Acute otitis media
The term acute otitis media refers to inflammation of the middle ear (behind the eardrum) caused by viruses and bacteria. It is one of the most common conditions of childhood and less commonly affects adults. Characteristically, more than 40% of children will have 1 to 3 episodes of OMO by the age of 3 years. Usually the onset of the condition follows the seasonal onset of respiratory infections in the winter months. Recurrent OMO is defined as the occurrence of 3 or more episodes over 6 months, or 4 or more episodes over 1 year.
Causes of occurrence
Viruses:
- Respiratory syncytial virus
- Influenza
- Parainfluenza
- Rhinoviruses
- Adenoviruses
Bacteria:
- Pneumococcus
- Hemophilus
- Moraxella
- Streptococcus
- Staphylococcus aureus
Inflammation Mechanism
There are three ways in which viruses and bacteria can infect the ear. Either through the eustachian tube, the thin tube that connects the nose to the ear, or through the bloodstream, or finally through the eardrum if there is a rupture or a ventilation tube is inserted. The most common way is the former and this explains the presence of similar micro-organisms in the nose and ear.
Symptoms
The condition can start with a slight discomfort in the ear and can progress quite quickly. Severe pain, hearing loss, tinnitus, dizziness, fever and catarrh are the most common symptoms. In young children and infants there is also severe irritation and crying when the earlobe is irritated, anorexia and difficulty sleeping. When OMO progresses, rupture of the eardrum may occur and purulent fluid may leak into the ear canal while the patient will feel temporarily relieved of the severe symptoms.
Diagnosis
Taking a detailed history will form the basis of the diagnosis, which will be confirmed by otoscopy with either a handheld otoscope or microscope. Bright red tympanic membrane, which is prominent, is the classic clinical picture.
Treatment
It is not advisable for patients to start antibiotic treatment without first seeking the advice of their doctor. A transient discomfort in the ear may be the first sign of inflammation but may be due to many other factors, both pathological and non-pathological. If treatment is deemed necessary, broad-spectrum antibiotics to which the patient is not allergic are usually administered, always accompanied by painkillers and antipyretics to provide immediate relief.