Otitis media (patient information): Difference between revisions

	Otitis media (Ear Infection)
Overview
What are the symptoms?
What are the causes?
Who is at highest risk?
When to seek urgent medical care?
Diagnosis
Treatment options
Where to find medical care for Otitis media?
What to expect (Outlook/Prognosis)?
Possible complications
Prevention
Otitis media On the Web
Ongoing Trials at Clinical Trials.gov
Images of Otitis media
Videos on Otitis media
FDA on Otitis media
CDC on Otitis media
Otitis media in the news
Blogs on Otitis media
Directions to Hospitals Treating Otitis media
Risk calculators and risk factors for Otitis media

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Latest revision as of 23:30, 29 July 2020

For the WikiDoc page for this topic, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Meagan E. Doherty; Luke Rusowicz-Orazem, B.S.

Overview

Otitis media, commonly known as an ear infection, is an infection or inflammation of the middle ear. This inflammation often begins when infections that cause sore throats, colds, or other respiratory or breathing problems spread to the middle ear. These can be viral or bacterial infections. Seventy-five percent of children experience at least one episode of otitis media by their third birthday. Almost half of these children will have three or more ear infections during their first 3 years. It is estimated that medical costs and lost wages because of otitis media amount to $5 billion a year in the United States. Although otitis media is primarily a disease of infants and young children, it can also affect adults.

What are the symptoms of otitis media?

Otitis media is often difficult to detect because most children affected by this disorder do not yet have sufficient speech and language skills to tell someone what is bothering them. Common signs to look for are:

Ear pain
Unusual irritability
Difficulty sleeping
Tugging or pulling at one or both ears
Fever
Fluid draining from the ear
Loss of balance
Unresponsiveness to quiet sounds or other signs of hearing difficulty such as sitting too close to the television or being inattentive
Clumsiness and poor balance
Common cold symptoms

What causes Otitis media?

Anything that causes the eustachian tubes in the middle ear to become swollen or blocked causes more fluids to build up in the middle ear behind the eardrum. These causes include:

Allergies
Colds and sinus infections
Excess mucus and saliva produced during teething
Infected or overgrown adenoids
Tobacco smoke or other irritants

Risk factors for ear infections include the following:

Attending daycare (especially those with more than 6 children)
Changes in altitude or climate
Cold climate
Exposure to smoke
Genetic factors (susceptibility to infection may run in families)
Not being breastfed
Pacifier use
Recent ear infection
Recent illness of any type (lowers resistance of the body to infection)

Who is at highest risk?

Infants and young children are especially susceptible to ear infections:
- Immune systems are not fully developed.
- Smaller and straighter eustachian tubes are more prone to clogging.
- Larger adenoids interfering with eustachian tube openings.
- Close proximity with other infants and young children in settings such as schools or daycares, etc.
Those with consistent exposure to air pollution, such as secondhand smoke.

Diagnosis

The simplest way to detect an active infection in the middle ear is to look in the child's ear with an otoscope, a light instrument that allows the physician to examine the outer ear and the eardrum.
- Inflammation of the eardrum indicates an infection.
There are several ways that a physician checks for middle ear fluid:
- The use of a special type of otoscope called a pneumatic otoscope allows the physician to blow a puff of air onto the eardrum to test eardrum movement.
  - An eardrum with fluid behind it does not move as well as an eardrum with air behind it.
- Tympanometry is a test requiring insertion of a small soft plug into the opening of the child's ear canal, providing information indicative of hearing loss from middle ear congestion.

When to seek urgent medical care?

Call your child's doctor if:

Pain, fever, or irritability do not improve within 24 to 48 hours
At the start, the child seems sicker than just an ear infection
Your child has a high fever or severe pain
Severe pain suddenly stops hurting -- this may indicate a ruptured eardrum
Symptoms worsen
New symptoms appear, especially severe headache, dizziness, swelling around the ear, or twitching of the face muscles

For a child younger than 6 months, let the doctor know right away if the child has a fever, even if no other symptoms are present.

