What are the common causes of ear infections in children. How can parents recognize the symptoms of an ear infection. What treatment options are available for childhood ear infections. When should parents seek medical attention for their child’s ear pain.

Understanding the Prevalence of Ear Infections in Children

Ear infections are incredibly common among young children, with statistics showing that 5 out of 6 children will experience at least one ear infection by their third birthday. This high prevalence can be attributed to two main factors: the immaturity of children’s immune systems and the anatomical differences in their ears compared to adults.

Why are children more susceptible to ear infections? Their Eustachian tubes, which connect the middle ear to the throat, are shorter and more horizontal than those of adults. This makes it easier for bacteria and viruses to travel from the nose and throat to the middle ear, potentially causing an infection. Additionally, children’s immune systems are still developing, making them more vulnerable to various infections, including those affecting the ears.

Types of Ear Infections: Outer vs. Middle Ear

Ear infections can occur in different parts of the ear, each with its own set of causes and symptoms. The two main types of ear infections in children are:

1. Outer ear infections (otitis externa)
2. Middle ear infections (otitis media)

Outer Ear Infections

Outer ear infections, also known as swimmer’s ear, typically occur when water remains in the ear canal for an extended period, creating an ideal environment for bacterial growth. However, these infections can also result from small injuries to the ear canal, such as those caused by cotton swabs or other objects children might insert into their ears.

What are the symptoms of an outer ear infection? Children with outer ear infections may experience:

• Itching in the ear canal
• Pain when the outer ear is touched or moved
• Redness and swelling of the ear canal
• Drainage of clear or pus-like fluid

Middle Ear Infections

Middle ear infections are more common in children and often occur as a result of upper respiratory infections, such as colds or flu. These infections can cause the Eustachian tube to become swollen and blocked, leading to fluid buildup in the middle ear.

Recognizing the Signs and Symptoms of Ear Infections

Identifying an ear infection in children, especially in infants and toddlers who cannot verbalize their discomfort, can be challenging. Parents should be aware of the following signs and symptoms:

• Sharp ear pain or discomfort
• Difficulty sleeping, especially when lying down
• Hearing problems or muffled hearing
• Fever
• Fluid draining from the ear
• Dizziness or balance issues
• Congestion or stuffy nose

In infants and very young children, additional signs may include:

• Tugging or pulling at the ear
• Increased irritability or fussiness
• Loss of appetite or difficulty feeding
• Pushing away bottles due to pain while swallowing

Diagnostic Procedures for Ear Infections

How do healthcare providers diagnose ear infections in children? The primary diagnostic tool used by doctors is an otoscope, a specialized instrument that combines a magnifying lens with a light source. This device allows the physician to examine the ear canal and eardrum closely.

During the examination, the doctor looks for several indicators of an ear infection:

• Redness and swelling of the eardrum
• Fluid buildup behind the eardrum
• Perforation or rupture of the eardrum

In some cases, the doctor may use pneumatic otoscopy, which involves using a puff of air to observe the eardrum’s movement. Reduced movement can indicate fluid buildup in the middle ear.

Treatment Options for Childhood Ear Infections

The approach to treating ear infections in children has evolved in recent years, with a growing emphasis on careful observation before resorting to antibiotics. This shift is due to concerns about antibiotic resistance and the recognition that many ear infections, particularly those caused by viruses, will resolve on their own.

Wait-and-See Approach

For many cases of ear infections, especially in children over six months old with mild symptoms, doctors may recommend a wait-and-see approach. This involves monitoring the child’s condition for 48 to 72 hours before deciding whether antibiotic treatment is necessary.

Pain Management

Regardless of whether antibiotics are prescribed, managing the child’s pain and discomfort is crucial. Parents can use the following methods to alleviate pain:

• Applying a warm compress to the affected ear
• Administering over-the-counter pain relievers such as acetaminophen or ibuprofen (never aspirin for children)
• Using prescription ear drops for pain relief, if recommended by the doctor

Antibiotic Treatment

When are antibiotics necessary for ear infections? Doctors may prescribe antibiotics in the following situations:

• Severe symptoms or high fever
• Infections in infants under six months old
• Cases where symptoms do not improve after 48-72 hours of observation
• Children with a history of recurrent ear infections

It’s important to complete the full course of antibiotics as prescribed, even if symptoms improve before the medication is finished.

