance; 103 or 112 — if the child's condition rapidly worsens and is life-threatening.
The material is for reference: it helps to recognize the picture but does not replace consultation with a doctor.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer