Purulent otitis media symptoms in a child. Danger of bilateral and recurrent disease. How to recognize the disease in time

Purulent otitis media in a child dangerous disease because it dresses up in the clothes of a harmless cold. In order not to go broke on expensive treatment and not mourn their baby, parents should know what kind of disease it is and how to deal with it. Let's talk about this disease, methods of its treatment and diagnosis, as well as effective anti-otitis media.

Otitis media is one of the most common and serious diseases in children. It occurs most often during cold weather and epidemics of colds. Most of all, children aged from 1 month to 5 years are susceptible to the disease. Inflammations are unilateral or bilateral, only in 10-12% of cases there is unilateral otitis media. In other cases, the child is diagnosed with bilateral purulent otitis media.

In pediatric practice, the "leader" is acute otitis media. Every 2nd child suffers from this disease at least once during the first 3 years of his life. Many people fall ill several times a year.

Traditional classification of otitis media

Inflammation of the middle ear otitis media(labyrinthitis).
Inflammation between the tympanic membrane and the labyrinth otitis media.
Inflammation of the part of the ear canal between the tympanic membrane and the outer ear ear canal – otitis externa .

Otitis externa can be limited or diffuse. Otitis media can be catarrhal or purulent, acute or chronic.

Causes, symptoms and treatment of otitis externa

A limited type of otitis media can be caused by quite a few factors, the main one being staphylococcus aureus. It causes the formation of a furuncle in the ear canal or inflammation hair follicle. There are other causes of purulent otitis in a child. External limited or diffuse otitis media can cause:

fungal infection;
sulfur plug;
wounds and scratches;
eczema;
purulent otitis;
diabetes.

With diffuse otitis media, the inflammatory process often extends to the entire area of the ear canal.

Limited or diffuse otitis media is diagnosed with severe throbbing pain due to movement of the auricles, swelling of the external auditory canal, or enlarged lymph nodes near the ear. There is also a decrease and congestion of the ear. Visible swelling and redness in the ear canal, itching, sometimes quite strong. The rise in temperature may be slight or absent. Hearing can only be impaired as a result of severe edema.

Treatment Method

In the treatment of otitis externa in children, the use of turunda (cotton plaits) with boric alcohol, it can increase the pain. The doctor prescribes painkillers and ear drops with antibiotics. After the development of the boil, ENT - the doctor will make a small incision and remove the pus. You should not remove it yourself, this can lead to the spread of pus to the temporal region and serious complications.

Acute and chronic inflammation of the middle ear

In babies of 1 year of age, middle ear disease often occurs due to the anatomical features of the structure. They have the Eustachian tube located in a horizontal plane, between the nasopharynx and the middle ear. In addition, it is much wider and shorter than in adults, which makes it easier for harmful microorganisms.

Small children in the first year of life are mainly in the supine position, which contributes to the stagnation of mucus in the nasopharynx and the development of inflammatory processes. And in a newborn, breast milk or mixture can get into the ear this way when spitting up after feeding.

Acute and chronic otitis is determined by the speed and duration of the development of the disease. There are two forms of acute otitis media (AOM): catarrhal and purulent. The catarrhal form of otitis occurs quickly, almost immediately. What are the symptoms of purulent otitis in a child? The first and main symptom is the appearance of pain in the ear.

As in all other cases, CCA disease in children is manifested by an increase in temperature up to 39o, anxiety, and fatigue. Babies may refuse to eat due to increased pain when swallowing. Otitis media in young children is often accompanied by vomiting.

You can diagnose otitis in a child by pressing a finger on the tragus (a protrusion, cartilage located in front of the ear canal), while the baby will cry or try to move away, turn away from the irritating factor. With unilateral inflammation, the baby will try to lie on the sore ear and thus reduce pain. Will pull the pen to the ear or often pull it.

Important! The acute catarrhal form of the disease in children can turn into acute purulent otitis media already during the first day.

Acute purulent otitis media is diagnosed when mucus, pus, and ichor flow out of the ear. It happens when it breaks eardrum accumulated pus.

There are three stages of acute suppurative otitis media:

Preperforative characterized by increasing inflammation. Symptoms: severe, growing pain in the depths of the ear, high temperature, noise in the ear, congestion. Duration from 2 hours to 3 days.
Perforated, is characterized by rupture of the tissues of the tympanic membrane and the expiration of the collected pus and, as a result, a decrease in pain symptoms. The outflow of pus or ichor can last up to 7 days.
Reparative, characterized by a decrease in temperature, a decrease in pain symptoms, and the cessation of the inflammatory process. Gradual restoration of well-being and hearing, healing of the gap. The duration of the period is up to 2 weeks.