Complications and Long-Term Effects of Chronic Ear Infections

While most ear infections resolve without long-term consequences, recurrent or chronic ear infections can lead to several complications:

• Hearing loss: Temporary hearing loss is common during an ear infection, but frequent infections can lead to more permanent hearing impairment.
• Speech and language delays: Hearing loss from chronic ear infections can affect a child’s speech and language development.
• Eardrum perforation: Repeated infections can cause scarring and weakening of the eardrum, potentially leading to perforation.
• Mastoiditis: In rare cases, the infection can spread to the mastoid bone behind the ear.
• Meningitis: Although extremely rare, untreated ear infections can potentially lead to meningitis, an inflammation of the membranes surrounding the brain and spinal cord.

Surgical Interventions for Recurrent Ear Infections

For children who experience frequent ear infections or persistent fluid in the middle ear, surgical interventions may be considered. The most common procedures include:

Tympanostomy Tube Insertion

What are tympanostomy tubes? These are tiny tubes inserted through the eardrum to allow fluid drainage from the middle ear and prevent fluid buildup. The procedure, often referred to as “ear tube surgery,” is one of the most common childhood surgeries.

How long do ear tubes stay in place? Typically, the tubes remain in the ears for 6 to 9 months before falling out on their own. In some cases, longer-lasting tubes may be used, which can remain in place for several years.

Adenoidectomy

In some children, enlarged adenoids can contribute to recurrent ear infections by putting pressure on the Eustachian tubes. An adenoidectomy, the surgical removal of the adenoids, may be recommended in these cases, often in conjunction with the insertion of ear tubes.

Preventing Ear Infections in Children

While it’s not always possible to prevent ear infections, several strategies can help reduce their frequency:

• Practice good hygiene: Encourage frequent handwashing to reduce the spread of germs that can lead to upper respiratory infections.
• Avoid secondhand smoke: Exposure to tobacco smoke can increase the risk of ear infections.
• Breastfeed infants: If possible, breastfeed for at least six months to boost the baby’s immune system.
• Vaccinate: Ensure your child receives all recommended vaccinations, including the annual flu shot for children six months and older.
• Manage allergies: If your child has allergies, work with your doctor to manage them effectively, as allergies can contribute to ear infections.
• Practice safe swimming: Encourage children to wear earplugs while swimming and to dry their ears thoroughly afterward.
• Avoid bottle-feeding while lying down: For infants, avoid allowing them to drink from a bottle while lying flat, as this can promote fluid buildup in the middle ear.

By implementing these preventive measures and being vigilant about the signs and symptoms of ear infections, parents can help reduce the frequency and severity of ear infections in their children. However, it’s important to remember that some children may be more prone to ear infections due to factors beyond parental control, such as the anatomy of their Eustachian tubes or genetic predisposition.

When to Seek Medical Attention for Ear Infections

While many ear infections can be managed at home or with a wait-and-see approach, there are situations where prompt medical attention is necessary. Parents should contact their healthcare provider if their child experiences:

• Severe ear pain that persists for more than a day
• High fever (above 102.2°F or 39°C)
• Discharge of pus or blood from the ear
• Symptoms of an ear infection in a child under 6 months old
• Swelling or redness behind the ear
• Stiff neck or severe headache accompanying ear pain
• Signs of hearing loss or difficulty with balance

These symptoms may indicate a more serious condition or a complication of an ear infection that requires immediate medical evaluation and treatment.

Understanding ear infections, their causes, symptoms, and treatment options can help parents navigate this common childhood ailment more effectively. By working closely with healthcare providers and implementing preventive measures, parents can help minimize the impact of ear infections on their children’s health and well-being. Remember, each child is unique, and what works for one may not work for another. Always consult with a pediatrician or healthcare provider for personalized advice and treatment plans tailored to your child’s specific needs.

Anatomy of an Ear Infection

Medically Reviewed by Melinda Ratini, MS, DO on January 11, 2022

It’s not your imagination. Kids can get a lot of ear infections. In fact, 5 out of 6 children will have at least one by their third birthday. Why? Their immune systems are immature, and their little ears don’t drain as well as adults’ ears do.

It’s an infection in the outer ear that usually happens when the ear stays wet long enough to breed germs. But even if your kid hasn’t been swimming, a scratch from something like a cotton swab (or who knows what they stick in there?) can cause trouble. Watch out if your child’s ear gets itchy or hurts when you touch it. The answer is usually medicated drops and keeping ears dry.

