COMMON INFECTIONS OF CHILDHOOD: EAR INFECTIONS (OTITIS MEDIA) CAUSE AND INVESTIGATIONS: CAUSE AND INVESTIGATIONS
Cause
Otitis media is caused by infection of the eardrum by either a germ (bacteria) or a virus. Bacteria are responsible for about two-thirds of acute ear infections.
Usually an ear infection is accompanied by general signs of infection. Depending on the age of the child, these may include fever, irritability or drowsiness, loss of appetite, nausea or vomiting and sometimes diarrhoea, and headache.
While sometimes ear infections are ‘silent’ and do not cause any specific symptoms, usually the child will complain of earache or of a feeling of fullness or pressure in the ear. In babies there may be prolonged crying and pulling at the affected ear.
Ear infections may cause a temporary decrease in hearing, so that some children may have noticeable partial deafness during ear infections. Occasionally the eardrum may rupture (perforated eardrum), with a thick and sometimes bloody discharge. This results in relief of the pressure that has built up in the ear as a result of the infection, and eases the pain. The main complication of an acute ear infection is that it will turn into a ‘glue ear’ and affect the child’s hearing over a period of time. This may result in a delay in the child’s language, speech and communication skills.
Investigations
Apart from careful inspection of the child’s ear using an instrument called an otoscope, the doctor (usually a paediatrician or ENT specialist, although some general practitioners may also have this equipment) may perform a procedure called tympanometry, which measures how mobile the eardrum is and may assist in the diagnosis of whether the ear is normal. This is a painless procedure which takes a couple of minutes. If the child has had a number of ear infections, or if the doctor suspects there may be a chronic infection or a glue ear, then he may organise a hearing test. A formal hearing test should always be arranged if you suspect that the child has difficulty hearing.
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