Summary about Disease
Otitis media is an infection of the middle ear, the space behind the eardrum that contains tiny vibrating bones. It's common in children but can affect adults too. The infection often results from a bacterial or viral infection affecting the middle ear.
Symptoms
Ear pain (especially when lying down)
Tugging or pulling at an ear (in young children)
Difficulty sleeping
Crying more than usual
Difficulty hearing or responding to sounds
Loss of balance
Fever
Fluid draining from the ear
Headache
Loss of appetite
Causes
Otitis media is often caused by:
Bacterial infections: Common bacteria include Streptococcus pneumoniae and *Haemophilus influenzae*.
Viral infections: Viruses that cause colds and the flu.
Eustachian tube dysfunction: The Eustachian tube, which connects the middle ear to the back of the throat, can become blocked due to colds, allergies, or enlarged adenoids. This blockage prevents fluid from draining from the middle ear, leading to infection.
Medicine Used
Antibiotics: Amoxicillin is often the first-line treatment. Other antibiotics may be used if amoxicillin is ineffective or if the individual has allergies. (e.g., Azithromycin, Cephalosporins).
Pain relievers: Over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help reduce pain and fever.
Decongestants: To help clear congestion, but their effectiveness is debated.
Ear drops: For pain relief (e.g., numbing drops)
Is Communicable
Otitis media itself is not directly communicable. However, the *viruses or bacteria* that cause the upper respiratory infections which lead to otitis media are communicable. So, a cold or flu, which then causes an ear infection, can be spread to others.
Precautions
Frequent handwashing: To prevent the spread of germs.
Avoid exposure to cigarette smoke: Smoke irritates the respiratory system and can increase the risk of ear infections.
Vaccinations: Getting vaccinated against the flu and pneumococcal disease can help prevent upper respiratory infections that can lead to otitis media.
Breastfeeding: Breastfeeding infants for at least six months provides antibodies that can help protect against infections.
Proper bottle feeding: Hold infants upright during bottle feeding to prevent milk from flowing back into the Eustachian tubes.
Manage allergies: Properly managing allergies can help prevent Eustachian tube blockage.
How long does an outbreak last?
An acute otitis media infection typically lasts for a few days to a week with proper treatment. Symptoms usually improve within the first 48-72 hours of antibiotic treatment, if prescribed. Some cases can become chronic, meaning the infection persists or recurs frequently.
How is it diagnosed?
Otoscopy: A doctor uses an otoscope, a lighted instrument, to examine the eardrum. Signs of infection include redness, swelling, fluid behind the eardrum, and a bulging eardrum.
Pneumatic otoscopy: This involves using an otoscope to puff air into the ear canal. Normally, the eardrum will move; limited or no movement suggests fluid in the middle ear.
Tympanometry: This test measures the movement of the eardrum and can detect fluid in the middle ear.
Acoustic reflectometry: This test measures how much sound is reflected back from the eardrum.
In rare cases: A tympanocentesis, where a small sample of fluid is drained from the middle ear for culture.
Timeline of Symptoms
Initial Stage (1-2 days): Cold-like symptoms (runny nose, congestion, sore throat), mild ear discomfort.
Acute Stage (2-7 days): Increasing ear pain, potential fever, possible drainage from the ear, hearing difficulties.
Resolution Stage (Following treatment): Pain and fever subside within 24-72 hours of antibiotic treatment, hearing gradually returns to normal as fluid clears.
Important Considerations
Recurrent Infections: Frequent ear infections can lead to hearing problems or speech delays in children.
Antibiotic Resistance: Overuse of antibiotics can contribute to antibiotic resistance.
Complications: Untreated ear infections can, in rare cases, lead to more serious complications, such as mastoiditis (infection of the mastoid bone), meningitis (infection of the membranes surrounding the brain and spinal cord), or hearing loss.
Myringotomy and Ear Tubes: For recurrent ear infections, a doctor may recommend a myringotomy (a small incision in the eardrum to drain fluid) and the insertion of ear tubes (tympanostomy tubes) to prevent fluid buildup and allow ventilation.