In some cases, the course of the disease can be disturbed at the 1st stage or immediately take on a sluggish, protracted character. The stage of perforation in this case may not occur and in the cavity of the eardrum, thick pus will accumulate, which is difficult to remove. In this case, inflammation can go to the temporal region bone tissue which can even lead to death. Also, purulent otitis media can cause the following complications:

chronic suppurative otitis media;
meningitis;
brain abscess;
sepsis.

In some cases, in patients, despite perforation, there is no improvement in well-being. What is happening is usually associated with an active inflammatory process in the mastoid process, mastoiditis develops.

Inflammation of the inner ear or labyrinthitis

The causes can be injuries, viruses and bacteria, as well as their toxins. Most often, infection of the labyrinth occurs due to the proximity of foci of infection. This is possible with inflammation of the middle ear. First of all, the action of the vestibular apparatus is disrupted.

Symptoms of the disease

In most cases, the disease is manifested by a labyrinth attack, sudden severe dizziness, nausea and vomiting, imbalance. With a serous labyrinth, the symptoms last up to 3 weeks, gradually disappearing.

Purulent labyrinthitis is characterized by the occurrence of a protracted course, after the acute stage subsides.

Basic Treatments

How is purulent otitis media treated in children? With otitis in children, the use of antibiotics is practiced in combination with symptomatic treatment, anti-inflammatory drugs. Hyposensitizing therapy and vestibulolytics that normalize blood supply in the labyrinth.

Methods and means of treating children:

If otitis media is suspected, the best thing parents can do is to immediately seek help from an otolaryngologist.

Antibiotics. For children under 3 years of age, treatment with one of the following drugs is mandatory (as prescribed by a doctor): Ceftriaxone, Amoxiclav, Cefuroxime etc. An antibiotic for purulent otitis is prescribed by a doctor based on the results of tests and examination, as well as the severity of the condition, age, weight of the child. If necessary, the doctor performs a myringotomy (hospital only) - an incision and removal of pus from the eardrum.
Drops: for infants and children under one year old, vasoconstrictor drops and ear drops are not prescribed for purulent otitis media. Ear drops contain components that can cause side effects: convulsions, vomiting, etc.
Recommended nasal lavage saline solution (3 drops) to thin the mucus and after a few minutes suck it with a pear. For children under 3 years old, blowing your nose (carefully) and using vasoconstrictor drops before meals and bedtime is allowed.
Others: paracetamol-based drugs are used to bring down the temperature. It could be: Panadol, Kalpol, Efferalgan etc.

Children are not allowed to take Aspirin and Analgin tablets. In some forms of otitis media, ear heating is allowed: a blue lamp and dry heat.

Bathing and walking with a child on the street during illness is not recommended. With the right and timely treatment enough traditional methods without surgical intervention.

To avoid this disease, it is required to monitor the hygiene of the nose and nasopharynx, to prevent prolonged SARS and other respiratory diseases. One of the main tasks during illness in children is the speedy restoration of breathing through the nose with the use of vasoconstrictor drops.

Purulent otitis in a child often develops between the ages of 5 months and 5 years, when the organs of hearing are not yet fully formed. For this reason, pathogenic microorganisms can easily get inside. For therapy to be effective, it is necessary to know the first symptoms of the disease, as well as classical methods of treatment. If you do not visit a doctor in time, then even more serious pathologies may develop.

Frequent otitis in a child is a fairly common phenomenon, as this disease is provoked various infections. The purulent form of otitis is an acute inflammation of the part of the auditory system, which includes the eardrum. A relatively small area is inflamed, located near the temporal bone, where direct sound transformation takes place. Purulent otitis in a child also develops an inflammatory process of the mucous membrane, which leads to the accumulation of purulent discharge. The formation of pus can cause deafness, so it is important to start treatment in a timely manner.

The physiological structure of the ear of a child under 5 years old is distinguished by anatomical features, so it is easier for microorganisms to get inside the middle ear. The ear canal in children of this age is wide, and the lumen of the tube is narrow. The auditory tube is also located in horizontal position and not at an angle.

To quickly relieve inflammation, you need to know how to treat purulent otitis media. To do this, you must visit an otolaryngologist.

Without medical assistance, therapy may be ineffective, in addition, the treatment of children implies the use of only safe medicinal formulations and procedures. It is impossible to say how long purulent otitis media is treated, since everything depends on the neglect of the condition.

Symptoms of otitis in a child

Pus in the ear of a child is only outward sign otitis, so it is important to recognize the disease by a whole range of symptoms. As soon as purulent discharge begins to form, the child begins to feel severe pain in the ears. The pain syndrome is distinguished by a constant, cutting or pulsating character. General well-being the baby deteriorates sharply, the following symptoms may occur:

severe weakness;
pale skin;
Increase in body temperature;
Pain in the head, jaw;
Hearing loss;
Congestion and tinnitus;
The appearance of secretions from ear canal mixed with blood.

