Acute otitis media
Acute otitis media is commonly referred to as an ear infection. It is a
bacterial infection that causes inflammation of the membrane lining the middle
ear space. Redness of the eardrum and pain typically occurs. The middle ear
usually fills with fluid, which develops because of the inflammation of the
membrane lining the middle ear space.
The symptoms of acute otitis media
The most common symptoms of an acute ear infection in older
children is pain with or without fever. Younger children are often irritable and
therefore may have decreased appetite, worsening in their behavior and/or
inability to sleep through the night. Some children may tug at their ears. Fever
may or may not be present. Sometimes hearing and/or balance problems may occur.
Complications that can occur
An acute ear infection can cause serious complications,
which are much less likely to occur if the child has been appropriately treated
with an antibiotic. Complications include: Spread of infection to cause
mastoiditis, epidural abscess (pus inside the cranium, but outside the coverings
of the brain), abscess within the brain, meningitis, neck abscess, facial nerve
paralysis, permanent hearing loss and vertigo.
Treatment
We recommend that an acute ear infection always be treated
with an appropriate antibiotic in order to minimize the chance of a complication
occurring. Without antibiotic treatment, the body often does overcome the
infection. However, the likelihood of a complication occurring increases without
antibiotic treatment. Significant complications and even mortality were not
uncommon before antibiotics were readily available in the 1940s.
If a child does not respond to an antibiotic within the first 24 to 48 hours,
this medication may need to be changed. If a child remains in severe pain or
there are concerns about complications, the eardrum may need to be lanced in
order to drain out the pus within the middle ear space.
If your child has frequent episodes of acute ear infections, placement of
tubes is an important treatment option. This surgical procedure may be
recommended for your child depending on some of the following factors:
- Frequency of ear infections
- History of complications secondary to ear infections
- History of underlying permanent hearing loss
- History of speech problems
- Poor tolerance of or multiple allergies to antibiotics
- Degree and persistence of irritability