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What is Acute Otitis Media?

By D. Jeffress
Updated May 17, 2024
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Acute otitis media is the medical term for an infection of the middle ear that usually develops and resolves in less than four weeks. The condition is very common among young children and can be caused by viruses or bacteria. Common symptoms can include pain, itchiness, and congestion in the ears, hearing difficulties, and related problems, such as headache and fever. Most cases of acute otitis media do not require medical treatment, though it is still worthwhile to schedule an appointment with a pediatrician to make sure symptoms are not related to a bigger problem. In some instances, a doctor may consider prescribing antibiotics or surgically draining excess fluid from the ears.

Children are much more likely to develop acute otitis media than adults for a few reasons. A major factor is that a young child's immune system is not yet strong enough to fight off common viruses and bacteria responsible for infection. It is also suspected that the Eustachian tubes, the structures that drain mucus from the ears to the throat, are more likely to suffer infection during childhood because they are not fully developed. Developing tubes are smaller and positioned more horizontally, making them more susceptible to harboring pathogens.

Acute otitis media is usually preceded by a viral infection of the upper respiratory tract. Pathogens make their way from the throat to the Eustachian tubes, where they cause irritation, inflammation, and fluid buildup. Several types of common bacteria can also cause otitis media, including Streptococcus pneumoniae and Haemophilus influenzae.

A person who has acute otitis media may experience constant head pressure, dull or sharp earaches, mild hearing loss, and ringing in the ears. Fever is present in many cases, and other flu-like symptoms of the previous respiratory tract infection may linger. If the cause is bacterial, clear or yellow pus might drain out of the ears. Infants and very young children may become highly irritable and refuse to eat due to symptoms.

A pediatrician can usually diagnose acute otitis media by looking for middle ear redness and inflammation during a physical exam. He or she may also collect a sample of pus for laboratory testing to confirm the presence of specific pathogens. Hearing tests and imaging scans are needed whenever symptoms are severe to check for signs of eardrum rupture. The doctor can also ask parents or caregivers about the onset of problems to make sure it is not a chronic condition.

Acute otitis media is usually left untreated when symptoms are mild. A pediatrician might suggest over-the-counter anti-inflammatory drugs for older children and tell parents to monitor symptoms to make sure they do not get worse over the next few days. Oral antibiotics or ear drops may be prescribed if the cause is bacterial. In otherwise healthy children, infections usually get better in two to four weeks.

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