Kids MD - Ear Infection (ER Story)

Robert Seith | CWK Network

"The symptoms are fever, pain in the ear, crying, fussiness, maybe some vomiting and certainly some pulling at the ear."
- Dr. Kathleen Nelson, emergency room pediatrician -

Ten-month-old Jahiem has had a runny nose, a cough and a fever. He has a cold. "OK, I'm going to listen to him and then look in his ears," says Dr. Kathleen Nelson, emergency room pediatrician.

He's not crazy about the stethoscope. He reacts with a look of confusion when he feels it on his back. But it's the otoscope Dr. Nelson uses to look in his ear that causes Jahiem to cry loudly. Dr. Nelson has discovered the problem. "OK. Well, this side I think he's got a big glob of was there, but he definitely has an ear infection on this (left) side."

The infection had caused pus to build up inside his ear. "His eardrum was bulging and was immobile. When I tried to squeeze some air into my otoscope to see if the eardrum will flutter, which it does normally … I got no movement of the eardrum," says Dr. Nelson.

Dr. Nelson says a cold often leads to an ear infection in young children. The reason: The tubes that drain fluid from the ear are underdeveloped and during a cold, glands swell and put pressure on the tubes, making it harder for the ears to drain. "That allows for fluid to build up in the middle ear, and it allows germs to grow there. It's like a stagnant pond, and it's a good culture media for bacteria," says Dr. Nelson.

Today, doctors are less likely to use antibiotics to treat ear infections because so many germs have developed a resistance. But when the infection is bacterial and the child's in pain, antibiotics can still work and work fast. "When we treat children with ear infections with antibiotics, they should respond within 48 to 72 hours with a decrease in the fever and really feeling much better," says Dr. Nelson.

By Amye Walters
CWK Network, Inc.
Acute otitis media, commonly called an ear infection, usually starts when germs that cause colds or sore throats (either bacterial or viral infections) spread to the middle ear. Once in the ear, the infection can cause a buildup of pus or fluid behind the eardrum. The pressure on the eardrum can lead to significant pain in some children.

Acute otitis media is an inflammation of the area behind the eardrum (tympanic membrane) in the chamber called the middle ear. Deep within the outer ear canal is the eardrum. The eardrum is a thin, transparent membrane that vibrates in response to sound waves. The middle ear contains air and sits behind the eardrum. When the eardrum vibrates, tiny bones within the middle ear transmit the sound signals to the inner ear. In the inner ear, nerves are stimulated to relay the sound signals to the brain. The eustachian tube, which connects the middle ear to the nose, normally ventilates and equalizes pressure to the middle ear. When your child's ears "pop" when yawning or swallowing, the eustachian tube is adjusting the air pressure in the middle ear.

Two out of three children under the age of 3 experience at least one episode of acute otitis media.
Acute otitis media is the most common bacterial illness in children.
Fifty percent of antibiotics for American preschoolers are prescribed for ear infections.

By Amye Walters
CWK Network, Inc.
Acute otitis media is an infection that produces pus, fluid and inflammation within the middle ear. With proper medical treatment, the bacteria causing the infection can be killed. Antibiotics do not eliminate viral infections, however.

Older children often complain of ear pain, ear fullness or hearing loss. Younger children may demonstrate irritability, fussiness, or difficulty in sleeping, feeding or hearing. Fever may be present in a child of any age. These symptoms are frequently associated with signs of upper respiratory infection, such as a runny or stuffy nose or a cough. During the infection there will usually be some temporary hearing loss. As fluid and pus disappear from the middle ear, hearing improves.

While the number of office visits for otitis media with effusion – middle ear fluid – have decreased over the past decade from 25 million in 1990 to just 16 million in 2000, the number of antibiotic prescriptions written for treatment has remained constant. At the same time, concerns about the rising rate of antibiotic – or antibacterial – use and resistance have emerged.

Symptoms of acute otitis media include fever, ear pain or pulling at one or both ears, irritability, decreased appetite, and/or fluid coming from one or both ears.
Children experiencing an earache or a sense of fullness in the ear, especially when combined with fever or a prior upper respiratory tract infection, should always be evaluated by a doctor.
Ear infections are more common in children who live with someone who smokes.
Studies have shown that up to 80 percent of acute ear infections will clear up on their own without medical treatment.
Children whose ear infections are not treated immediately with antibiotics are not likely to develop a serious illness.

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