Acute Otitis Media

What Is Acute Otitis Media (ear Infections)?

This is an inflamed eardrum, often with pain and fever, when there is active infection in the middle ear. It is important to visit the doctor if your child has any pain or fever, and is fretful.

How does it happen?

Children under the age of 2 years do not produce antibodies against the most common bacteria that cause acute otitis media (which are Streptococcus pneumoniae, and Haemophilus influenzae) little ones are very susceptible to contracting AOM. More children today are attending some form of pre-school or day-care, which means they are in contact with airborne bacteria, which can cause upper respiratory tract infections. The infection travels to the middle ear via the eustachian tube.

What is the treatment?

As the child often has a sore ear, pain relief can be the first choice of treatment. The use of antibiotics is becoming controversial.

Most children with AOM will resolve within 48 hours. If the symptoms have not settled in that time, antibiotics may be needed. This is why it is important to see your doctor early. All children with AOM should be followed up as some will still have middle ear fluid up to 12 weeks later.

This can affect their hearing. They then should be treated as otitis media with effusion (OME).

What are the complications?

The infection (pus) in the middle ear can progress to cause the eardrum to bulge out as pressure builds and is very painful. The eardrum cam then rupture (burst), draining pus into the ear canal. When this happens the child usually settles as the pain goes away.

This hole in the eardrum should heal normally if dry and kept free of water.

Months of chronic discharge can lead to a larger hole developing in the eardrum and may eventually damage the bones of hearing.

If the symptoms of AOM don’t settle after a course of antibiotics, a referral to the ENT specialist is suggested. Some children may develop meningitis or acute mastoiditis.