If the baby is already talking, then you can simply ask him exactly where it hurts, which cannot be said about infants. Babies with otitis can often cry, act up. Due to ear pain, such children can also observe:

poor appetite;
Bad sleep;
The desire of the child to lie on the side where the ear hurts;
The appearance of vomiting;
Frequent scratching of the ear with a pen;
Increase in body temperature.

What to do if pus in a child appears immediately in both ears? Purulent otitis in children during the first months of life often proceeds in this way. Every fifth case of bilateral otitis media is converted into purulent. Doctors divide the symptoms of purulent otitis in children into several stages at once.

The famous doctor Komarovsky purulent counts the first step to development chronic otitis media Therefore, it is important to learn to distinguish between the stages of development of this disease:

Development primary signs as constant noise in the ears mild dizziness, slight weakness.
Increasing pain sensations. In a horizontal position, the pain intensifies, the body temperature rises.
Increased pain. The shootings in the ears are getting brighter, the pain radiates to the head, jaw. When pressing on the ear, the condition worsens even more.
Pain peak. The noise gets louder, the hearing decreases, the pain is hard to endure, the eyes begin to hurt in parallel, the nasopharynx becomes inflamed, the temperature does not subside.
Reduction of pain after the removal of pus. Noise and congestion persist, but the temperature returns to normal. Allocations can be observed within 5-7 days.
Scarring of perforations. Inflammation decreases, soreness and noise disappear, hearing acuity is restored.

Such a frequency of development of purulent otitis media is possible with proper treatment. If medical assistance is not provided on time, then pus can spread to neighboring tissues and vessels, causing inflammation of the brain, eye sockets, etc. If the child was taken to the doctor on time, then often otitis media does not reach the stage of tissue perforation.

Are antibiotics needed?

For installation accurate diagnosis the doctor needs to examine the child's ears with an otoscope. This equipment is a small probe that is placed in the ear. With its help, it is easier for the doctor to see the condition of the tissues inside the organ. If the alleged diagnosis is confirmed, then at the initial stage of the disease, home treatment is acceptable, but under medical supervision. Strong immunity is able to cope with otitis in just a few days, but taking into account the parallel intake of antipyretics, painkillers and antihistamines. If otitis media is diagnosed as moderate, then it is reasonable to connect antibiotics to basic therapy.

How much purulent otitis is treated in a child can only be said by an otolaryngologist, since each organism is individual. Antibiotics for purulent otitis in children are prescribed only after a laboratory study of discharge. Laboratory assistants must accurately determine the nature of the microorganism that caused the inflammatory process.

It is necessary to prescribe antibiotic therapy in a severe form of the disease, when the temperature is above 38 degrees, there is severe acute pain and intoxication of the body. Children under 2 years of age can be prescribed antibiotics only after an accurate diagnosis. Before prescribing, the doctor must find out everything possible contraindications to taking the selected drug in order to minimize the risk of complications and side effects. For the treatment of purulent otitis media in children, the following antibiotic drugs are used:

Augmentin. Let's admit for reception from 3 months of life. the maximum period of admission is 14 days. The drug has a semi-synthetic composition, has a wide spectrum of action on pathogenic microorganisms.
Sumamed. The drug has a pleasant fruity taste, but it should not be given to children under 6 months of age.
Dioxidine. It also has a wide spectrum of action, but is contraindicated in children under 7 years of age. Patients older than this age can be used in the form of drops.

If antibiotic treatment was short-term, then repeated otitis media may occur within a week. It is important to properly deal with the main causative agent of the disease. If the antibiotic was taken correctly and was selected by a qualified doctor, then it will quickly relieve inflammation, reduce swelling, and stop the release of purulent masses. There are times when the prescribed antibiotic does not give the expected result, then the doctor is forced to change the prescribed medication.

Medical treatment

Frequent otitis in a child is a direct signal of weak immunity, therefore, for both treatment and prevention, it is appropriate to give the baby immunostimulating drugs. The defenses of the child's body are subject to frequent attacks of viruses and infections, so this fact should be especially taken into account during epidemics, in the cold season.

Symptoms of purulent otitis in children are directly related to the methods of treatment, but self-medication in this case is simply unacceptable. If you choose the wrong drug, then the transition of the acute form of otitis into chronic is possible. In advanced situations, purulent otitis media can lead to disability or even death.

