<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><strong>Contents:</strong></span></span></p>

<p style="text-align: justify;"><em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Causes</span></span></em></p>

<p style="text-align: justify;"><em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Symptoms</span></span></em></p>

<p style="text-align: justify;"><em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Exams and Tests</span></span></em></p>

<p style="text-align: justify;"><em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Treatment</span></span></em></p>

<p style="text-align: justify;"><em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Outlook (Prognosis)</span></span></em></p>

<p style="text-align: justify;"><em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Possible Complications</span></span></em></p>

<p style="text-align: justify;"><em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">When to Contact a Medical Professional</span></span></em></p>

<p style="text-align: justify;"><em><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Prevention</span></span></em></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Ear infections are one of the most common reasons parents take their children to the doctor. The most common type of ear infection is called otitis media. It is caused by swelling and infection of the middle ear. The middle ear is located just behind the eardrum.</span></span></p>

<p style="text-align: justify;">&nbsp;</p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">An acute ear infection starts over a short period of time and is painful. Ear infections that last a long time or come and go are called&nbsp;chronic ear infections.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><img alt="" src="https://www.zdrav.kz/images/refs3/otiten.png" /></span></span></p>

<h2 style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><a id="Causes" name="Causes">Causes</a></span></span></h2>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">The eustachian tube runs from the middle of each ear to the back of the throat. Normally, this tube drains fluid that is made in the middle ear. If this tube becomes blocked, fluid can build up. This can lead to infection.</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Ear infections are common in infants and children, because the eustachian tubes become clogged easily.</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Ear infections may also occur in adults, although they are less common than in children.</span></span></p>
	</li>
</ul>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Anything that causes the eustachian tubes to become swollen or blocked causes more fluid to build up in the middle ear behind the eardrum. Some causes are:</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Allergies</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Colds and sinus infections</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Excess mucus and saliva produced during teething</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Infected or&nbsp;overgrown adenoids&nbsp;(lymph tissue in the upper part of the throat)</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Tobacco smoke</span></span></p>
	</li>
</ul>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Ear infections are also more likely in children who spend a lot of time drinking from a sippy cup or bottle while lying on their back. However, getting water in the ears will not cause an acute ear infection, unless the eardrum has a hole in it.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Acute ear infections occur most often in the winter. You cannot catch an ear infection from someone else, but a cold may spread among children and cause some of them to get ear infections.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Risk factors for acute ear infections include:</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Attending day care (especially those with more than 6 children)</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Changes in altitude or climate</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Cold climate</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Exposure to smoke</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Family history of ear infections</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Not being breastfed</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Pacifier use</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Recent ear infection</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Recent illness of any type (because illness lowers the body&#39;s resistance to infection)</span></span></p>
	</li>
</ul>

<h2 style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><a id="Symptoms" name="Symptoms">Symptoms</a></span></span></h2>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">In infants, often the main sign of an ear infection is acting irritable or crying that cannot be soothed. Many infants and children with an acute ear infection have a&nbsp;<a href="http://www.nlm.nih.gov/medlineplus/ency/article/003090.htm">fever</a>&nbsp;or trouble sleeping. Tugging on the ear is not always a sign that the child has an ear infection.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Symptoms of an acute ear infection in older children or adults include:</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Ear pain or earache</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Fullness in the ear</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Feeling of general illness</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Vomiting</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Diarrhea</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Hearing loss&nbsp;in the affected ear</span></span></p>
	</li>
</ul>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">The ear infection may start shortly after a cold. Sudden drainage of yellow or green fluid from the ear may mean the eardrum has ruptured.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">All acute ear infections involve fluid behind the eardrum. At home, you can use an electronic ear monitor to check for this fluid. You can buy this device at a pharmacy. You still need to see your doctor to confirm an ear infection.</span></span></p>

<h2 style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><a id="Exams and Tests" name="Exams and Tests">Exams and Tests</a></span></span></h2>

<p style="text-align: justify;">&nbsp;</p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">The health care provider will look inside the ears using an instrument called an otoscope. This may show:</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Areas of dullness or redness</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Air bubbles or fluid behind the eardrum</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Bloody fluid or pus inside the middle ear</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">A hole (perforation) in the eardrum</span></span></p>
	</li>
</ul>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">The health care provider might recommend a hearing test if the person has a history of ear infections.</span></span></p>