Treatment options

Many physicians recommend the use of an antibiotics when there is an active middle ear infection to kill the causative bacteria.
- Once started, the antibiotic should be taken until it is finished. Most physicians will have the child return for a followup examination to see if the infection has cleared.
- Several different antibiotics may have to be tried before an ear infection clears due to possibility of the bacteria developing resistance to the antibiotics.
If a child is experiencing pain, the physician may also recommend a pain reliever, such as tylenol.
Following the physician's instructions is very important. Once started, the antibiotic should be taken until it is finished. Most physicians will have the child return for a followup examination to see if the infection has cleared.
A surgical procedure called a myringotomy may be performed in children where middle ear fluid buildup persists for longer than 3 months.
- While the child is asleep under general anesthesia, the surgeon makes a small opening in the child's eardrum.
- A small metal or plastic tube is placed into the opening in the eardrum, ventilating the middle ear and helps keep the air pressure in the middle ear equal to the air pressure in the environment.
- The tube normally stays in the eardrum for 6 to 12 months, after which it usually comes out spontaneously.
- Some children may need to have the operation again if the otitis media returns after the tubes come out.

Where to find medical care for Otitis media?

Directions to Hospitals Treating Otitis media

Prevention

Prevention of otitis media is contingent upon preventing exposure to the cause, including the following:
- Bacteria and viruses responsible for middle ear infection, such as common cold.
  - Vaccinations include pneumococcal and influenza.
- Washing hands frequently.
- Avoiding common cold patients.
- Limiting child enrollment in daycare.
- Avoiding pacifiers for infants.
- Limiting exposure to air pollution, such as secondhand smoke.
- Breastfeeding infants up to 6 months old to help develop their immune systems.
- Antibiotic regimens for children that have high risk for otitis media.

What to expect (Outlook/Prognosis)?

Otitis media's prognosis is usually good without treatment.
- Otitis media from infection will usually go away naturally within two weeks.
- Otitis media from non-infectious causes with fluid buildup will usually go away naturally within 3 months.
Complications from otitis media, including meningitis and mastoiditis (infections of the brain and bones around the skull, respectively) can lead to poor prognosis without treatment.
Untreated otitis media may lead to permanent hearing impairment due to persistent fluid in the middle ear reducing a child's hearing.
- Children who have early hearing impairment from frequent ear infections are likely to have speech and language disabilities.

Possible complications

Complications include spread of infection outside of the middle ear
- Mastoiditis
- Meningitis
Other potential complications include the following:
- Ruptured or perforated eardrum.
- Chronic, recurrent ear infections.
- Enlarged adenoids or tonsils.
- Formation of an abscess or a cyst (called cholesteatoma) from chronic, recurrent ear infections.
- Speech or language delay in a child who suffers lasting hearing loss from multiple, recurrent ear infections.