Otolaryngologists advise adhering to the following algorithm for the treatment of purulent otitis media:

Taking antipyretic drugs based on paracetamol - Calpol, Panadol, Efferalgan;
The use of nasal vasoconstrictor drops, but they cannot be used to treat children under 1 year old (drops Otipaks, Nazivin, Otrivin) ;
Reception of immunomodulators (Viferon);
Taking antihistamines in case of otitis due to allergies;
Prescribing antibiotics.

It is strictly forbidden to use Aspirin and Analgin for children. During the treatment period, walks on the street, swimming in the pool, hypothermia are contraindicated. Symptoms and treatment are always interrelated, so for effective therapy it is important to see a doctor on time.

In addition to drug treatment, doctors must prescribe a number of physiotherapy procedures:

Warming up with ultraviolet rays, but not in the case of purulent otitis media;
Pneumomassage;
Washing and blowing out the ears.

Only the attending physician should choose the exact type of procedure, since heating the ear tissues with a purulent form is contraindicated. When heated, infection can spread through the vessels of the brain, eye sockets, and internal organs.

Folk remedies

It is sometimes appropriate to treat bilateral purulent otitis media in children with folk methods, but before using them, you should definitely consult a doctor. Not all components non-traditional recipes treatments are acceptable for the child's body, it is necessary to take into account their high sensitivity and individual intolerance to the compositions. Alternative treatment options:

Turundas from camphor oil. It is enough just to moisten a cotton swab in the form of a turunda in camphor oil. It should be slightly hydrated. Place in ear for 3 hours. From above, cover your ear with a warm scarf or put on a hat. Repeat the procedure 1-2 times a day. For children from 2 years of age, camphor oil is best diluted in equal proportions with water.
Boric acid compress. Moisten the finished cotton turunda in boric acid and place in the ear for 30 minutes. At the time of the procedure, take a horizontal position. Repeat 2-3 times a day.
Drops from carrot juice and butter. Pre-melt the butter and cool a little, add carrot juice in a ratio of 1: 1. The finished mixture, 1-2 drops, is instilled into the child's ear. The procedure is acceptable for children over 5 years old.

Any recipes traditional healers should not be used without first consulting a doctor. You can not use those formulations where bee products are present for those children who are allergic to honey. Drops with any composition are contraindicated for all children under 2 years of age.

Possible Complications

If therapy is not started on time, a number of complications may develop:

Transition of acute otitis into chronic;
Meningitis;
Antrite;
Mastoiditis;
Paralysis of the facial nerve;
hearing loss;
Adhesions on the eardrum;
Cholesteatoma (tumor).

It is impossible to start such a disease, because it is characterized by a rapid transition from one form to another. The likelihood of a stroke increases sharply, as damage to the vessels of the brain can occur.

Preventive measures

To protect the child from the development of otitis, parents need:

Monitor the frequency and duration of walks in the fresh air, do not overcool the child.
The head of the baby should always be warm, but not overheated.
Strengthen the child's immunity with complex vitamins and proper nutrition.
Do not visit pools and open water sources with the primary symptoms of a cold.
Treat viral infections under the supervision of a doctor so that there is no recurrence of the disease.
Timely carry out hygiene of the child's ears, do not bring to a large accumulation earwax.
Diseases of the nasopharynx are treated in a complex manner so that there are no complications.

It is important for parents at the first symptoms of otitis media to seek medical assistance, since every day without proper treatment aggravates the course of the disease.

Self-treatment of purulent otitis in a child is unacceptable, so do not trust folk methods treatment. This disease is fraught with serious complications, there is no need to once again endanger the health of the baby.

Purulent otitis is an inflammatory phenomenon of an infectious nature, which is localized mainly in the air cavities of the middle ear. Physiologically, the development of purulent otitis in a child is due to the peculiarities of the process of formation of the hearing organs. In particular, the development of the Eustachian tubes lasts up to 5 years and underdevelopment leads to the unhindered penetration of various pathogens of infectious diseases into the middle ear, tympanic cavity.

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Causes of the disease

Toddlers who have not yet reached one year old, bilateral otitis media is predominantly diagnosed, which in 20% of cases turns into a purulent form.

The main reasons for the development of purulent otitis media in children are:

fetal pathology (due to bad habits of the mother during pregnancy or past infectious diseases);
difficult childbirth;
prematurity;
instability of immunity;
diseases of the upper respiratory tract of any kind;
consequences of acute catarrhal otitis;
inflammation of the adenoids;
transferred infectious diseases, the consequence of which is a decrease in the protective properties of the immune system;
proliferation of myxoid tissue in the middle ear.

Also, the reason that can provoke the development of purulent otitis media in a child is a decrease in the body's resistance against the background of renal failure or diabetes mellitus.

Disease classification

There is a species difference in purulent otitis according to the nature of the course and the type of inflammatory process.

