Acute Otitis media (Middle Ear Infection)

Acute otitis media is an infection in the middle space of the ear, behind the ear drum. It is usually caused by bacteria or a virus. Often times, an ear infection occurs at the same time or soon after another infection such as a cold, flu, or allergies.  Children tend to get ear infections more often than adults due to the anatomy of the ear and eustachian tubes (tubes connecting the middle ear to the back of the throat).

Symptoms of an ear infection include: fevers (100.4°F or greater), ear tugging/pain, muffled/decreased hearing, irritability, fatigue, trouble sleeping, nausea/vomiting, diarrhea, headache, and sometimes ear drainage.

In order to diagnose a middle ear infection, your pediatrician will ask about the symptoms listed above as well as examine the child. Your pediatrician will check your child’s ear and they may see redness of the ear drum, bulging of the ear drum, and possibly fluid behind the ear drum. Your pediatrician will also check the child for any other possible causes of infection.

Acute Otitis media is usually treated with a course of antibiotics. Multiple antibiotics are available for treatment, so please let your pediatrician know if the child is allergic to any medications/antibiotics.

Sometimes the fluid behind the ear drum can linger, even weeks after the infection has cleared. This need to be monitored. If fluid persists or there are recurrent ear infections, this can impact hearing.

Other causes of ear pain that may resemble and ear infection include: outer ear infection (otitis externa), teething, barotrauma (ear pain due to loud noises or air travel), rashes, allergies, or other infection (colds, flus).

Some children get ear infections more often. If your child has 3+ infections within 6 months or 4+ infections in 1 year, then they may need to see a specialist (ENT) for possible placement of ear tubes (tympanostomy tubes).

Breast fed infants are less likely to get otitis media as compare to formula fed. Also, small group day care for infant and toddlers, avoiding household tobacco smoking are important factors in reducing the incidence of otitis media. It is important to timely immunize for pneumococcal and flu vaccines. There are some data to suggest that using pacifier after twelve months of age and putting dirty hands and inappropriate things in the mouth is associated with increase risk of ear infection. It is important when you are formula feeding your infant, keep the head in upright position. horizontal position causes the formula to flow into eustachian tubes resulting in recurrent infection.

There certain congenital conditions which predisposes to increase risk of otitis media, like cleft palate, craniofacial anomalies, down syndrome, and immune deficiencies.

Acute otitis media (AOM) is quite a common condition and a leading cause of health care visits and antibiotic prescription. As per WHO globally, acute OM incidence rate is 10.85% i.e. 709million cases each year with 51% of these occurring in under-fives. OM-related hearing impairment has a prevalence of 30.82 per ten thousand. Each year 21thousand people die due to complications of OM. Its complications and sequelae are important causes of preventable hearing loss, particularly in developing countries.  (

If you believe your child may have an ear infection or have further questions, please contact us.

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