Otitis in Children

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Causes

The space behind the eardrum, the middle ear, closes the auditory system and is empty. The natural secretions formed here are removed through an internal route called the Eustachian tube. In children, this does not always work well, probably because it is not fully matured and so it does not have the required strength and the secretions are not eliminated entirely. When a problem occurs in the Eustachian tube there is a risk of fluid accumulation behind the eardrum. The bacteria existent sometimes in the nasal passages multiply easily in this fluid, causing infection. Often, after a catarrh, the nose is clogged and this is why otitis media occurs during or after it.
 
Article Content:
Causes
Symptoms
Treatment
What should be done if the infection recurs?


Symptoms

Usually, the symptoms are ear pain and sometimes fever. Some children may have only fever and irritability and very rarely they may have no symptoms despite of the infection. Otitis can be diagnosed by examining the ear with an instrument called “otoscope”. With this, the doctor can see directly the eardrum which is red and bulging sometimes because of the infected fluid pressure. Severe complications are rare but still exist. Otitis media can cause the infection of the lining of the brain (meningitis), the infection of the bones surrounding the ear or bacterial contamination of blood. Because of the risk of developing these complications, oral antibiotics are fully justified.


Treatment

Antibiotics are usually prescribed for a period of three, five or seven days, depending on their type. The reatment must be followed at the doctor’s recommendation, even if symptoms improve or disappear before ending it. Generally, a relief of the symptoms is felt within the first 48 hours since the beginning of the treatment. During these first 48 hours, symptoms are likely to persist but that does not mean that antibiotics do not act. In order to relieve pain or fever, tylenol can be given according to the child’s weight or age. Meanwhile, children can be examined again to see if the antibiotic has to be changed. After the treatment with antibiotics, the child must be kept under observation to ensure that the infection was completely eliminated.
 
Are antibiotics necessary?
The use of antibiotics has been questioned by those who claim that some infections are caused by viruses and not bacteria. Antibiotics are not effective against viruses, this is the reason why some people are afraid of their excessive use. Some studies show that about 30% of earaches do not heal by themselves without the help of antibiotics. So 70% can heal by themselves. The problem is that that 30 percent can not be identified through a simple examination of the ear. The identification is important because untreated otitis media can lead to serious infectious complications.
In some cases, in the case of an older child, some doctors may opt for his supervision until the infection is reabsorbed, without administering antibiotics immediately. However, if the infection is severe, especially in young children, the doctor prescribes an antibiotic. This choice depends entirely on the situation.


What should be done if the infection recurs?

The most common complications of otitis media are the recurring or persistent infection, or the constant presence of the fluid in the middle ear, despite the treatment with anibiotics. This fluid lead to the decrease of hearing. Hearing loss result in the delayed understanding of words of all children. If the infection continues to occur despite the treatment with antibiotics, there are two options: the administration of a low-dose of antibiotics, daily, for several months (prophylactic treatment), or a little surgical intervention – tympanostomy, performed by an ENT physician (ear, nose, and throat specialist), which consists of the introduction in the eardrum of a small plastic tube to drain the middle ear to the outside. This tube is used until the natural drainage system of the ear, the eustachian tube, matures.
Most children outrun this problem and do not develop any permanent sechela in the auditory acuity plan with the passage of time and do not suffer from any other long term complications from otitis.

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