By the nature of the flow

On this basis, purulent otitis media is divided into:

Spicy. It is a consequence of a cold. It is usually easily treated and does not lead to complications.
Chronic. Develops due to improper treatment acute illness.
Recurrent. It is characterized by frequent manifestations throughout the year and is observed in children from 2 to 5 years.

Depending on the type of inflammation

There are three gradations of purulent otitis media:

Otitis externa. This is an inflammation of the area between the eardrum and the external auditory canal.
Otitis media, during which parts of the ear canal between the labyrinth and the tympanic membrane are affected.
Otitis media, also called labyrinthitis.

The main symptoms and methods of treatment of purulent otitis media in children are described in a video from the Doctor Doktorit channel.

Stages of the course of the disease and symptoms

In order to start treatment in a timely manner, it is necessary to know the symptoms and signs of inflammation of the middle ear.

Acute purulent otitis in children can occur in three successive stages:

Preperforative. It is characterized by an increasing inflammatory process and can last from 2 to 72 hours. The child complains of pain in the ear area, there is an increase in body temperature.
Perforated. At this stage, there is a rupture of the tissues of the eardrum, in which there is an outflow of pus and mucus. The duration of the stage is up to 7 days. The baby's health improves, the temperature gradually decreases.
Reparative. The final stage of the disease, in which hearing is restored and inflammation subsides. The rehabilitation process takes up to 2 weeks, during which the scarring of the membrane occurs.

Among the most striking manifestations of symptoms, doctors note:

the appearance of shooting or sharp pain in the ear;
a sharp increase in body temperature up to 39 degrees;
hearing loss;
the appearance of vomiting;
causeless dizziness;
blanching of the surface of the skin;
excessive sweating;
apathetic behavior;
the appearance of purulent discharge from the ear.

These symptoms are common, but the chronic and relapsing forms have additional distinguishing features.

Signs that indicate the urgency of treatment are:

causeless capriciousness of the baby;
lack of appetite in infancy because the process of sucking leads to increased pain;
the appearance of painful sensations with pressure in the area of the ear tragus;
presence of otorrhea or discharge from the ear.

Diagnosis of the disease

The diagnosis is made exclusively by an otolaryngologist. A set of measures is being taken to determine exact reason disease and appropriate therapy.

Diagnostics includes the following examinations:

Cleaning the ear canals for endoscopic examination, examination of the ear cavity, nose and nasopharynx.
Computed tomography of the temporal region and X-ray examination.
Audiological procedures and examination of the patient's vestibular apparatus.
Removal of exudate or secreted fluid into the cavity of the auditory canal. The process is otherwise known as the Valsalva maneuver.
Conducting a laboratory analysis of secretions for their susceptibility to medicines.
Determination of the qualitative state of the immune system.

Stages of disease treatment

Treatment steps include:

Appointment of warming procedures.
Implementation surgical operation in advanced cases or if perforation of the eardrum has not occurred. This reduces pressure and relieves pain.
Taking antibiotics and nasal vasodilators.
Ear cleaning.
Preventive measures necessary to prevent the risk of recurrence or chronic form.

If surgery is required, two types of procedures are performed:

Tympanostomy. It is prescribed in the absence of a positive result of drug treatment. The operation consists in introducing a special outlet tube into the cavity of the ear canal to facilitate the outflow of escudate.
Myringotomy. Opening the eardrum, which is used for acute pain and the presence of pronounced symptoms.

Treatment

After carrying out diagnostic measures, the doctor determines how to treat. The process of therapy itself is allowed to be carried out at home, but only under the supervision of the attending physician.

With the existing otitis media, the treatment allows warming procedures, which are possible only at the stage of the absence of purulent discharge. When exudate appears, heating is strictly prohibited.

The main measure in the treatment of a purulent form is the removal of fluid accumulation in the ear canal. How effective further treatment will be depends on this procedure. Experts do not recommend using as tools for cleaning the ear cotton buds or matches, since there is a high probability of damage to the eardrum or injury to the mucous membrane.

Physiotherapy

One of effective methods in the complex therapy of purulent otitis in children is the use of physiotherapy:

UHF procedures. The impact is carried out using high-frequency currents. Conductive plates are placed around the mastoid process and on the temples.
Carrying out pneumomassage. An air type of massage is used with the help of a special APMU compressor.
Use of ultraviolet lamps. The tympanic membrane, mastoid process and external passage are exposed to irradiation.
Ionogalvanization or electrophoresis. Using this technique, it is possible to deliver the necessary drugs, such as zinc sulfate or antibiotics, to the ear.

The use of physiotherapy techniques is recommended only as concomitant treatment and is not the only way to cope with the disease.

