Pedriatic Problems

Otitis refers to an infection of the ear. There are two types: Otitis externa (outer ear infection) and otitis media (middle ear infection).

Otitis externa is an infection in the outer ear canal. Another name for this infection is "swimmer's ear" as this infection can be associated with exposure to water. This can make the skin more susceptible to infection by bacteria, yeast, and fungi. The symptoms include redness and swelling of the skin in the ear canal, significant pain of the ear canal and drainage. Treatment for this infection includes antibiotic or antifungal eardrops and possibly oral (by mouth) antibiotics. Otitis media is also known as a middle ear infection (an infection in the space behind the ear drum). For children, otitis media is one of the most common infections. More than 90% of all children will have at least one infection by two years of age. There are two common forms: 1) recurrent "acute" infections, or 2) long lasting "chronic" infections. Persistent fluid behind the eardrum is known as otitis media with effusion.

Ear infections can be caused by bacteria or viruses. Risk factors include day care (usually with more than ten children) and smoking in the home. Allergies may contribute to ear disease but are not usually the direct cause of infections. Middle ear infections are the most common reasons children present to the doctor's office. By three years of age, most children have had at least one ear infection, and 30% of children have had three or more episodes. If ear infections start before 6 months of age, your child may be "otitis prone" and will suffer more than the usual number of infections in the first three years of life. Also, infections in newborn infants can lead to more severe complications of otitis media when compared to older children. Otitis media will often resolve without any treatment. However, possible complications of untreated otitis media include a hole (perforation) of the eardrum, hearing loss, and mastoiditis (see section below). Even more life threatening complications, such as meningitis (infection in the fluid surrounding the brain), brain abscess (pocket of pus in the brain), and/or blood clots in the veins in the head brain, are uncommon, but can occur.

Because of the severity of these possible complications, Dr. Shea recommends treatment for most ear infections with antibiotics.

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