Sources

http://www.nlm.nih.gov/medlineplus/earinfections.html Template:WH Template:WS

@@ Line 1: / Line 1: @@
+__NOTOC__
+{{Otitis media (patient information)}}
 '''For the WikiDoc page for this topic, click [[Otitis media|here]]'''
-{{SI}}
-'''Editor-in-Chief:''' Meagan E. Doherty
-{{EJ}}
+{{CMG}}; {{AE}} Meagan E. Doherty; {{LRO}}
-==What is Otitis media?==
+==Overview==
-Otitis media is an infection or inflammation of the middle ear. This inflammation often begins when infections that cause sore throats, colds, or other respiratory or breathing problems spread to the middle ear. These can be viral or bacterial infections. Seventy-five percent of children experience at least one episode of otitis media by their third birthday. Almost half of these children will have three or more ear infections during their first 3 years. It is estimated that medical costs and lost wages because of otitis media amount to $5 billion* a year in the United States. Although otitis media is primarily a disease of infants and young children, it can also affect adults.
+Otitis media, commonly known as an ear [[infection]], is an [[infection]] or [[inflammation]] of the middle ear. This inflammation often begins when infections that cause sore throats, colds, or other respiratory or breathing problems spread to the [[middle ear]]. These can be [[viral]] or [[bacterial]] infections. Seventy-five percent of children experience at least one episode of otitis media by their third birthday. Almost half of these children will have three or more ear infections during their first 3 years. It is estimated that medical costs and lost wages because of otitis media amount to $5 billion a year in the United States. Although otitis media is primarily a disease of infants and young children, it can also affect adults.
 ==What are the symptoms of otitis media?==
 Otitis media is often difficult to detect because most children affected by this disorder do not yet have sufficient speech and language skills to tell someone what is bothering them. Common signs to look for are:
-* unusual irritability
+*[[Ear pain]]
-* difficulty sleeping
+*Unusual [[irritability]]
-* tugging or pulling at one or both ears
+*Difficulty [[sleep]]ing
-* fever
+*Tugging or pulling at one or both ears
-* fluid draining from the ear
+*[[Fever]]
-* loss of balance
+*Fluid draining from the ear
-* unresponsiveness to quiet sounds or other signs of hearing difficulty such as sitting too close to the television or being inattentive
+*[[Loss of balance]]
+*Unresponsiveness to quiet sounds or other signs of hearing difficulty such as sitting too close to the television or being inattentive
+*Clumsiness and poor balance
+*[[Common cold]] symptoms
-==Who is at risk for yourdisease?==
+==What causes Otitis media?==
+Anything that causes the [[Eustachian tube|eustachian tubes]] in the [[middle ear]] to become swollen or blocked causes more fluids to build up in the middle ear behind the eardrum. These causes include:
+* [[Allergies]]
+* [[Common cold|Colds]] and [[Sinus infection|sinus infections]]
+* Excess mucus and saliva produced during teething
+* Infected or overgrown [[adenoids]]
+* Tobacco smoke or other irritants
-==How to know you have Otitis media (Diagnosis)?==
+Risk factors for ear infections include the following:
-The simplest way to detect an active infection in the middle ear is to look in the child's ear with an otoscope, a lightinstrument that allows the physician to examine the outer earand the eardrum. Inflammation of the eardrum indicates aninfection. There are several ways that a physician checks for middle ear fluid. The use of a special type of otoscopecalled a pneumatic otoscope allows the physician to blow a puff of air onto the eardrum to test eardrum movement. (An eardrum with fluid behind it does not move as well as an eardrum with air behind it.)
+* Attending daycare (especially those with more than 6 children)
+* Changes in altitude or climate
+* Cold climate
+* Exposure to smoke
+* Genetic factors (susceptibility to infection may run in families)
+* Not being breastfed
+* Pacifier use
+* Recent ear infection
+* Recent illness of any type (lowers resistance of the body to infection)
-A useful test of middle ear function is called tympanometry. This test requires insertion of a small soft plug into the opening of the child's ear canal. The plug contains a speaker, a microphone, and a device that is able to change the air pressure in the ear canal, allowing for several measures of the middle ear. The child feels air pressure changes in the ear or hears a few brief tones. While this test provides information on the condition of the middle ear, it does not determine how well the child hears. A physician may suggest a hearing test for a child who has frequent ear infections to determine the extent of hearing loss. The hearing test is usually performed by an audiologist, a person who is specially trained to measure hearing.
+==Who is at highest risk?==
+*Infants and young children are especially susceptible to [[ear infections]]:
+**Immune systems are not fully developed.
+**Smaller and straighter [[Eustachian tube|eustachian tubes]] are more prone to clogging.
