Acute otitis media:Inflammation of the middle ear in which there is fluid in the middle ear accompanied by signs or symptoms of ear infection: abulgingeardrumusually accompanied by pain; or a perforated eardrum, often with drainage ofpurulentmaterial (pus).Acute otitis mediais the most frequent diagnosis in sick children in the U.S., especially affecting infants and preschoolers. Almost all children have one or more bouts ofotitis mediabefore age 6.
TheEustachian tubeis shorter in children than adults which allows easy entry of bacteria andviruses地中海进入中耳,导致急性中耳炎ia. Bacteria such asStreptococcus pneumoniae(strep) andHemophilus influenzae (H. flu)account for about 85% of cases of acute otitis media and viruses the remaining 15%. Babies under 6 weeks of age tend to have infections from different bacteria in the middle ear.
Bottlefeedingis arisk factorfor otitis media. Breastfeeding passes immunity to the child that helps prevent acute otitis media. The position of the breastfeeding child 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.
Upper respiratory infections are a prominent risk factor for acute otitis media so exposure to groups of children as in child care centers results in more frequent colds and therefore more earaches. Irritants such as tobacco smoke in the air also increase the chance of otitis media. Children with cleftpalateor Down syndrome are predisposed to ear infections. Children who have acute otitis media before 6 months of age have more frequent later ear infections.
Young children with otitis media may be irritable, fussy, or have problems feeding or sleeping. Older children may complain about pain and fullness in the ear. Fever may be present in a child of any age. These symptoms are often associated with signs ofupper respiratory infectionsuch as a runny orstuffy noseor a cough.
The buildup of pus within the middle ear causes pain and dampens the vibrations of the eardrum (so there is usually transient hearing loss during the infection). Severe ear infections may cause the eardrum torupture. The pus then drains from the middle ear into the ear canal. The hole in the eardrum from the rupture usually heals with medical treatment.
治疗急性中耳炎是最通用的nly antibiotics usually for 7- 10 days. Otherwise healthy children 6 months to 2 years of age and older, without severe symptoms or uncertain diagnosis, may be observed without antibiotics. Otherwise healthy children 6 months to 2 years of age and older, without severe symptoms or uncertain diagnosis, may be observed without antibiotics. About 10% of children do not respond within the first 48 hours of treatment. Even afterantibiotictreatment, 40% of children are left with some fluid in the middle ear which can cause temporary hearing loss lasting for up to 3-6 weeks. In most children, the fluid eventually disappears (resorbs) spontaneously (on its own). Children who have recurring bouts of otitis media may have a tympanostomy tube inserted into the ear during surgery to permit fluid to drain from the middle ear. If a child has a bulging eardrum and is experiencing severe pain, a myringotomy (surgicalincisionof the eardrum to release the pus) may be necessary. The eardrum usually heals within a week.
Acute otitis media is not contagious (although the cold that preceded it may be). A child with otitis media can travel by airplane bur, if the Eustachian tube is not functioning well, changes in pressure (such as in a plane) can cause discomfort. A child with a draining ear should, however, not fly (or swim).
