What is the cause of an earache?
Otitis media is a term for inflammation
of the middle ear, located behind the eardrum. The inflammatory reaction
is caused by an infection in the middle ear that leads to build up and
an accumulation of fluid. This fluid build up can be perceived as a
sensation of fullness in the middle ear. When too much fluid
accumulates, it produces pressure on the tympanic membrane and causes
pain. Otitis media can be acute or chronic, with or without symptoms. It
can take two forms: acute otitis media (AOM), or otitis media with
effusion (OME). AOM is a more severe form of otitis media, with pus
present in the middle ear, whereas, OME is less severe, without pus in
the middle ear. OME occurs more frequently than AOM. It is not always
possible to distinguish between these two forms using physical
examination (4). Otitis media is the most common illness in
preschool-aged children and is responsible for the most visits to the
doctor’s office. About 50% of American infants will have their first
episode of otitis media by 6 months of age and 90% of children will have
developed one or more episodes of otitis media by the age of 2 years
(1). As a result, more children in this age group see doctors for otitis
media, than for well child care (2). Immaturity of the immune system and
age-related difference in middle ear anatomy makes young children more
prone to developing otitis media following infections with respiratory
microbes. Other factors that put children at higher risk of developing
otitis media include day care attendance and exposure to tobacco smoke.
Frequency of otitis media declines as children mature.
WHAT CAUSES AN INFANT EAR INFECTION?
Microbes most commonly responsible for otitis
media include bacteria, such as Streptococcus pneumoniae (also known as
pneumococcus); Haemophilus influenzae; Moraxella Catarrhalis; and less
often group A streptococcus—the same bacteria that frequently causes
“strep throat;” Staphylococcus aureus; Pseudomonas aeruginosa; and many
viruses, especially respiratory syncytial virus, also known as RSV;
parainfluenza; influenza; entero; and adenoviruses (3).
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