<h2 style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><a id="Treatment" name="Treatment">Treatment</a></span></span></h2>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Some ear infections will safely clear up on their own without antibiotics. Often, treating the pain and allowing the body time to heal itself is all that is needed:</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Apply a warm cloth or warm water bottle to the affected ear.</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Use over-the-counter pain relief drops for ears, or ask the doctor about prescription ear drops to relieve pain.</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Take over-the-counter medications for pain or fever, such as ibuprofen or acetaminophen. Do NOT give aspirin to children.</span></span></p>
	</li>
</ul>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">All children younger than 6 months with a fever or symptoms should see the doctor. Children who are older than 6 months may be watched at home if they do NOT have:</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">A fever higher than 102&deg;F (38.9&deg;C)</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">More severe pain or other symptoms</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Other medical problems</span></span></p>
	</li>
</ul>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">If there is no improvement or if symptoms get worse, schedule an appointment with your health care provider to determine whether antibiotics are needed.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">ANTIBIOTICS</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">A virus or bacteria can cause ear infections. Antibiotics will not help an infection that is caused by a virus. Many health care providers no longer prescribe antibiotics for every ear infection. However, all children younger than 6 months with an ear infection are treated with antibiotics.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Your health care provider is more likely to prescribe antibiotics if your child:</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Is under age 2</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Has a fever</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Appears sick</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Does not improve in 24 to 48 hours</span></span></p>
	</li>
</ul>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">If antibiotics are prescribed, it is important to take them every day and to take all of the medicine. Do NOT stop the medicine when symptoms go away. If the antibiotics do not seem to be working within 48 to 72 hours, contact your doctor. You may need to switch to a different antibiotic.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Side effects of antibiotics may include nausea, vomiting, and diarrhea. Although rare, serious allergic reactions may also occur.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Some children have repeat ear infections that seem to go away between episodes. They may receive a smaller, daily dose of antibiotics to prevent new infections.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">SURGERY</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">If an infection does not go away with the usual medical treatment, or if a child has many ear infections over a short period of time, the doctor may recommend&nbsp;ear tubes.</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">A tiny tube is inserted into the eardrum, keeping open a small hole that allows air to get in so fluids can drain more easily.</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Usually the tubes fall out by themselves. Those that don&#39;t fall out may be removed in your doctor&#39;s office.</span></span></p>
	</li>
</ul>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">If the adenoids are enlarged, removing them with surgery may be considered if ear infections continue to occur. Removing tonsils does not seem to help prevent ear infections.</span></span></p>

<h2 style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><a id="Outlook (Prognosis)" name="Outlook (Prognosis)">Outlook (Prognosis)</a></span></span></h2>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Most often, an ear infection is a minor problem that gets better. Ear infections can be treated, but may occur again in the future.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Most children will have minor, short-term hearing loss during and right after an ear infection. This is due to fluid in the ear.&nbsp;Fluid can stay behind the eardrums&nbsp;for weeks or even months after the infection has cleared.</span></span></p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Speech or language delay is uncommon, but it may occur in a child who has lasting hearing loss from many, repeated ear infections.</span></span></p>

<h2 style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><a id="Possible Complications" name="Possible Complications">Possible Complications</a></span></span></h2>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Rarely, a more serious infection may develop, such as</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Mastoiditis&nbsp;(an infection of the bones around the skull)</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Meningitis&nbsp;(an infection of the brain)</span></span></p>
	</li>
</ul>

<h2 style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><a id="When to Contact a Medical Professional" name="When to Contact a Medical Professional">When to Contact a Medical Professional</a></span></span></h2>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Call your child&#39;s doctor if:</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Pain, fever, or irritability do not improve within 24 to 48 hours</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">At the start, the child seems sicker than just an ear infection</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Your child has a high fever or severe pain</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Severe pain suddenly stops -- this may indicate a ruptured eardrum</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Symptoms get worse</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">New symptoms appear, especially severe headache, dizziness, swelling around the ear, or twitching of the face muscles</span></span></p>
	</li>
</ul>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Let the doctor know right away if a child younger than 6 months has a fever, even if no other symptoms are present.</span></span></p>

<h2 style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><a id="Prevention" name="Prevention">Prevention</a></span></span></h2>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">You can reduce your child&#39;s risk of ear infections with the following practices:</span></span></p>

<ul>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Wash hands and toys often.</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">If possible, choose a day care that has 6 or fewer children. This can reduce your child&#39;s chances of getting a cold or other infection, and lead to fewer ear infections.</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Avoid pacifiers.</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Breastfeed -- this makes a child much less prone to ear infections. If you are bottle feeding, hold your infant in an upright, seated position.</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Do not expose your child to secondhand smoke.</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Make sure your child&#39;s immunizations are up to date. The pneumococcal vaccine prevents infections from the bacteria that most commonly cause acute ear infections and many respiratory infections.</span></span></p>
	</li>
	<li style="text-align: justify;">
	<p><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Avoid overusing antibiotics. Overusing antibiotics can lead to antibiotic resistance.</span></span></p>
	</li>
</ul>

<p style="text-align: justify;">&nbsp;</p>

<p style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><strong>Source:&nbsp;</strong><a href="http://www.nlm.nih.gov/medlineplus/ency/article/000638.htm">http://www.nlm.nih.gov/medlineplus/ency/article/000638.htm</a></span></span></p>
