What are the symptoms?

Sufferers often complain about ear pain, ear fullness, or hearing loss. Younger children may be irritability, or suffer difficulty in sleeping, feeding, or hearing. There maybe a fever.

There may also be upper respiratory infection symptoms, such as a runny or stuffy nose or a cough.

If there is a rupture of the eardrum then the pus will start to drain. The hole in the eardrum from the rupture will usually heal with medical treatment.

If the infection is not adequately treated, it can lead to complications. Therefore, children complaining of earache when combined with fever or an upper respiratory tract infection, should be examined by a doctor.

The doctor will wish to examine the ear using an otiscope (a magnifying lens with a light). If they are concerned about the hearing a further hearing test may be undertaken.

Initial treatment for acute otitis media is antibiotics. 10% of children do not respond within the first 48 hours of treatment. 40% of children may retain non-infected residual fluid in the middle ear that can cause some temporary hearing loss. This may last for 3 to 6 weeks after the initial antibiotic therapy.

Chronic otitis media may develop when infection persists for more than 2 weeks.

In the child with a bulging eardrum and who is experiencing severe pain, a myringotomy (surgical incision of the eardrum to release the pus) may be necessary. The eardrum usually heals within a week.

Children with recurring otitis media infections may be given a low dose antibiotic treatment that will last for a few months.

In infants, breastfeeding helps to pass along immunities that prevent acute otitis media. Also, the position of the child when breastfeeding is better than the bottle-feeding position for eustachian tube function. If a child needs to be bottle-fed, holding the infant rather than allowing the child to lie down with the bottle is best. A child should not take the bottle to bed. In addition to increasing the chance for acute otitis media, falling asleep with milk in the mouth increases the incidence of tooth decay.

Multiple upper respiratory infections may lead to frequent acute otitis media. Exposure to large groups of children, such as in nursery, results in more frequent colds and therefore more earaches. Environmental irritants, such as secondhand tobacco smoke, should also be avoided.

Males are also more commonly affected than females. Children who have acute otitis media when younger than 6 months may be more prone to frequent bouts of ear infection.

Children who are prone to recurring bouts of otitis media or who have deficiencies in their immune system may be prescribed antibiotics or a tympanostomy tube by their doctor to prevent future infections. A tympanostomy tube is inserted into the ear during surgery to permit fluid to drain from the middle ear. Antibiotics are not an effective treatment for otitis media with effusion.

Once the symptoms have settled down there will be no need for further follow-up unless the hearing is affected.