+**Larger [[adenoids]] interfering with [[eustachian tube]] openings.
+**Close proximity with other infants and young children in settings such as schools or daycares, etc.
+*Those with consistent exposure to air pollution, such as secondhand smoke.
-==When to seek urgent medical care==
+==Diagnosis==
+*The simplest way to detect an active infection in the middle ear is to look in the child's ear with an [[otoscope]], a light instrument that allows the physician to examine the [[outer ear]] and the [[eardrum]].
+**Inflammation of the eardrum indicates an infection.
+*There are several ways that a physician checks for middle ear fluid:
+**The use of a special type of otoscope called a pneumatic otoscope allows the physician to blow a puff of air onto the eardrum to test eardrum movement.
+***An eardrum with fluid behind it does not move as well as an eardrum with air behind it.
+**[[Tympanometry]] is a test requiring insertion of a small soft plug into the opening of the child's ear canal, providing information indicative of hearing loss from middle ear congestion.
-==Treatment options==
+==When to seek urgent medical care?==
-Many physicians recommend the use of an antibiotic (a drug that kills bacteria) when there is an active middle ear infection. If a child is experiencing pain, the physician may also recommend a pain reliever. Following the physician's instructions is very important. Once started, the antibiotic should be taken until it is finished. Most physicians will have the child return for a followup examination to see if the infection has cleared.
+Call your child's doctor if:
-Unfortunately, there are many bacteria that can cause otitis media, and some have become resistant to some antibiotics. This happens when antibiotics are given for coughs, colds, flu, or viral infections where antibiotic treatment is not useful. When bacteria become resistant to antibiotics, those treatments are then less effective against infections. This means that several different antibiotics may have to be tried before an ear infection clears. Antibiotics may also produce unwanted side effects such as nausea, diarrhea, and rashes.**
+*[[Pain]], [[fever]], or [[irritability]] do not improve within 24 to 48 hours
+*At the start, the child seems sicker than just an ear infection
+*Your child has a high fever or severe pain
+*Severe pain suddenly stops hurting -- this may indicate a ruptured eardrum
+*Symptoms worsen
+*New symptoms appear, especially severe [[headache]], [[dizziness]], [[swelling]] around the ear, or twitching of the face muscles
-Once the infection clears, fluid may remain in the middle ear for several months. Middle ear fluid that is not infected often disappears after 3 to 6 weeks. Neither antihistamines nor decongestants are recommended as helpful in the treatment of otitis media at any stage in the disease process. Sometimes physicians will treat the child with an antibiotic to hasten the elimination of the fluid. If the fluid persists for more than 3 months and is associated with a loss of hearing, many physicians suggest the insertion of "tubes" in the affected ears. This operation, called a myringotomy, can usually be done on an outpatient basis by a surgeon, who is usually an otolaryngologist (a physician who specializes in the ears, nose, and throat). While the child is asleep under general anesthesia, the surgeon makes a small opening in the child's eardrum. A small metal or plastic tube is placed into the opening in the eardrum. The tube ventilates the middle ear and helps keep the air pressure in the middle ear equal to the air pressure in the environment. The tube normally stays in the eardrum for 6 to 12 months, after which time it usually comes out spontaneously. If a child has enlarged or infected adenoids, the surgeon may recommend removal of the adenoids at the same time the ear tubes are inserted. Removal of the adenoids has been shown to reduce episodes of otitis media in some children, but not those who are under 4 years of age. Research, however, has shown that removal of a child's tonsils does not reduce occurrences of otitis media. Tonsillotomy and adenoidectomy may be appropriate for reasons other than middle ear fluid.
+For a child younger than 6 months, let the doctor know right away if the child has a [[fever]], even if no other symptoms are present.
-Hearing should be fully restored once the fluid is removed. Some children may need to have the operation again if the otitis media returns after the tubes come out. While the tubes are in place, water should be kept out of the ears. Many physicians recommend that a child with tubes wear special ear plugs while swimming or bathing so that water does not enter the middle ear.
+==Treatment options==
+*Many physicians recommend the use of an [[antibiotics]] when there is an active middle ear infection to kill the causative [[bacteria]].
+**Once started, the antibiotic should be taken until it is finished. Most physicians will have the child return for a followup examination to see if the infection has cleared.
+**Several different antibiotics may have to be tried before an ear infection clears due to possibility of the bacteria developing resistance to the antibiotics.
