What is otitis media?

Otitis media is a bacterial infection of the middle ear. It occurs most frequently in children under the age of 8 years, although anyone can get a middle ear infection.

How does it occur?

Acute otitis media usually begins with a viral infection of the upper respiratory system such as a cold. Bacteria enter the ear canal through the eustachian tube (the tube that connects the ear with the throat) and cause the middle ear to become inflamed. Inflammation and swelling of the nose and sinus may block the eustachian tube.

Besides providing a drain, the eustachian tube also functions to maintain normal air pressure in your inner ear. When the tube is inflamed, fluid produced by the infection cannot drain properly through the eustachian tube. When the tube is clogged with fluid, the pressure in the ear increases and can cause the delicate membrane in the middle ear (eardrum) to rupture. Fluid may then drain from the ear.

What are the symptoms?

The symptoms can include:

• earache

• hearing loss

• feeling of blockage in the ear

• nasal discharge that is usually colored

• fever

• dizziness

• nausea or stomach pain

• vomiting.

How is it diagnosed?

To diagnose acute otitis media, your health care provider will review your symptoms and look at your eardrum with an otoscope. Your provider may first have to remove excess earwax.

Your health care provider may do a tympanogram test. This test is performed with a small device in the ear canal. A puff of air is blown into the ear and movement of the eardrum is measured. If there is fluid behind the eardrum, the membrane won't move well.

How is it treated?

The treatment for acute otitis media is antibiotic medication for 10 days. Your health care provider may also prescribe decongestant medicine (tablets or a nasal spray) to help clear the eustachian tube. This will help relieve pressure on the middle ear.

How long will the effects last?

You should feel better 48 to 72 hours after you start taking the antibiotic. If the eardrum has not returned to normal when your health care provider examines you again, you may need to take a different antibiotic or other medication. After 2 weeks, you should feel normal again.

What can I do to take care of myself?

Follow your health care provider's instructions, and take all prescribed medication, even when your symptoms have gone away.

To help relieve pain, apply warm compresses or a hot water bottle to the area around the ear.

If you have discharge from your ear, you can wipe it away and loosely plug the ear with cotton to catch further drainage. If you have excessive fluid and pus draining from your ear, the eardrum has probably ruptured and there may be a more serious infection. Ask your health care provider how to handle ear discharge.

If you have a fever:

• Stay in bed until your temperature has fallen below 100 degrees F (37.8 degrees C), and then become as active as you comfortably can.

• Ask your health care provider if you can take aspirin, acetaminophen, or ibuprofen to control your fever. Anyone under the age of 21 with a viral illness should not take aspirin because of the increased risk of Reye's syndrome.

• Keep a daily record of your temperature.

Also, call your health care provider if you have:

• a temperature over 102 degrees F (38.9 degrees C) that persists even after you take acetaminophen, aspirin, or ibuprofen

• a severe headache or pain around the ear

• swelling around the ear

• convulsions or decreased alertness

• dizziness

• worsening of your hearing

• weakness of one side of your face.

Your health care provider will want you to have one or more follow-up exams until all signs of inflammation and infection have disappeared. Be sure to keep all your appointments.

How can I prevent acute otitis media from occurring?

See your health care provider for treatment of an upper respiratory infection before it leads to ear infection.