Ear infections

Ear infections are a common ailment, especially in children, and are caused by bacteria or viruses. While ear infections often clear up on their own, some require medical treatment to manage pain and prevent complications. 

Common causes

Ear infections are typically classified by their location: outer, middle, or inner ear. Each has different causes. 

  • Middle ear infections (Otitis Media): The most common type, often starts after a cold, flu, or allergy flares up. The illness causes swelling and blockage of the Eustachian tubes, which connect the middle ear to the back of the throat. This blockage prevents fluid drainage, allowing germs to grow behind the eardrum.

    • In children, Eustachian tubes are narrower and more level, making them more prone to blockages.

    • Swollen adenoids, which are near the Eustachian tubes, can also block drainage and cause infections.

  • Outer ear infections (Otitis Externa): Also known as "swimmer's ear," this infection of the ear canal is caused by bacteria or fungi that thrive in moist environments. It can result from water trapped in the ear after swimming or showering.

  • Inner ear infections (Labyrinthitis): Less common, this infection is typically caused by a viral illness and affects balance and hearing. 

Signs and symptoms

Symptoms vary depending on the type of infection and the patient's age. 

In adults:

  • Ear pain or a feeling of pressure.

  • Fluid or pus draining from the ear.

  • Reduced hearing.

  • Inner ear infections can also cause dizziness, vertigo, and nausea. 

In children:

  • Ear pain, especially when lying down.

  • Tugging or pulling at the ear.

  • Fussiness, irritability, and crying more than usual.

  • Difficulty sleeping or eating.

  • Fever, particularly in infants and young children.

  • Fluid draining from the ear.

  • Loss of balance.

  • Not reacting to sounds as they normally would. 

Diagnosis

A doctor can diagnose an ear infection with a simple physical exam. 

  • Physical exam: Using a lighted tool called an otoscope, the doctor can look inside the ear. Redness, bulging, or dullness of the eardrum can indicate an infection or fluid buildup.

  • Pneumatic otoscope: This tool puffs a bit of air into the ear. If the middle ear is filled with fluid, the eardrum will move very little or not at all.

  • Specialized tests: For persistent issues, a doctor might order a tympanometry test to measure eardrum movement or an acoustic reflectometry test to measure fluid. 

Treatment

Treatment options depend on the type of ear infection and its severity. Many middle ear infections, especially in older children and adults, can resolve on their own. 

  • Observation: For mild middle ear infections without severe symptoms, a doctor may recommend "watchful waiting" for 48–72 hours to see if it improves on its own.

  • Pain management: Over-the-counter pain relievers like acetaminophen or ibuprofen can help relieve fever and pain. Applying a warm compress to the ear may also provide relief.

  • Antibiotics: These are used for severe or persistent bacterial infections. They can be prescribed as oral medication or antibiotic ear drops. It is important to finish the entire course of medication, even if symptoms improve.

  • Ear tubes: For children with frequent ear infections or chronic fluid buildup, a specialist may recommend surgically placing small tubes in the eardrums. These tubes help drain fluid and equalize pressure.

  • Home care: Keeping the ears clean and dry, especially for outer ear infections, is key. Using a hairdryer on a low, cool setting to dry the ear after showering or swimming can help. 



 

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