+*If a child is experiencing pain, the physician may also recommend a pain reliever, such as [[tylenol]].
+*Following the physician's instructions is very important. Once started, the antibiotic should be taken until it is finished. Most physicians will have the child return for a followup examination to see if the infection has cleared.
+*A surgical procedure called a [[myringotomy]] may be performed in children where middle ear fluid buildup persists for longer than 3 months.
+**While the child is asleep under general anesthesia, the surgeon makes a small opening in the child's eardrum.
+**A small metal or plastic tube is placed into the opening in the eardrum, ventilating the middle ear and helps keep the air pressure in the middle ear equal to the air pressure in the environment.
+**The tube normally stays in the eardrum for 6 to 12 months, after which it usually comes out spontaneously.
+**Some children may need to have the operation again if the otitis media returns after the tubes come out.
-==Diseases with similar symptoms==
+==Where to find medical care for Otitis media?==
+[http://maps.google.com/maps?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|map+top+hospital+Otitis media}}}}&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&um=1&ie=UTF-8&sa=N&hl=en&tab=wl Directions to Hospitals Treating Otitis media]
-==Where to find medical care for yourdisease==
+==Prevention==
-[http://maps.google.com/maps?f=q&amp;hl=en&amp;geocode=&amp;q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|yourdisease}}}}&amp;sll=37.0625,-95.677068&amp;sspn=65.008093,112.148438&amp;ie=UTF8&amp;ll=37.0625,-95.677068&amp;spn=91.690419,149.414063&amp;z=2&amp;source=embed Directions to Hospitals Treating Otitis media]
+*Prevention of otitis media is contingent upon preventing exposure to the cause, including the following:
+**[[Bacteria]] and [[viruses]] responsible for [[middle ear infection]], such as [[common cold]].
+***Vaccinations include ''[[pneumococcal]]'' and [[influenza]].
+**Washing hands frequently.
+**Avoiding [[common cold]] patients.
+**Limiting child enrollment in daycare.
+**Avoiding pacifiers for infants.
+**Limiting exposure to air pollution, such as secondhand smoke.
+**Breastfeeding infants up to 6 months old to help develop their immune systems.
+**Antibiotic regimens for children that have high risk for otitis media.
-==Prevention of Otitis media==
+==What to expect (Outlook/Prognosis)?==
-Specific prevention strategies applicable to all infants and children such as immunization against viral respiratory infections or specifically against the bacteria that cause otitis media are not currently available. Nevertheless, it is known that children who are cared for in group settings, as well as children who live with adults who smoke cigarettes, have more ear infections. Therefore, a child who is prone to otitis media should avoid contact with sick playmates and environmental tobacco smoke. Infants who nurse from a bottle while lying down also appear to develop otitis media more frequently. Children who have been breast-fed often have fewer episodes of otitis media. Research has shown that cold and allergy medications such as antihistamines and decongestants are not helpful in preventing ear infections. The best hope for avoiding ear infections is the development of vaccines against the bacteria that most often cause otitis media. Scientists are currently developing vaccines that show promise in preventing otitis media. Additional clinical research must be completed to ensure their effectiveness and safety.
+*Otitis media's prognosis is usually good without treatment.
+**Otitis media from infection will usually go away naturally within two weeks.
+**Otitis media from non-infectious causes with fluid buildup will usually go away naturally within 3 months.
+*Complications from otitis media, including [[meningitis]] and [[mastoiditis]] (infections of the brain and bones around the skull, respectively) can lead to poor prognosis without treatment.
+*Untreated otitis media may lead to permanent hearing impairment due to persistent fluid in the middle ear reducing a child's hearing.
+**Children who have early hearing impairment from frequent ear infections are likely to have speech and language disabilities.
-==What to expect (Outlook/Prognosis)==
+==Possible complications==
+*Complications include spread of infection outside of the middle ear
+**[[Mastoiditis]]
+**[[Meningitis]]
+*Other potential complications include the following:
+**Ruptured or perforated eardrum.
+**Chronic, recurrent ear infections.
+**Enlarged [[adenoid]]s or [[tonsil]]s.
+**Formation of an [[abscess]] or a [[cyst]] (called [[cholesteatoma]]) from chronic, recurrent ear infections.
+**Speech or language delay in a child who suffers lasting hearing loss from multiple, recurrent ear infections.
 ==Sources==
+http://www.nlm.nih.gov/medlineplus/earinfections.html
+{{WH}}
+{{WS}}
+[[Category:Patient information]]
+[[Category:Pediatrics]]
+[[Category:Otolaryngology]]
+[[Category:Inflammations]]
+[[Category:Otology]]
+[[Category:Disease]]
-{{SIB}}
-[[Category:Patient Information]] {{WH}} {{WS}}