The only way to know for sure if your child has one is for a doctor to look inside her ear with a tool called an otoscope, a tiny flashlight with a magnifying lens. A healthy eardrum (shown here) looks sort of clear and pinkish-gray. An infected one looks red and swollen.

The Eustachian tube is a canal that connects your middle ear to your throat. It keeps fluid and air pressure from building up inside your ear. Colds, the flu, and allergies can irritate it and make it swell up.

If the Eustachian tube gets blocked, fluid builds up inside your child’s middle ear. This makes the perfect breeding ground for bacteria that cause infections. Your doctor may look inside your child’s ear with an otoscope, which can blow a puff of air to make his eardrum vibrate. If it doesn’t move as much as it should, chances are there’s fluid inside.

If too much fluid or pressure builds up inside the middle ear, the eardrum can actually burst (shown here). If that happens, you may see yellow, brown, or white fluid draining from your child’s ear. It sounds scary, but the eardrum usually heals itself in a couple of weeks. Hearing usually returns to normal once the eardrum heals –unless the eardrum has been damaged.

The main warning sign is sharp pain. Your child may be more uncomfortable lying down, so he might have a hard time sleeping. Other problems to look for:

• Trouble hearing
• Fever
• Fluid oozing from ears
• Dizziness
• Stuffy nose

These infections can be sneaky with babies or children who are too young to tell you what hurts. A lot of times they’ll start tugging or pulling on an ear. Little kids can also just get cranky, have trouble sleeping, or not eat well. Babies may push their bottles away because pressure in their ears makes it hurt to swallow.

While the immune system fights the ear infection, you can ease any pain your child feels. A warm washcloth on the outside of the ear can be soothing. Depending on the cause of the earache, your doctor may recommend eardrops. Non-prescription painkillers and fever-reducers, such as acetaminophen and ibuprofen, are also an option. Do not give aspirin to children.

Ear infections often go away on their own, so don’t be surprised if your doctor suggests a “wait and see” approach. The more we use antibiotics, the less effective they become. That’s because bacteria learn to fight back against common medicines. Viruses can also cause ear infections, and antibiotics only work on bacteria. Your doctor will know best when to use them.

If your child’s ear infections keep coming back, they can scar his eardrums and lead to hearing loss, speech problems, or even meningitis. If he has lots of them, you might want to have his hearing tested just in case.

For kids who get a lot of ear infections, doctors sometimes put small tubes through the eardrums. They let fluid drain out of the middle ear and stop it from building up again. This can ease the pressure or pain and clear up hearing problems. The tubes usually stay in for 6 to 9 months and fall out on their own.

Sometimes a child’s tonsils get so swollen that they put pressure on the Eustachian tubes that connect her middle ear to her throat — which then causes infections. If that keeps happening, she may need to have her tonsils taken out.

The biggest cause of middle ear infections is the common cold, so avoid cold viruses as much as you can. The best way to stop germs is to make sure your child washes her hands well and often. Also, keep your child away from secondhand smoke, get her a flu shot every year once she turns 6 months old, and breastfeed your baby for at least 6 months to boost her immune system.

Like colds, allergies can also irritate the Eustachian tube and lead to middle ear infections. If you can’t keep your child away from whatever’s bothering him, consider an allergy test to figure out his triggers. Medicine or allergy shots may offer relief and stop the infections, too.

IMAGES PROVIDED BY:

(1)  Mauro Fermariello / Photo Researchers, Inc.
(2)    David Nardini / Photographer’s Choice / Getty Images
(3)    Copyright © ISM / Phototake — All rights reserved.
(4)    Laurie O’Keefe / Photo Researchers, Inc.
(5)    Brian Evans / Photo Researchers, Inc.
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(7)    Mark Clarke / Photo Researchers, Inc.
(8)    Mark Clarke / Photo Researchers, Inc.
(9)    Stockbyte / Getty Images
(10)    Michael Denora / Photographer’s Choice / Getty Images
(11)  PHANIE / Photo Researchers, Inc.
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(13)  PHANIE / Photo Researchers, Inc.
(14)  Ariel Skelley / Blend Images / Photolibrary
(15)  Stockxpert / Jupiter Images
 

SOURCES:

Academy of American Family Physicians.

American Academy of Otolaryngology.

American Academy of Pediatrics: “Allergy Tips.”

