Ear infections in children

What is an ear infection?
There are 3 main types of ear infection: acute middle ear infection (acute otitis media or AOM), resolved ear infection with fluid in the middle ear (otitis media with effusion or OME), and infection of the external ear canal (otitis externa).

What causes ear infections?
Acute middle ear infection: Bacteria or viruses can cause acute middle ear infections, usually following a cold that is caused by a virus. The viruses that cause colds close off the tube that drains fluid between the middle ear and the throat (eustachian tube). The trapped fluid in the middle ear may contain bacteria that grow and multiply. The immune system sends infection-fighting cells (like white blood cells) to the middle ear to fight the bacteria, forming pus. This results in pressure and painful swelling of the middle ear tissues, and a red, bulging eardrum. Children with acute middle ear infections usually have fever and ear pain and may be irritable or at times inconsolable. Your doctor can diagnose the condition using an otoscope to look into the ear canal. The doctor sees a bulging, red eardrum that cannot move, and pus behind the eardrum. The preferred initial treatment is usually amoxicillin, an antibiotic that kills bacteria. When antibiotics are prescribed, it is important to finish the complete prescription to make sure all the bacteria are killed. The last few bacteria may be the most resistant to antibiotics, and can cause a worse infection next time.

Resolved ear infection with fluid in the middle ear: It is normal for fluid to remain in the middle ear for weeks after the bacteria that caused the acute ear infection are killed. This type of fluid behind the eardrum should not be treated with antibiotics. In this case, the antibiotics do no good, and can be harmful by selecting for tougher bacteria that they cannot kill.

Infection of the external ear canal: Drainage from the middle ear can occur from an infection of the external ear canal, or from a middle ear infection with a hole in the eardrum. Depending on the cause, the doctor may prescribe drops for the ear canal or antibiotics for the middle ear, or both. In older children, infection of the ear canal may result from swimming ("swimmers' ear").

Why does my child get so many ear infections?
Children get more ear infections than adults because the tube (called the eustachian tube) that connects the middle ear to the back of the throat is more likely to be closed. The eustachian tube of children is smaller and more horizontal than in adults, making fluid drain more slowly, and the muscles and cartilage that help the tube open and close are not as well developed.

Antibiotic-resistant bacteria may cause recurrent ear infections. Ear infections caused by bacteria that are antibiotic-resistant are harder to cure than ear infections caused by antibiotic-susceptible bacteria. Some recurrent ear infections require tubes in the eardrum to allow drainage of the middle ear. Children who have recently used antibiotics are at higher risk to develop resistant ear infections. This is one reason not to use antibiotics unless they are needed.

Posted on Wednesday, November 7, 2007 at 12:35AM by Registered CommenterAdministrator | CommentsPost a Comment