- Knowledgebase: Information on Specific Illnesses
- Here you will find discussions of specific illnesses and their management.
- 57. Ear Infection - Top
- Definition
A disorder involving inflammation and/or infection of the structures of the middle ear.
Causes, Incidence and Risk Factors
Inflammation of the ear (sterile otitis or serous otitis) may occur when there is a collection of sterile fluid in the ear. This may be caused by overproduction of fluid by the structures in the middle ear. It may also be caused by blockage of the eustachian tube (the connection between the middle ear and the back of the nose/upper throat). The presence of excess fluid causes the ear to become irritated and inflamed.
Acute otitis media (acute ear infection) occurs when there is bacterial or viral infection of the fluid of the middle ear, which causes production of fluid or pus. This may be accompanied by bleeding in the middle ear.
Pressure from fluids associated with ear infection may cause the eardrum to rupture. Conversely, a ruptured eardrum can result in ear infection by allowing bacteria or viruses direct entry to the middle ear. Ear infections are most common following respiratory infections, or if the sinuses or eustachian tube are blocked from allergies or enlarged adenoids.
Ear infections occur in approximately 3 out of every 100 people. They may affect anyone but are more common in children because their eustachian tubes are shorter, narrower, and more horizontal than in adults.
Risk factors include recent illness of any type (which lowers resistance of the body to infection), crowded or unsanitary living conditions, genetic factors (susceptibility of the ear to infection may run in families), high altitude, cold climate, and bottle feeding of infants allowing fluid to pool in the throat near the eustachian tube.
Symptoms
ear discomfort or pain
earache may be severe
fullness, pressure in the ear
in children, pulling at the ear
drainage from the ear
hearing loss in the affected ear
fever
chills
irritability
feeling of general illness
nausea, vomiting
diarrhea
Note: Symptoms may occur spontaneously, or after a cold or other upper respiratory infection.
Additional symptoms that may be associated with this disease:
throat, sore
neck pain
nasal discharge
nasal congestion
joint pain
headache
ear noise or buzzing
Signs And Tests
An ear inspection may show dullness, redness, air bubbles, or fluid behind the eardrum. The eardrum may bulge out or retract inward, or it may show openings (perforation). An examination and culture of fluid may show blood, pus, and bacteria.
Treatment
The goal of treatment is cure of the infection.
Nasal sprays, nose drops, oral decongestants, or, occasionally, oral antihistamines may be used to promote drainage of fluid through the eustachian tube.
Ear drops may be prescribed to relieve pain. Over-the-counter antipyretic and analgesic medications (such as acetaminophen - oral) may be used to reduce fever and discomfort. Aspirin should not be given to children during a viral upper respiratory infection because this has been linked with Reye's syndrome. Antibiotics may be prescribed if infection is present and the infection appears bacterial rather than viral. Oral corticosteroids may occasionally be prescribed to reduce inflammation. Warmth to the ears (using warm cloths or warm water bottles, for example) may relieve pain.
Keep the ears clean and dry to reduce the risk of reinfection.
Myringotomy (surgical cutting of the eardrum) may occasionally be needed to relieve pressure and allow drainage. This may or may not also involve placement of drainage tubes in the ear. Surgery to remove the adenoids may prevent them from blocking the eustachian tube.
Expectations (Prognosis)
Otitis media is curable with treatment but may recur. It is not life threatening but may be quite painful.
Complications
ruptured or perforated eardrum
chronic ear infection
loss of hearing, temporary or permanent
enlarged adenoids
mastoiditis
meningitis
- Updated: March 5, 2001
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