Ear Infections In Children (OTITIS MEDIA)

An ear infection is the inflammation of the middle ear which is usually caused by bacteria as a result of fluid buildup behind the eardrum.

The ear has three major parts:

  1.  The outer ear – also called the pinna. It is everything we see on the outside. It also includes the ear canal which begins at the opening of the ear and extends to the eardrum. The eardrum is a membrane that separates the outer ear from the middle ear.
  2. The middle ear – it is located between the eardrum and the inner ear. This is where ear infections occur. There are small bones in the middle ear which transmit sound from the eardrum to the inner ear.
  3. The inner ear – it contains the labyrinth which helps us keep our balance. There is a part of the labyrinth called the cochlea, it converts sound vibrations from the middle ear into electrical signals. The auditory nerve will carry these signals to the brain.


Children get ear infections more commonly than adults and it is one of the major reasons for a child’s visit to the doctor. Ear infections usually follow a common cold or sore throat.


This is the most common ear infection. Parts of the middle ear are infected and swollen and fluid is trapped behind the eardrum.


There are a few bacteria that can cause acute otitis media. They include:

  • Hemophilus influenza
  • Hemolytic streptococcus
  • Streptococcus pneumonia
  • Staphylococcus aureus


Children may present with some of the below symptoms:

  • Fever
  • Sudden and persistent ear ache; the child would be seen to be constantly tugging his/her ear
  • Purulent discharge from the ear
  • Vomiting
  • Diarrhea
  • Crying and agitation
  • Impaired hearing


If you suspect a child has an ear infection, take them to see a doctor who will run the following tests:

  • Full Blood Count
  • Ear swab for culture and sensitivity


  • Paracetamol which will work as an antipyretic and an analgesic.
  • Antibiotics to fight the infection.
  • Encourage lots of fluid intake.
  • Continue feeding the child.
  • Drainage of the eardrum.
  • Wicking the ear to prevent re-infection.


This is when an infection has run its course and fluid stays trapped behind the eardrum. A child may not show symptoms but the doctor will be able to see the fluid behind the eardrum with an instrument known as an otoscope.


It is an infection of the middle ear with perforation of the tympanic membrane and pus discharging from the ear for more than 2 weeks. There is usually no fever or pain. When there is fever or pain, there is a likely obstruction to drainage of the perforated drum with secondary infection of some bacteria. A chronically draining ear would only heal if it is dry.


  • Complication of acute otitis media.
  • Secondary bacterial infections: pseudomonas aeruginosa, proteus vulgaris, pneumococci


  • Chronic ear discharge (otorrhoea)
  • Hearing loss


The diagnosis of chronic otitis media is similar to the acute form. Lab investigations done for acute otitis media will be done.


Treatment aims at keeping the ear dry and fighting any secondary infections.

  • Frequent wicking to keep the ear dry; at least four times a day. A piece of clean absorbent gauze is rolled into a wick and inserted carefully into the child’s ear. It is left for one minute and then removed and replaced with a clean wick. If bleeding occurs, drying the ear should be immediately stopped. Nothing should be left in the ear between wicking.
  • The child should avoid swimming or getting the inside of the ear wet.
  • The child should be assessed weekly to ensure drying of the ear is being done correctly.
  • If there is any secondary bacterial infection, antibiotics would be given.


Ear infections can be prevented by the following:

  1. Vaccinate your child against the flu. The pneumococcal conjugate vaccine (PCV 13) is highly recommended.
  2. Washing hands frequently. This helps prevent the spread of germs.
  3. Avoid exposing your child to cigarette smoke.
  4. Limit your child’s exposure to other children who are sick.


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