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A middle ear infection (acute otitis media) typically occurs a week or two after your child has an upper respiratory tract infection, which can cause inflammation and fluid to build up behind his ear drum. This fluid can then become infected with bacteria and your child will likely develop ear pain, fever and irritability and he may be tugging at his ears. Your doctor can tell if your child has a middle ear infection by looking inside his ear at the ear drum. With an ear infection, the ear drum will look red and will usually be bulging because of pus building up behind it. The ear drum will also be immobile, meaning that your Pediatrician will not see the ear drum move when he squeezes the rubber insufflator bulb on the otoscope.

Since there are other conditions that can make an ear drum look red, including fever or just a crying child, it is important that your Pediatrician check the mobility of the ear drum when he evaluates your child for an ear infection. An ear drum that is red from crying or because of a fever will still be mobile when tested, and this is a good way to prevent misdiagnosis or over diagnosis of ear infections. A tympanogram can also be used to test for the mobility of the ear drum.

What is otitis media (OM)?

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Otitis media is inflammation located in the middle ear. Otitis media can occur as a result of a cold, sore throat, or respiratory infection.

Who is at risk for getting ear infections?

While any child may develop an ear infection, the following are some of the factors that may increase your child's risk of developing ear infections:

  • being around someone who smokes
  • family history of ear infections
  • a poor immune system
  • spends time in a daycare setting
  • absence of breastfeeding
  • having a cold
  • bottle fed while laying on his/her back

What causes otitis media?

Middle ear infections are usually a result of a malfunction of the eustachian tube, a canal that links the middle ear with the throat area. The eustachian tube helps to equalize the pressure between the outer ear and the middle ear. When this tube is not working properly, it prevents normal drainage of fluid from the middle ear, causing a buildup of fluid behind the eardrum. When this fluid cannot drain, it allows for the growth of bacteria and viruses in the ear that can lead to acute otitis media. The following are some of the reasons that the eustachian tube may not work properly:
  • a cold or allergy which can lead to swelling and congestion of the lining of the nose, throat, and eustachian tube (this swelling prevents the normal flow of fluids)
  • a malformation of the eustachian tube

What are the different types of otitis media?

Different types of otitis media include the following:
  • acute otitis media (AOM) - the middle ear infection occurs abruptly causing swelling and redness. Fluid and mucus become trapped inside the ear, causing the child to have a fever, ear pain, and hearing loss.
  • otitis media with effusion (OME) - fluid (effusion) and mucus continue to accumulate in the middle ear after an initial infection subsides. The child may experience a feeling of fullness in the ear and hearing loss.

What are the symptoms of otitis media?

The following are the most common symptoms of otitis media. However, each child may experience symptoms differently. Symptoms may include:
  • unusual irritability
  • difficulty sleeping or staying asleep
  • tugging or pulling at one or both ears
  • fever
  • fluid draining from ear(s)
  • loss of balance
  • hearing difficulties
  • ear pain
  • nausea and vomiting
  • diarrhea
  • decreased appetite
  • congestion

The symptoms of otitis media may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.


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