What is an ear infection?
Otitis is an inflammation or infection caused by a viral or bacterial cause in the ear, whether caused by viruses, fungi or bacteria, which usually causes pain. It is a very common infection in babies and children up to 4 years old.
Are there different types of otitis?
yes. The most common types of otitis are:
- Otitis media: the inflammation occurs in the middle ear, behind the eardrum, caused by viruses or bacteria and is the most common type in childhood. It is a recurrent process of cold or flu and the consequent nasal obstruction
- Serous otitis media: occurs when fluid accumulates in the middle ear behind the eardrum. This type of otitis can be a consequence of an otitis media in which fluid persists, but no longer has the symptoms of acute infection. There are usually no symptoms, but the existence of this fluid in the ears interferes with hearing
- otitis externa: occurs when there is inflammation of the outer ear canal and often results from water entering the ear or infections in the ear canal
Otitis can also be characterized by:
- acute: when there is an infectious episode and the symptoms last less than 4 weeks
- Chronic: when the infection drags on over time and symptoms last for more than 12 weeks
What are the most common causes of otitis?
The vast majority of acute otitis media (the most common type of otitis, especially in childhood) are of viral origin, and can be started by a cold or flu. However, they can also be caused by bacteria, such as Streptococcus pneumoniae and Haemophilus influenzae.
What are the symptoms of otitis?
The main symptoms of otitis are:
- pain, usually aggravated at night
- blocked ear or pressure in the ear
- fever
- temporary hearing loss, which comes on suddenly
- dizziness and loss of balance
- nausea or vomiting
- fatigue
Specifically in each type of otitis, the following signs may be noted:
Acute otitis media:
In addition, in babies, it may show some signs such as crying more than usual, rubbing or pulling the ears, restless sleep or if you are very irritable.
Serous otitis media: differs from other types of otitis because despite the existence of fluid in the ear that interferes with hearing, it is usually less painful or even painless. The most common symptoms are:
- muffled hearing
- Filling sensation in the ear
otitis externa:
- Sensation of the ear canal clogged due to secretions
- pain
- itchy ears
- decreased hearing
What are the risk factors for developing otitis?
The main risk factors vary with age, with the type of otitis involved, but they are also related to:
- upper respiratory infection such as a cold, flu
- Allergic factors
- Anatomical features
- Immune immaturity
In children, respiratory syncytial virus is the main cause of acute otitis media.
Who is part of the risk groups?
Children are usually the most affected by ear infections, especially in preschool children, although ear infections can be common up to the age of 12. Acute otitis media is more common in children aged 6 to 24 months, while serous otitis media is common, especially up to 4 years.
The main reason is due to issues of an anatomical nature. That is, in children, the Eustachian tube, the canal that connects the nasal passages to the ear, is narrower and shorter and is in a more horizontal position. In these circumstances, viruses and bacteria have their passage facilitated to the middle ear, where they end up accumulating, promoting the development of infection.
Associated with the anatomical issue, there is also the lack of maturation of the immune system.
Can otitis leave sequelae?
Ear infections can be painful and disabling, but have few long-term complications if treated properly. Exceptionally, acute otitis media can leave sequelae, such as:
- hearing loss
- Perforated eardrum
Is acute otitis media contagious?
Acute otitis media, when associated with viral infection of the airways, is contagious. That is, the infection is transmissible from person-to-person. In these cases, you should refrain from contact with other people, maintain hygiene habits and respiratory etiquette and children should not attend school as they can infect other children.
How can I prevent ear inflammation?
Some habits and behaviors can help prevent ear inflammation, such as:
- Keep recommended vaccines up to date
- Avoid spaces with smoke, pollution or allergenic factors
- Wash them more frequently to slow the spread of bacteria
- Avoid excessively high temperatures and humidity while showering
- Dry your ears and ears thoroughly after bathing or swimming, and
- Protect your ears in cold weather
- In children:
- Clear nasal secretions
- Breastfeed whenever possible: breastfeeding decreases the risk of ear infections, particularly by increasing immunity
- Avoid the use of pacifiers
- Bottle feeding in a semi-upright position and not lying down
How is the diagnosis made?
Evaluation of symptoms and direct observation of the ear (with a light instrument – otoscope) are usually sufficient to diagnose otitis. If necessary, other diagnostic tests, such as audiometry, may be used.
What is the treatment of otitis?
Usually, the treatment of otitis is done with medications that are intended to improve the symptoms of pain and fever.
Is antibiotic treatment effective?
The use of antibiotics should be evaluated by the doctor because it is not always necessary.
Its use depends on the risk of serious infection or complications, and re-evaluation of the child may be indicated to see if its use is necessary. The excessive use of antibiotics, in unnecessary cases, favors the appearance of resistant organisms.