Middle earinfection(otitis media)
Symptoms, diagnosis and treatment
Definition: an acute middle ear infection (otitis media acuta) is a condition often triggered by a cold. Viruses travel from the nasopharyngeal cavity via the auditory tube into the middle ear, and the mucous membrane of the tympanum gets inflamed. The result is a change in pressure conditions, which impairs the vibration ability of the eardrum and the quality of sound transmission.
The ear, nose and throat specialist examines your eardrum with an otoscope (ear speculum with light source and magnifier) and subsequently determines if and what kind of treatment is necessary. A hearing test performed for the purpose of diagnosing an acute middle ear infection would first reveal conductive hearing loss. Immune-compromised patients and those who do not respond to antibiotics treatment are subjected to a smear test and bacteriological testing, which allows for the identification of the specific pathogen and hence the use of targeted antibiotics. Prior to the therapy, conditions causing earaches, like diabetes or allergies have to be checked.
Complications with middle ear infections are varied. In general, complications with ear infections are relatively rare, but if they occur, they can can severely impact health. A common complication is the inflammation of the mastoid process, which is located behind the outer ear at the temporal bone. Doctors also use the term acute mastoiditis, characterized by redness and variable swelling of the skin at this location. Frequent middle ear infections bear the risk of turning into a chronic condition. This can lead to scarring of the eardrum, and the ossicles can suffer damage as well. These three tiny bones only measure a few millimeters and can become misshapen or even destroyed due to a chronic middle ear infection. Both can in turn result in permanent hearing loss, which is why the consultation of an ENT-specialist should be imperative with the first signs of symptoms.
Reasons for the development of a middle ear infection
Otitis media acuta can develop in three different ways:
An infection in the nose and throat region travels over to the auditory tube into the middle ear.
- In some cases, the infection, i.e. pathogens, enter from the outside directly to the middle ear due to a defect in the eardrum.
- In very rare cases, pathogens can travel to the middle ear via the bloodstream.
Generally, there are two causes that can contribute to the development of middle ear infections:
- A continuous aeration of the middle ear
- An acute or prior infection
The aeration malfunction is almost always caused by a deficiency in the aeration of the tube. Prior infections are mostly viral and bacterial infections of the upper respiratory tract.
What types of pathogens can cause a middle ear infection?
The following bacteria and viruses are causative agents for middle ear infections:
- Streptococcus pneumoniae: Can cause pneumonia
- Haemophilus influenzae: Can cause feverish inflammation of nose and throat area
- Beta-hemolytic streptococci: Can lead to sepsis, meningitis, or pneumonia, especially in preterm babies
In rare cases it is possible that influenza viruses are the causative agents for an acute middle ear infection. Here the adopted term is flu-otitis, which is the most dangerous form of otitis media acuta, since a possible outcome is deafness of the ear.
Middle ear infection in children
Children up to 6 years of age are most often affected by otitis media acuta. During their first year of life, 50% of infants contract a middle ear infection. By the time they are three years old, this number jumps to 80%. The greatest risk hereby is that the children’s complaints are not taken seriously and the condition is protracted. This can quickly lead to a permanent hearing loss in the child. The following are important signs that your child is affected:
- Increasing body temperature
- Fever higher than 102° Fahrenheit
- Child is constantly touching the ear
- Pain in the stomach area
With infants and toddlers, who more frequently have middle ear infections, an enlargement of the tonsils can occur. In such a situation, the following signs can determine whether the tonsils should be removed:
- Problems breathing through the nose
- Accumulation of fluid behind the eardrum
- Several middle ear infections within a year
In the medical field, doctors use the term adenoitis for an inflammation of the tonsils.
Protect children and babies
Children of parents who smoke have a higher incidence for acute middle ear infections.1 Also, children who have had previous instances of infection have an increased risk for a relapse. On the other hand, it has been shown that infants who were breastfed by their mothers are significantly less often afflicted by middle ear infections.