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Acute Otitis Media in Children

Infection of the middle ear, which often causes earache

  • More common under the age of 5
  • Passive smoking is a probable risk factor; more common in children who attend daycare centres
  • Gender and genetics are not significant factors

The most common cause of earache in children is acute otitis media, which is caused by infection in the middle ear. Children are at risk because the eustachian tubes, which connect the middle ear to the throat, are small and become obstructed easily. Acute otitis media is often part of an infection of the respiratory system with a virus such as the common cold. Infection causes inflammation that may block one of the eustachian tubes, causing a build-up of fluid in the middle ear that may then become infected with bacteria.

About 1 in 5 children under the age of 4 has an episode of acute otitis media each year. There is some evidence to suggest that the condition is more common in children whose parents smoke. Children who attend daycare centres are also more susceptible. The condition is less common in children over the age of 5.

What are the symptoms?

The symptoms usually develop rapidly over several hours. A very young child may have difficulty locating the pain, and the only symptoms may be fever, vomiting, and disturbed sleep. In older children, however, the symptoms may be more specific and include:

  • Earache.

  • Tugging or rubbing the painful ear.

  • Temporary impaired hearing in the affected ear.

Left untreated, the eardrum may rupture, relieving the pain but causing a discharge of blood and pus. Recurrent infections in the middle ear may cause chronic secretory otitis media.

Acute otitis media

The eardrum shown above is bulging and inflamed as a result of the middle-ear infection acute otitis media.

What might be done?

You should consult your child’s doctor if liquid is discharged from the ear or if the earache lasts more than a few hours. He or she will examine your child’s ears and may blow air into the affected ear using a special instrument to check that the eardrum is moving normally. Acute otitis media can clear up without treatment; however, the doctor will probably prescribe antibiotics if he or she suspects that a bacterial infection is present. Paracetamol or ibuprofen (see Painkillers) may be given to relieve discomfort. The doctor will re-examine your child after a few days.

The symptoms usually clear up in a few days with appropriate treatment. A ruptured eardrum should heal within a few weeks. In some children, hearing is affected for more than 3 months until the fluid in the ear disappears.

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

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