Otitis Media Paediatric-various aspects- INTRODUCTION to otitis media paediatric-
Children frequently have acute otitis media, generally known as ear infections. By the time they turn one, one-fourth of infants in nations with plenty of resources have experienced at least one ear infection. In addition to typical symptoms like loss of appetite and irritability, ear infections can result in ear pain, fever, and temporary hearing loss. While some kids recover without specialised antibiotic therapy, using an antimicrobial medication frequently reduces the length of a fever and earache. Early-life ear infections in some kids increase their risk of developing recurrent infections and persistent middle ear fluid. They might be more likely to develop infections-related problems. In these situations, a paediatrician and an ENT specialist’s opinion should always be sought as it is very important in otitis media paediatric.
In this article, we’ll go over the definition, causes, signs, symptoms, prognosis, and possible complications of newborn and toddler ear infections.
A EAR INFECTION in chidren- otitis media paediatric- IS WHAT?
Acute otitis media is another name for ear infection (otitis = ear, media = middle). Middle ear infection known as otitis media. The majority of the time, it is brought on by germs that almost all kids at some point have in their throat and nose.
The most frequent cause of ear infections is a viral respiratory tract illness like the flu or a cold. The mucous membranes of the nose and throat may enlarge as a result of these illnesses, which can also weaken natural host defences including the removal of bacteria from the nose, leading to an increase in the number of germs there. Eustachian tube function can also be hampered by viral respiratory tract infections. For the pressure in the ear to remain normal, regular Eustachian tube function is crucial. Pressure in the middle ear fluctuates when the Eustachian tube is not functioning properly (like when you are flying in an airplane). Inflammation in the middle ear may develop as a result of fluid (also known as an effusion), bacteria, and viruses (figure 1). The eardrum may swell as a result of the increased pressure, producing the typical symptoms of pain and fussiness in young children, or it may even rupture and cause fluid to flow from the ear canal.
SYMPTOMS OF EAR INFECTION IN CHILDREN –otitis media paediatric –
A brief loss of hearing and ear pain are typical signs of an ear infection in teenagers and older kids. These signs typically appear out of nowhere.
The signs of an ear infection in newborns and young children are sometimes ambiguous. A concurrent viral respiratory tract infection may be the root of many ear infection symptoms. An ear infection may show these signs:
Fever (temperature above 100.4°F or 38°C; refer to the table for instructions on how to take a child’s temperature) (table 1)
Removing the earphone
Fussiness, annoyance, or disturbed sleep
Absence of appetite or trouble eating
nausea or diarrhoea
Draining the outer ear’s fluid (called otorrhea)
Diagnosis of an ear infection in children- otitis media paediatric-
Call your Paediatrician or ENT specialist doctorif you think your kid may have an ear infection to find out if and when the child needs to be evaluated.
Even though the procedure is not painful, the majority of newborns and kids dislike having their ears inspected. Holding your child in your lap and cuddling their arms and bodies will make the procedure go more smoothly as the doctor or nurse looks inside the child’s ear using an otoscope. In order for your doctor or nurse to gain a clear view of the ear drum, cerumen (ear wax) will frequently need to be removed.
By examining the ear drum (tympanic membrane) for the common signs of an ear infection, the doctor or nurse can determine whether your kid has an ear infection.
TREATMENT FOR EAR INFECTION IN CHILDREN-otitis media paediatric-
Among the options for ear infection treatment are:
medications for fever and pain
Observation is sometimes known as watchful waiting.
Combining the aforementioned
Depending on your child’s age, history of prior infections, level of illness, recent use of antibiotics, and any underlying medical conditions, treatment should be customised.
Antibiotics for otitis media paediatric – Although children with these conditions recover more quickly from antibiotic treatment, antibiotics are frequently administered to infants younger than 24 months old, as well as those who have a high fever or an infection in both ears. Children older than 24 months who exhibit minor symptoms may be given an antibiotic or frequently monitored to see whether they get better quickly without them.
Overuse of antibiotics might result in bacteria that are harder to cure (resistant), which can cause side effects like diarrhoea and rash. Resistance indicates that an antibiotic is no longer effective or that bigger doses may be required in the future.
Observation in otitis media paediatric — Your kid’s doctor or nurse may occasionally advise you to observe your child at home before administering antibiotics. Antibiotics may not be required, depending on observation.
It may be advised to observe in the following circumstances:
In the event that a youngster is older than 24 months
If the fever and ear discomfort are not severe
If the infant is healthy
Regardless of whether your child is receiving antibiotics or is just being watched, painkillers should be administered to reduce discomfort. Pain management is described below.
