All About Ear Infections ByTulaKarras WebMD Feature
Ear infection: The diagnosis strikes fear in the hearts of parents, who want to do what's best for their child but tend to get conflicting medical advice. What makes ear infections so troubling is not only the damage that repeated infections can cause, but also the danger of over-treating the infection: antibiotic resistance. What's a concerned parent to do? Here's what the experts know.
Usually Not a Cause for Alarm: Two-thirds of children have had an ear infection, also known as acute otitis media, before their first birthday. Young children are susceptible to these infections in part because their eustachian tube, which connects the middle ear to the throat and nose, is underdeveloped and lies at a horizontal angle (it becomes more angled with age), easily clogging with fluid. Also, young children's immune systems are still developing, putting them at high risk for upper respiratory infections, which can lead to ear infections.
Symptoms of an Ear Infection: Fever, pain in the ear (babies rub or pull on their ears), vomiting and diarrhea (in infants only), difficulty hearing, crying/pain when sucking, and loss of sleep or appetite
Treatments and Complications: In about half of all cases, an ear infection resolves itself without any need for medication. However, in the majority of cases children need an antibiotic, usually amoxicillin, for a course of 10 days. The drug starts to work within a day or so. Sometimes the fluid in the middle ear doesn't drain, blocking the eardrum and causing temporary hearing loss, or otitis media with effusion. Again, this is not uncommon, and in many cases another round of amoxicillin or another type of antibiotic will do the trick. Repeated ear infections can be a problem, since they're associated with extended temporary hearing loss. During the early years of childhood, proper hearing is essential to speech development. And if children have significant hearing loss for a long period of time, they may experience difficulties in language learning.
To Tube or Not to Tube: Traditionally, children who experience recurrent ear infections for three months or longer and have hearing loss are candidates for a myringotomy, a surgery in which tubes are inserted into the ear to keep the middle ear ventilated. However, in light of new studies, doctors are increasingly opting to forgo this surgery. A 1994 study found that in 23 percent of cases, tubes were medically unnecessary. In addition, a new study of 182 children, published in a recent issue of the medical journal Lancet, found that putting off surgery for up to nine months didn't hamper a toddler's long-term language abilities. If your doctor suggests a myringotomy, you might want a second opinion.
Danger of Misusing Antibiotics: Before considering a myringotomy, many doctors prescribe a long course of antibiotics as a preventive measure. This can reduce the number of infections a child gets, but it also promotes the spread of antibiotic-resistant bacteria. To help minimize the overuse of antibiotics, the American Academy of Pediatrics (AAP) advises that antibiotics be withheld if there's fluid but no sign of infection or fever. Some pediatricians, however, will cave in to a parent's request to prescribe antibiotics even when they're not warranted, simply because the parent expects a prescription. It's important that you don't pressure your pediatrician to prescribe antibiotics if they're not necessary. If your doctor does prescribe antibiotics, it's vital that your child completes the entire course. Not finishing a round of antibiotics can set the stage for antibiotic resistance.
What Are the Dangers of Ear Infections? Last Updated: Jul 31, 2010 | By Whitney Hopler
Ear infections happen when fluid builds up inside the ear, giving bacteria or viruses a place to grow. Ear pain and fever can result. Although the National Institutes of Health says most ear infections resolve without causing additional problems, sometimes ear infections cause dangers beyond their immediate symptoms. Dangerous complications can occur if ear infections don't clear up quickly, or if they repeatedly recur.
Hearing Loss: People who experience prolonged or repeated ear infections can suffer hearing loss, says CNN.com--which is particularly a problem for young children who need to hear properly to be able to learn language and fully develop their speech skills. The Mayo Clinic says ear infections may cause either short-term hearing loss for a few weeks before fluid drains out of the ear, or long-term hearing loss if fluid remains trapped inside the ear for several months and permanently damages the eardrum and nearby bones that must work properly to sense sound vibrations. Children who have suffered long-term hearing loss from ear infections are at risk of speech and language development delays, according to the National Institutes of Health.
More Infections: If ear infections remain untreated, they can spread to other parts of the body, according to the National Institutes of Health. One of the most common of those additional infections is mastoiditis, a type of sinus infection that affects the portion of the skull bone located behind people's ears, the Mayo Clinic says. Although it's rare, adds the Mayo Clinic, ear infections can move to other parts of the head. The National Institutes of Health cautions that untreated ear infections may cause meningitis, a life-threatening infection that causes the membranes that cover the brain and spinal cord to swell and become inflamed.
Ruptured Eardrum: When fluid from an ear infection builds up behind the eardrum, the pressure can cause the eardrum to break open, says the National Institutes of Health. Pus and blood flowing out of the ear are signs of a ruptured eardrum, the Mayo Clinic reports. However, the situation is usually temporary; the eardrum often heals on its own, without surgery, after the pressure from clogged fluid is released.
Enlarged Adenoids or Tonsils: Sometimes ear infections cause inflammation that makes people's adenoids or tonsils swell, according to the National Institutes of Health. Adenoids and tonsils are both tissues that are part of the body's lymphatic system, designed to help protect the body from germs coming in through the mouth and nose. The adenoids are located in the upper throat behind the nose; the tonsils are located in the back of the throat. If they become enlarged, breathing and hearing problems may result, the National Institutes of Health reports.