Preparations

For the treatment of purulent otitis media, regardless of its form and causes of appearance, the following drugs are used:

Pain relievers and antispasmodics are used to relieve pain. If there is a high temperature, antipyretic drugs are prescribed. Nurofen is allowed to be given from three months, the minimum dosage is 50 mg 3 times a day. Paracetamol is used at a dosage of 10-15 mg per kilogram of weight starting from 3 months.
Anti-inflammatory and analgesic drugs, which include Otipax drops (3-4 drops 3 times a day), Otinum (3-4 drops 3 times a day). Their use allows you to temporarily get rid of discomfort and reduce inflammation.
Vasoconstrictor drugs. These are Tizin drops (from 2 to 6 years at a concentration of 0.05%, one injection twice a day), Nazivin for children (1-3 drops three times a day for children from one to 6 years old), Otrivin sprays (for children under 12 years at a concentration of 0.05% only as prescribed by a doctor). Their use is designed to eliminate swelling of the mucous membranes, which helps to improve the outflow of exudate and restore ear function.
An effective method of treating a purulent form is the use of antibiotics. Amoxicillin is prescribed at a dosage of 20 mg per kilogram of body weight from the first year of life. Ceftriaxone is used at 20-30 mg per kilogram per day. For children over 12, the dosage is 80 mg per kilogram of body weight. Their task is to destroy the bacteria that are the source of the disease.
Means to increase immunity. This can be Viferon gel (3-5 times a day is applied to the surface of the mucous membranes by 0.5 cm), Immunorix (one bottle per day) and vitamin complexes. They serve to strengthen the protective properties of the immune system.

Amoxicillin - 52 p. Imunorix - 782 rubles. Nazivin - 117 rubles. Nurofen - 91 rubles. Otinum - 165 rubles Otipaks - 208 rubles. Otirelax - 159 rubles. Otrivin - 124 rubles Paracetamol - 78 p. Tizin - 179 rubles. Ceftriaxone - 26 r. Viferon - 131 rubles.

Local treatment

Local procedures include warming up, which is carried out by means of compresses and the use of turundas with anti-inflammatory drugs applied to them.

The compress is applied in the following way:

A cotton bandage is made from several layers of material. Its size should be slightly larger than the surface of the auricle.
An incision is made in the middle for the ear.
Gauze is wetted with warm vodka or alcohol diluted 1:1 with water.
A compress is applied.
A layer of cotton wool, wax paper or just fabric is placed on top to create a greenhouse effect.
The bandage is worn for 3-4 hours.

Direct instillation of drops into the ear, especially on alcohol based undesirable. Therefore, it is recommended to use turundas. These are pieces of cotton wool twisted into a tight tourniquet, which are moistened with a medicinal solution.

Folk remedies

There are many folk recipes for the treatment of otitis media in children. They are predominantly based on the use alcohol infusions herbs.

Among the most available methods are:

Sagebrush. One teaspoon of wormwood flowers should be infused with rubbing alcohol for a week. The resulting solution is injected into the ear by means of cotton flagella, which simply need to be dipped into the composition. The use of this herb, according to reviews, is good for pain relief.
Walnut. Leaves walnut finely chopped and poured vegetable oil. The mixture is stored tightly closed in a cool place for a month. During treatment, it is required to apply the agent in the ear with cotton swabs moistened with 1 drop of the composition. The substances that make up the leaves of the tree have an antimicrobial effect.
Onion. It is used for treatment in the form of drops. Onion juice, squeezed into saline through gauze in proportions of 1: 3, can be instilled into the ear 3 drops three times a day, provided that the eardrum is intact.
Bay leaf. The leaves are small and pour boiling water. Let it brew for an hour. With the resulting decoction, cotton swabs are made at the rate of 8-10 drops in each ear 3-5 times a day.
Aloe juice. The juice squeezed from the leaves is instilled into the ear 4 drops several times a day. At a young age, the juice is recommended to be diluted with water. Treatment with this method is also allowed with an intact eardrum.

Folk remedies can also be only a treatment that accompanies the main one. Before using prescriptions, consult with a specialist.

Complications of purulent otitis media

With untimely treatment or non-compliance with the methods of therapy prescribed by the doctor, purulent otitis media in a child is dangerous with the following complications:

damage to the bone tissue behind the ear cartilage;
development of otogenic sepsis;
hearing loss or significant reduction;
rupture of the eardrum;
acquisition of a chronic form;
the occurrence of choleosteatoma or tumor;
infection of the outer lining of the brain.

Prevention

To prevent disease, one should preventive actions, the focus of which should cover the prevention of colds.

Prevention methods include:

Avoid visiting crowded places.
Correctly remove accumulated mucus in the nose for colds or rhinitis.
Prevent water from entering the ears when bathing a child.
Strengthen immunity.