If your child is receiving observation rather than antibiotic treatment, you might need to contact or visit the Paediatrician or ENT specialist doctor again in 24 hours for a check-in. Repeat testing may be required and antibiotics are typically advised if your child’s pain or fever persists or gets worse. If your child is improving but isn’t quite back to normal, observation may still be useful.
Pain management in otitis media paediatric– To lessen discomfort, pain-relieving medications like acetaminophen (sample brand name: Tylenol) and ibuprofen (example brand name: Motrin) may be utilised.
Antihistamines,Antibiotics and decongestants are required in otitis media paediatric .It has not been demonstrated that cough and cold medications, which frequently contain a decongestant or an antihistamine, hasten healing or lessen the severity of ear infections in children. These treatments also come with potentially harmful side effects. Children with ear infections shouldn’t take decongestants or antihistamines.
Follow-up in otitis media paediatric – Whether or whether your child received an antibiotic prescription, their symptoms should subside in 24 to 48 hours. Call your doctor or nurse for guidance if your child’s condition does not improve within 48 hours or worsens at any time. Even though the child may still have a fever and have discomfort after taking antibiotics, things should get better every day. Contact the healthcare provider as soon as you can if your child seems sicker than when they were last visited by the provider.
Two to three months after receiving ear infection treatment, children under the age of two and those with language or learning issues should have a follow-up ear examination. These kids run the risk of experiencing speech delay. This checkup enables us to make sure that the fluid accumulation, which could have an impact on hearing, has disappeared. (See ‘Complications of ear infections’ below.)
COMPLICATIONS OF EAR INFECTION IN CHILDREN-otitis media paediatric –
Rupture of the tympanic membrane, commonly known as an ear drum perforation, is one of the most frequent side effects of an ear infection. As fluid presses against the tympanic membrane, it may rupture, restricting blood flow and weakening the tissue. When the membrane bursts, it does not hurt, and many kids feel better since the pressure is reduced. Thankfully, the tympanic membrane typically returns to normal within hours to days after rupturing. An ear infection should be treated with antibiotics if the ear drum ruptures.
Hearing loss in otitis media paediatric – An effusion, or fluid buildup behind the eardrum, can linger for weeks or months after the discomfort of an ear infection has subsided. Hearing loss brought on by an effusion is typically mild to moderate and transient. But, if the fluid continues, it might obstruct speech and/or learning.
Effusions typically go away on their own with time and no treatment. However, if the effusion lasts for longer than three months, surgery might be necessary to treat the youngster. The effusion’s impact on the infant’s hearing and the likelihood that learning or speech issues may arise will determine whether or not the youngster should be treated.
The effects of fluid and conductive hearing loss may be exacerbated for kids who have underlying speech, hearing, or developmental issues. They should be assessed earlier than the three months suggested for children without these issues since they might require earlier intervention.
It’s important to keep track of kids who don’t get treated for effusions throughout time. Up until the effusion disappears, this involves an ear check and hearing test every three to six months.
PREVENTION OF EAR INFECTION IN CHILDREN- otitis media paediatric –
Some kids commonly get ear infections. Three or more ear infections within a six-month period, or four or more over a 12-month period, are considered recurrent ear infections. All children should receive the influenza and pneumococcal conjugate vaccines, as advised by the American Academy of Pediatrics and the American Academy of Family Practice, but there are other steps that can be taken to lower the risk of recurrent infections. They include avoiding tobacco use, breastfeeding, taking regular, low-dose antibiotics (referred to as prophylaxis), and/or having tubes surgically placed in the ears.
Antibiotics used as a preventive measure in otitis media paediatric – In the fall, winter, and early spring, doctors may prescribe a daily antibiotic treatment for kids who get recurring ear infections. Although using preventive antibiotics may help lower the incidence of ear infections, a kid may still get an infection. Also, there is a chance that using antibiotics for an extended period of time will result in germs that are resistant to conventional antibiotics. The possible advantages and disadvantages of this strategy can be discussed with your child’s doctor.
Surgery for otitis media paediatric – According to some research, inserting tympanostomy tubes surgically in the ears can help avoid recurring ear infections. Tympanostomy tubes maintain the same pressure in the middle ear and ear canal while allowing fluid to drain from the middle ear and air to enter the middle ear (figure 2). Tympanostomy tubes are not beneficial for preventing recurrences, according to other research. Consult your child’s paediatrician and ENT surgeon about the advantages and disadvantages of surgery.