Health : Otitis media-infection of the middle ear

Otitis media is an inflammatory condition of the middle ear, i.e. the area between the tympanic membrane and the inner ear, including a duct present there known as Eustachian tube. It may be acute or chronic in onset. It is a common infection in children as well as adults. Frequent cold, pricking of the ears by match sticks or needles, cross infection in swimming pools, are some of the conditions which predispose to ear infection in adults. In case of children, feeding the child by a bottle in a supine position, sending in group care at a very early age, cross infections in crowded school rooms are conditions which make a child more susceptible to otitis media. Parental smoking also increases the risk of developing otitis in children. Because the children are exposed to smoke exhaled by parental smoking passively. This damages the protective mucosal lining of the respiratory system making a child more prone to upper respiratory tract infections including otitis. Some children have a short Eustachian tube which makes them more prone to otitis. Malnutrition and immune deficiency conditions also increase the risk of developing otitis both in children and adults. There is severe pain in the affected ear accompanied by sense of blockade or propping up. There may be associated itching inside the ear. In bacterial infections, there may be pus discharge. These symptoms may be accompanied by high fever and enlargement of surrounding lymph nodes. Otitis can lead to inflammation of the mastoid (mastoiditis), which is manifest as a painful swelling outside the ear. Initially the hearing may be slightly impaired. But if the inflammation becomes severe causing perforation of the ear drum, there may be permanent loss of hearing in that ear. Infections of the ear or otitis have to be given due attention because they can give rise to serious infections elsewhere. The infectious germs may spread to lungs directly causing pneumonia. Through the blood stream, the infection may spread to the coverings of the brain causing meningitis, which is a life threatening infection. It can also lead to abscess in the brain which can result in severe headache, convulsions and paralysis of one or more limbs. Infection of the middle ear can be bacterial. Streptococcus pneumonia is the most common germ implicated. But others like Haemophilus influenzae, pseudomonas aeroginosa, Moraxella catarrhalis, e.t.c., are also implicated in causing middle ear infections. These bacterial infections most often cause high fever, severe pain and are more likely to be associated with pus discharge. Viruses such as RSV(respiratory synctial virus) and others which cause common cold can cause otitis also. But the infection is comparatively mild and subsides spontaneously within a week. Fungal infections of the ear usually occur in people with impaired immunity such as HIV/AIDS patients or those having renal failure or malignancy. Indiscriminate use of antibiotic drops inside the ear also makes one more susceptible to fungal infections of the ear. Spores of fungus like Cryptococcus or aspergillosis settle in the ear and then the mass grows slowly. The symptoms are like bacterial infections of the ear but less acute. There may be intermittent ear pain. Diagnosis of otitis is made by otoscopy (visualization of the ear internally). Causative germs are identified by microscopic examination of the discharge or culture, where the microbes present are grown in a suitable media and then identified. Treatment is by suitable antibiotic and anti-inflammatory drugs. Any discharge coming out is cleansed sufficiently. In case of perforation of the ear drum, it is repaired surgically. Because of the suffering caused by otitis and the risk of developing deafness, one should make efforts to prevent it.The ears should be kept dry at all times. Even while taking a shower, one should try to avoid water entering the ears. At times one may have sense of itching in ears due to common cold, but one needs to avoid putting a needle or key inside the ears for scratching. One should be careful while bottle feeding a baby and a sick child should be kept at home to avoid infecting other children. E-mail-rachna212002@yahoo.co.k