Purulent otitis media is an infectious inflammation affecting the anatomical parts of the middle ear: the mastoid process, the Eustachian (auditory) tube and the tympanic cavity.

Children, as a rule, suffer from purulent otitis media more often than adults.

Statistics show that almost five out of six children had at least one case of the disease by the age of three.

The reasons

Purulent otitis in a child is caused by bacteria. To understand how microbes get inside the ear, consider its structure.

The ear helps us hear as well as maintain balance. Therefore, it is important in our life. This unique organ includes three sections - the outer, middle ear and inner. All three parts help the child to hear and maintain balance.

When a child listens, the first thing that happens is the movement of sound waves in outer ear. This is the visible part of the organ of hearing. From outside department sound waves pass through the ear canal and reach the middle ear, where the eardrum (membrane) and three tiny bones are located. When waves hit the eardrum, it vibrates, and the ossicles amplify the vibration, allowing it to reach the inner ear. Here the vibrations are converted into electrical signals and sent to the auditory nerve, which connects the ear to the brain. When electrical signals or nerve impulses reach the brain, it interprets them as sound.

In order for the middle ear to function normally, there must be the same pressure inside it as the outer ear. This pressure is maintained by the Eustachian tube, which is a small tube that connects the middle ear to the nasopharynx. The tube allows air to enter the middle ear, so the pressure inside is the same as outside. In addition, the Eustachian tube allows mucus to drain from the middle ear into the throat.

In children, the Eustachian tube is almost horizontal, and this sometimes interferes with the flow of mucus from the middle ear to the throat.

With colds and allergies, the tube can become inflamed, as a result of which the outflow of mucus is blocked, it remains in the middle ear. Its accumulation leads to an increase in intra-ear pressure. Germs can migrate from the throat and nose to the middle ear through the Eustachian tube. These pathogens multiply in the mucus, causing suppurative otitis media.

Adenoids are another culprit

We all have a pharyngeal tonsil. These are the adenoids. In children, they are quite large and can sometimes block the pharyngeal openings of the Eustachian tubes, preventing the flow of mucus. A favorable environment is created for the reproduction of bacteria, which leads to purulent inflammation.

Other factors that provoke otitis media

The chances of developing otitis media increase when the child is exposed to cigarette smoke, drinks milk from a bottle or attends a kindergarten, since the proximity among children is greater in children's groups, the infection spreads quickly.

More rarely, suppurative otitis occurs due to a damaged tympanic membrane or mastoid process. This is traumatic otitis media. The rarest way for the development of purulent otitis media is hematogenous, when bacteria enter the middle ear through the blood.

The main causative agents of purulent otitis media

There are some specific types of bacteria that are usually responsible for the development of suppurative otitis media. These are: Moraxella catarrhalis, Streptococcus pneumoniae, Haemophilus influenzae, Streptococcus pyogenes and Staphylococcus aureus. In fact, these bacteria live in the inside of the ear without causing harm. When they multiply excessively, for a number of reasons, it leads to disease.

Forms of purulent otitis media

This form develops in diseases of the upper respiratory tract, when pathogens enter the middle ear through the auditory tube.

Stages:

Catarrhal - the beginning of the inflammatory process. At this stage, inflammatory exudate accumulates in the ears, there are the first manifestations of the disease - hearing loss, ear pain, fever.
Purulent. If before this stage there was no treatment with antibiotics and other drugs, the tympanic membrane ruptures, and pus begins to drain from its cavity - the symptoms weaken.
Convalescence. Inflammation gradually disappears, suppuration stops, hearing is gradually restored.

The disease does not always follow this course. At any stage, acute otitis media can develop into chronic, with indistinct manifestations. If this happens at the first stage, the rupture of the eardrum does not happen, thick, viscous mucus, difficult to remove, accumulates in the tympanic cavity.

If perforation does not occur for a long time acute form diseases, the amount of pus increases, as a result of which dizziness, severe pain in the head, vomiting, high fever are possible. In this case, from the middle ear, the pathogen can penetrate deeper into the cranial cavity and cause serious life-threatening complications.

If, after a rupture of the tympanic membrane and outflow of pus, the body temperature rises again, and the pain in the ears resumes, this may indicate stagnation of pus in the tympanic cavity or inflammation of the mastoid process. In this case, the discharge of pus lasts 3 to 4 weeks. The acute course of otitis media lasts approximately 2 to 3 weeks. Inadequate antibiotic therapy and a weakened immune system are the cause of complications.

