What is a middle ear infection?
The middle ear is the space behind the eardrum. It is connected to the throat by a narrow passage. During an infection this space fills with fluid, and the resulting pressure and inflammation of the eardrum cause pain. In rare cases, when pressure is very high, the eardrum may rupture and pus may drain from the ear. By looking inside with a special instrument (an otoscope), the doctor can see redness or swelling of the eardrum from the outside and in this way confirm a middle ear infection.
What causes a middle ear infection?
Middle ear infections are caused by viruses or bacteria. Children often have a cold with a runny nose at the same time. How does a middle ear infection present? Older children complain of ear pain. Younger children cry and frequently reach for the ear. Fever, diarrhoea or vomiting may occur at the same time. Pus draining from the ear indicates that a perforation has formed in the eardrum. In such cases the pain often eases.
How is a middle ear infection treated?
Since a middle ear infection resolves on its own in most cases, treatment begins with pain relief (Paracetamol, Dafalgan, Panadol, ben-u-ron) or Voltaren, Algifor, Ponstan and similar. In addition, decongestant nose drops may be given. At the follow-up examination it is decided whether antibiotics are necessary. This check-up normally takes place after 1–3 days (the younger the child, the sooner). If the eardrum ruptures and pus drains, antibiotic treatment should be started straight away.
What are the risks of a middle ear infection?
A middle ear infection is normally a condition with good treatment prospects. A ruptured eardrum usually heals without problems. Serious complications, such as inflammation of the bone or of the membranes of the brain, are rare. It is therefore important to follow the treatment prescribed by the doctor consistently. After a middle ear infection, fluid may remain in the middle ear for a long time. For this reason the affected children hear less well. When this fluid persists in the middle ear, this is referred to as chronic inflammation of the middle ear tube. If your child still appears not to hear well or seems irritable after 6–8 weeks, see the paediatrician. Please note: recurrent middle ear infections are normally not a reason to operate on the tonsils.
Ear pain: what should you do?
If your child complains of ear pain, giving pain relief is recommended (see above). A visit to the doctor is advisable but not urgent, except in the case of: – continuous pain – a child who remains unwell despite pain relief – persistent vomiting – headache despite pain relief – swelling around the ear. If you are unsure or have questions, you can call our clinic for advice on 044 700 125.