Chonmaitree, T. Clinical Infectious Diseases, March 15, 2008.

Chavanet, P. Clinical Infectious Diseases, March 15, 2008.

KidsHealth: “Swimmer’s Ear.”

National Institute on Deafness and Other Communication Disorders: “Ear Infections in Children.”

Merck.

National Institute on Deafness and Other Communication Disorders.

Sander, R. American Family Physician, March 1, 2001.

Spiro, D. JAMA, The Journal of the American Medical Association, Sept. 13, 2006.

CDC.

Mayoclinic.org.

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13 Causes of Earaches in Adults

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5. 13 Causes of Earaches in Adults

09/10/2021

If you’re experiencing an earache as an adult, you might assume it’s an ear infection. That’s why kids’ ears normally hurt, right? But ear pain in adults is usually not caused by infection.

“Often, it’s not even caused by the ear — it could be the jaw or throat,” says Kimberly Bean, a board-certified Family Nurse Practitioner at Beaufort Memorial Bluffton Primary Care (located in the Okatie Medical Plaza). “It’s rare, but sometimes, ear pain could be a sign of a serious underlying condition, such as blood vessel inflammation or a tumor, and even hearing loss, so it’s important to talk to a doctor about your symptoms.”

Read More: Where Do I Go for Care?

Causes of Earaches in Adults

Your ear has three main parts: the outer ear, middle ear and inner ear. Many earaches happen when fluid builds up in the middle ear, leading to infection and pain. Some causes of ear pain include:

1. Arthritis in your jaw
2. Cyst
3. Dental infection
4. Ear infection
5. Ear injury
6. Eardrum rupture
7. Earwax buildup
8. Foreign object in your ear
9. Ménière’s disease, when fluid builds up in the inner ear
10. Sinus infection
11. Swimmer’s ear, an infection in the ear canal caused by bacteria commonly found in water
12. Temporomandibular joint (TMJ) disorders, a group of conditions that cause pain in the jaw, neck and head
13. Tumor

Read More: Antibiotics: Not Always the Best Answer

What Adults Can Do for an Earache

If your ear pain is mild, a cold compress placed on the ear and over-the-counter pain medications may be enough to relieve your symptoms. But you should talk to your primary care provider if you experience ear infection symptoms, such as:

• Discharge that is white, yellow, clear or bloody
• Dizziness
• Fever
• Hearing loss
• Itching
• Ringing in your ear
• Trouble swallowing
• Severe pain or pressure

“While some conditions could resolve on their own, we can help you find the right treatment,” Bean says. “We can refer you to an ear, nose and throat specialist if we need to, and we can work to help you prevent ear infections, for example, with giving you the flu vaccines and helping you quit smoking or vaping, which can increase your risk for ear infections.”

If ear pain is getting you down, a Beaufort Memorial primary care provider can help. Find a provider accepting new patients.

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Read “The gypsy needle of the sorceress” – Hussein Alla – Page 1 th, like an explosion, hitting the front door of the apartment from below. Following along the corridor of the entrance, the echo of this blow rolled with a booming echo. His trumpet bass was shouted down by the neighbor himself, who jumped out of that apartment:

– You are a complete fool, and so is your mother! Ah, fuck you, three kilos of berries in my mouth! He swore loudly and desperately.

And, continuing to mutter some nonsense, heavy, unsteady steps stomped down the stairs, rattling the railing. This neighbor, even in the rare sober moments of his life, exuded the smell of alcoholic fumes throughout the corridor, which stably kept after he went out into the street. For the second time, he violently banged the front door of the entrance below, which screeched indignantly with a tight spring.

Instantly, in response to these shudders of the entrance, a nervous lapdog from the neighbors upstairs squealed like a bell.

“So, everything’s fine! Everything is in place, everything is as usual and the morning starts as usual with one difference! What a blessing – you don’t have to go to the office today, it’s a day off! You can get high a little longer”… After a couple of minutes, the bell of the proletarian conscience rang again the conscience-contagion took over and its owner thought with contrition: “It’s good to lie down, of course, but you have to get up. ” So sluggishly and sleepily Natashka, the IT girl, continued to persuade herself.

But she definitely didn’t want to get up at all and didn’t have the slightest desire to even open her eyes. She was thrilled by sweet languor all over her body, but the neighbor and the dog woke her up and it was no longer possible to fall asleep again.

