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Ear infection - symptoms, prevention & treatment

User profile imageDr. Daisy Dharmaraj

Ear infection

A.Introduction

Ear infections are more common than we think. These are very common in babies and young children due to the shorter, narrower and more horizontal structure of the Eustachian tube (ear canal). Nasal infection results in obstruction to the opening of the Eustachian tube. This is followed by accumulation of fluid in the middle ear, which later gets infected. 
 

An Ear infection usually follows a common cold with viruses. After a few days of stuffy nose, the patient suffers from severe ear pain due to accumulation of fluid and a build up of pressure behind the eardrum. The pain usually settles in a day or two but can last over a week. The fluid accumulation is followed by bacterial infection. 

The infection of the middle ear does not cause ear discharge unless the eardrum ruptures. The type of ear discharge gives a clue of the underlying cause.  A scant white mucus discharge indicates acute external ear infection.  A fungal infection of the external ear results in a fluffy white to off-white, black, gray, bluish-green or yellow discharge.  A pus and mucus discharge without pain which is seen on and off may indicate chronic middle ear infection.
 

Children with middle ear infections often suffer from fever. A rupture of the eardrum results in relief of pain and drainage of pus into the ear canal. The discharge is usually milky white to yellow, sometimes with a foul odour.

B.Causes of ear infections

A foreign material that remains in the ear gets infected and causes ear discharge. Eczema and other skin conditions affecting the outer ear can also cause ear discharge.  Swimming,  Using or sharing of  ear buds,  ear phones , lowered  immunity  are some of the ways  which expose you  to  infections.

Head injury is one of the most serious causes of ear drainage and requires immediate medical intervention. A clear and watery drainage following head injury maybe due to leakage of cerebrospinal fluid indicating a fracture of the skull.  This is an emergency that needs immediate attention.

C.What are the complications of ear infections if they are not treated?

Complications from ear infections are rare, but they can arise. Some problems that can occur include:

  • Trouble hearing. Some children may have problems learning to talk and to understand speech if they have repeat ear infections
  • Rupture of the eardrum. If fluid continues to build up in the middle ear, the eardrum may burst. This leaves a small hole that often heals within 2 weeks.

·         Ongoing inflammation of the middle ear, a condition called Chronic supportive otitis media(CSOM). The major symptom of this condition is repeat or ongoing drainage of pus from the ear through a small hole in the eardrum. Many children with CSOM have some hearing loss.

The following complications may also develop if there are repeat ear infections:

  • Tissue growth behind the eardrum. If the tissue grows large enough, it can block the middle ear and affect hearing. Surgery is necessary to remove the growth.
  • Damage to the tiny bones in the middle ear

Rare complications include infection in the bone that is located behind the ear (mastoiditis). tissues surrounding the brain and spinal cord (meningitis).

4. How does one prevent ear infection?

If  chronic   ear discharge is  not treated there could be complications such as c  infection, abscesses in the  bones and in the  brain, nerve involvement, Meningitis,   hydrocephalus sinus thrombosis  and other problems in the central nervous system.

a)Prevention in babies

 

  • Try not to let infants and toddlers share toys that they put in their mouth, and, when possible, keep kids away from others with colds, flu, or sore throats.
  • Keep babies from lying down with a bottle -- liquid can pool inside the Eustachian tube, allowing bacteria to grow.
  • Teach your child to cough or sneeze into a tissue or the crook of the elbow.
  • Insist that children and caregivers wash hands often.
  • When practical, look for smaller daycare settings. Doctors say that groups of fewer than seven kids tend to have fewer infections.
  • As always, make sure your child drinks plenty of fluids and gets adequate rest.
  • Breastfeed for at least 3 months. Several studies have confirmed that breastfeeding may help protect a baby from illness due to the immune-boosting components of breast milk.
  • Limit using pacifiers. If your baby loves his, try giving it only at naptime and bedtime.
  • Steer clear of secondhand smoke. Kids who are exposed to cigarette smoke get more ear infections; it irritates mucous membranes and damages tiny hairs in the middle ear.
  • Stay up-to-date with vaccines. The pneumococcal vaccine, recommended for all healthy children under 2, mainly prevents bacterial meningitis, but also guards against seven strains of ear infection-causing bacteria. (Babies typically get four shots, between 2 and 15 months.). The influenza vaccine may also prevent some cases of AOM, since the virus involved, makes a child more susceptible

b. Prevention in adults

  • One can prevent swimmer's ear by using ear plugs before swimming or bathing, gently drying your ears with a blow dryer on the lowest setting after swimming or bathing, not inserting objects in the ears, and not swimming in polluted water.

·         Adults who have frequent middle ear infections should see an ENT doctor because surrounding tissues in the nose or throat could be blocking the Eustachian tube and preventing drainage.

·         Ear infections often occur after you had a flu, a bout with seasonal allergies, or after flying on an airplane.

·         Avoid sticking foreign objects, such as Q-tips, in the ea, or using pins, sticks etc to clear the ear.

  • avoid cigarette smoke
  • take a decongestant when you have a cold or before getting on an airplane

D.    Treatment

Middle ear infections in adults are often treated with oral antibiotics. However, recurrent ear infections caused by enlarged structures in the ear or throat, such as (tiny bones inside of the nose), or nasal polyps may have to be surgically removed or reduced in size.

 


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