Otitis
Ear infection; Infection - ear
Otitis is a term for infection or inflammation of the ear.
The ear consists of external, middle, and inner structures. The eardrum and the three tiny bones conduct sound from the eardrum to the cochlea.
The external structures of the ear may aid in diagnosing some conditions by the presence or absence of normal landmarks and abnormal features including earlobe creases, preauricular pits, and preauricular tags.
Otitis media is an inflammation or infection of the middle ear. Acute otitis media (acute ear infection) occurs when there is bacterial or viral infection of the fluid of the middle ear, which causes production of fluid or pus. Chronic otitis media occurs when the eustachian tube becomes blocked repeatedly due to allergies, multiple infections, ear trauma, or swelling of the adenoids.
Causes
Otitis can affect the inner or outer parts of the ear. The condition can be:
- Acute ear infection -- Starts suddenly and lasts for a short period of time. It is often painful.
- Chronic ear infection -- Occurs when the ear infection does not go away or keeps coming back. It may cause long-term damage to the ear.
Based on location otitis can be:
- Otitis externa (swimmer's ear) -- Involves the outer ear and ear canal. A more severe form can spread into the bones and cartilage around the ear.
- Otitis media (ear infection) -- Involves the middle ear, which is located just behind the eardrum.
- Otitis media with effusion -- Occurs when there is thick or sticky fluid behind the eardrum in the middle ear, but there is no ear infection.
Is your child irritable, inconsolably crying, feverish, and having trouble sleeping? If so, your child may have an ear infection. Ear infections are one of the most common reasons parents take their children to the doctor. The most common type is called otitis media, which means an inflammation and infection of the middle ear. The middle ear is located just behind the eardrum. The Eustachian tube runs from the middle of each ear to the back of the throat. This tube drains fluid normally made in the middle ear. If the tube gets blocked, fluid can build up, leading to infection. Ear infections are common in infants and children because their tiny. Eustachian tubes become easily clogged. They're often caused by allergies, colds, and excess mucus and saliva produced during teething. Infants with an ear infection will often be irritable. You may have a hard time consoling their crying, and your child may have a fever and not sleep very well. Older children may have an ear ache and tell you their ear feels full. Because ear infections have fluid behind the ear drum, you can use an electronic ear monitor to detect this fluid at home. Children under 6 months old who might have an ear infection need to see a doctor. Your child's doctor will look inside the child's ear using an instrument called an otoscope. The doctor might see areas of redness, air bubbles behind the ear drum, and fluid inside the middle ear. Often, an ear infection will clear up on its own. For older children, you can place a warm cloth or bottle on their ear and give them over-the-counter ear drops to relieve their pain. If bacteria caused the ear infection, your child may need to take antibiotics. In fact, all ear infections in children under 6 months old are treated with antibiotics. If the infection does NOT go away, on its own or with treatment, the doctor may recommend ear tube surgery. In this procedure, a tiny tube is inserted into the eardrum to drain the fluid. The tube will usually fall out on its own. Ear infections are very treatable, but they may come back again. If your child has to take an antibiotic, make sure they take all of the medicine.
Does your child have pain or discomfort in his ear? Does your child often have a fever and is fussy a lot? If so, they may have chronic ear infections. Ear infections are one of the most common reasons parents take their children to the doctor. The Eustachian tube runs from the middle of each ear to the back of the throat. This tube drains fluid normally made in the middle ear. If the tube gets blocked, fluid can build up, leading to infection. Ear infections are common in infants and children because the Eustachian tubes become easily clogged. If the ears get infected a lot or individual ear infections don't clear up, your child has chronic ear infections. How do you know for sure that your child has a chronic ear infection? Your child will feel like there's pressure or fullness in his ear. He may pain or discomfort in his ear a lot and have a low-grade fever. An infant may be fussy a lot. You may see a pus-like drainage from an ear, and your child may have trouble hearing. Your child's doctor will check for redness, air bubbles, and thick fluid in your child's middle ear. A swab of your child's ear may reveal bacteria that are harder to treat than bacteria that commonly cause an ear infection. The doctor may see a hole in your child's eardrum. To treat a chronic ear infection, your child will probably need to take antibiotics if the infection is due to bacteria, maybe for a long time. If there is a hole in the eardrum, your child may need to use antibiotic ear drops or a mixture of vinegar and water. If the infection does NOT go away, the child may need surgery, to clean the infection out of the mastoid bone in the middle ear, to repair or replace the small bones in the middle ear, or to repair the eardrum. The doctor may also recommend ear tube surgery. In this procedure, a tiny tube is inserted into the eardrum to drain the fluid. The tube will usually fall out on its own. Chronic ear infections are treatable, but your child may need to keep taking medicine even for several months. These infections can be uncomfortable, and they may result in hearing loss or other serious problems.
References
Chole RA, Sharon JD. Chronic otitis media, mastoiditis, and petrositis. In: Flint PW, Francis HW, Haughey BH, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 140.
Pelton SI. Otitis externa, otitis media, and mastoiditis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 61.
Pham LL, Bourayou R, Maghraoui-Slim V, Kone-Paut I. Otitis, sinusitis and related conditions. In: Cohen J, Powderly WG, Opal SM, eds. Infectious Diseases. 4th ed. Philadelphia, PA: Elsevier; 2017:chap 26.
Version Info
Last reviewed on: 7/28/2022
Reviewed by: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