“And why am I going to lie in bed just like that – I have to get up already. Look, how you have softened up,” she summed up finally waking up.

Natashka stretched with all her strength, let out a groan of bliss and thought:

“How nice it is to wake up in a warm bed in your apartment next to your beloved hubby!”

That’s it, their first child should move any day now. It will soon be four months since he and Andrei learned about the good news for both. The doctors said the baby is developing normally. She felt great, there was not even toxicosis, with which Natasha was frightened by her friends. She stroked her growing tummy and joked affectionately:

– Hey, you there, kid, how are you? Good morning, it’s time for us to get up for gymnastics and breakfast, wake up!

Natashka opened one eye and squinted towards her husband – didn’t he hear her? No, Andrei was lying on his stomach and was still in dreams, but so sweet that his saliva flowed onto the pillow. I worked yesterday until late – I’ve been at work for a week already.

“And what did he just see in me? I’m ‘one foot tall’, as he says himself. And my hips are disproportionately wide, suitable for a two-meter-tall figure. It’s easier to jump over me than to bypass me, as he laughs at me “And he’s so tall and athletic. Yes, what’s there – a real muscleman, only not thanks to a rocking chair in a smelly basement, but thanks to physical labor at a construction site in the fresh air.

Love. She is so masterful, inexplicable and mysterious. Comes without knocking and warning, absolutely asking for permission to enter whenever she wants and to whom she wants. So she came to us just as unexpectedly, “Natashka concluded, intermittently and strongly kissing her husband on her free cheek with prints of folds from the pillow case, and whispered in his ear:

Wake up, honey.

And louder she uttered his favorite joke:

“Wake up, you are gray!”

Andrey reacted and also languidly, without opening his eyes, drawled:

– You are a piggy repeater. This is my joke!

Then he threw back the terrycloth sheet and, stroking his cubes on his hairy stomach, added:

– Wow! How hot is that!

Andrei spread his arms and legs around the “sexodrome” in a wide “X”. So he jokingly called their wide bed on which four of them could sleep comfortably. Then, fully awake, he carefully placed the builder’s large and heavy male hand on Natashka’s stomach and carefully asked:0014

– Well, Mommy, isn’t he kicking yet?

– Maybe “she”? No, daddy, it’s still too early for him, be patient, Natashka played along with her husband.

“Okay, mommy, everything has its time,” he cooed like a dove, smacking Natasha in the belly.

And then he asked in a mockingly stern tone:

– And you, my beauty, why are you lying down? Who will cook breakfast for your husband? And have you forgotten that today is the first day off and the Simakovs and I agreed to go fishing with an overnight stay to the lake today? I still need to see all the gear and get well together. They’ll pick us up after dinner. Come on, come on, move! – And gently slapped his wife on the pope.

– Well, you get up slowly, and I went to the bathroom to clean my ass, wash my teeth, – he joked as always.

– Here’s the idler, go already! Natasha grumbled smiling.

After lying down for about twenty seconds after Andrey left, she sat up on the bed. Then, without haste, she combed her long blond blond hair with a large wooden comb and stood up. But at the same moment, uttering a loud cry, she folded in half on her haunches near the bed from the pain in her stomach that pierced her. The day is gone.

She woke up from the swaying and howling of the siren of the ambulance, which was rushing through the streets of the city at breakneck speed. Outside the window flashed the reflections of the signal lights of the ambulance. Everything swam and swayed around. And she could hardly make out in the foggy veil Andrey’s preoccupied face bent over him, who painfully kneaded her palms and kept repeating, as if wound up:0014

– Everything will be fine, everything will be fine. ..

Without having time to answer anything, Natasha again plunged into warm oblivion.

She recovered with difficulty from the fact that someone strongly and persistently pulled her now by the leg and anxiously asked:

– Tell me where is your child?

Natashka, who did not understand anything, opened her eyes and looked around with a wild, incomprehensible look. Slowly returning to reality, she hardly realized that she was lying on the table in the operating room. Because on the ceiling above her head there was a large round lamp, and under her back there was a sticky cold oilcloth. And the walls around in white tiles. Opening her swollen lips with difficulty, she asked in a whisper:0014

– What happened and what do you want from me? How is it where my child is, what is going on?

The anxious face of a doctor in a medical mask leaned towards her:

– We immediately realized that your pregnancy was terminated, because we did not hear the fetal heartbeat during your admission.