Chronic otitis media

A characteristic feature of the pathology is the recurrent nature of purulent discharge. Other manifestations include severe rupture of the tympanic membrane and gradual hearing loss. This form of the disease progresses when the acute form of otitis media is not properly treated. Pathology can also manifest itself as a complication of chronic rhinitis, sinusitis.

Subtypes

Mesotympanitis. Inflammation involves the mucosa auditory tube and tympanic cavity. The gap is located in the central part of the membrane.

Epitympanitis. In addition to the mucous membrane, bone tissue becomes inflamed. The gap is located at the top of the membrane.

Symptoms

Purulent otitis in a child is difficult to confuse with another pathology, since its symptoms are obvious.

The main manifestations of the disease are:

ear pain;
hearing loss;
fever;
purulent discharge from the ear.

Babies cannot explain that their ears hurt or that they cannot hear anything. The baby becomes irritable, restless, does not sleep, often cries for no apparent reason. There is a way for parents to test their suspicions about otitis media. The outer ear has a cartilaginous protrusion (tragus). When a baby has purulent otitis media, pressure on this cartilage will lead to a significant increase in pain and, accordingly, to screaming or crying.

Diagnostics

It is not difficult to diagnose purulent otitis media. First, the doctor will conduct a survey for complaints and symptoms, and examine the child's ears. At this stage, the specialist can make an approximate diagnosis.

But, in some cases, the following procedures may be required:

a blood test to determine the degree of inflammation;
pneumatic otoscopy allows the doctor to check for fluid behind the tympanic membrane; he will use special medical device called a pneumatic otoscope, which gently blows air into the ear; the eardrum is flexible, and when air reaches it, the membrane moves; if there is fluid behind the tympanic membrane, it will not move;
tympanocentesis involves puncturing the tympanic membrane so that exudate can flow out;
analysis of the contents of the ear to determine the causative agents of the disease - this will allow you to choose the right antibiotics for treatment.

After receiving all the results, the doctor can diagnose and determine the stage of the disease.

Today, antibiotic therapy is a priority in the treatment of purulent otitis for the following reasons:

when using antibiotics, the risk of developing complications of otitis media decreases;
the use of antibacterial drugs improves the results of treatment of patients at an early and late stage of the disease.

Other pharmacological agents are also used in the treatment of purulent otitis media. Painkillers and antipyretics will help relieve the child of pain and reduce fever.

Antihistamines help reduce inflammation of the ear mucosa. Nasal vasoconstrictor drops can be used to reduce the swelling of the Eustachian tube and resume its functioning.

Systemic steroids have not shown their effect in the acute phase.

Antimicrobial therapy must be carried out in accordance with the rules.

Choice of antibiotic.

In the absence of culture results, the choice of antibiotic should have the following two objectives:

the antibiotic should act on most common bacterial pathogens;
the drug should be individualized for the child in terms of allergy, tolerance, previous exposure to antibiotics, cost, and level of microbial community resistance.

First choice drugs.

Amoxicillin remains the drug of first choice for uncomplicated otitis media in most cases due to its excellent safety record, relative efficacy, and low cost. Amoxicillin is the most effective oral drug available. antimicrobials against strains of S. pneumoniae. However, amoxicillin may not be effective against some strains of H. influenzae and most strains of M. catarrhalis. This factor is becoming increasingly important with data showing a general increase in the incidence of H. influenzae as the primary causative agent of suppurative otitis media.

For children allergic to penicillins, cephalosporin class antibiotics such as cefdinir are the first choice. If a child has hypersensitivity to cephalosporins, for him azithromycin is a suitable first-line alternative.

duration of treatment.

The duration of treatment for otitis media has historically been set at 10 days, and most efficacy studies examining antimicrobial treatment diseases, used this duration as a reference. But 10 days may be too long for some children, though not long enough for others. Studies comparing shorter periods with longer durations of treatment show that a short course of therapy is often insufficient in children under 6 years of age, and especially in infants under 2 years of age. As a result, for most episodes, in the vast majority of children, treatment for at least 10 days seems appropriate. Treatment beyond 10 days may be required for very young children, for a severe episode of suppurative otitis media, or if a previous case was problematic.

Poor response to treatment with first-choice drugs.

Healing of suppurative otitis media depends on the eradication of the causative pathogen, as well as on the restoration of ventilation of the middle ear.

Factors contributing to poor response to first-line treatment include:

ineffectiveness of the selected antibiotic;
poor adherence to treatment regimen;
concomitant viral infection;
persistent dysfunction of the auditory tubes;
re-infection of the middle ear;

Despite these many potential factors, switching to an alternative drug is prudent when there is insufficient improvement in the condition of the middle ear.

Second line drugs.

When treatment of suppurative otitis with a first-line drug has failed, there are a number of second-line alternatives. These drugs should work against strains of H. influenzae and M. catarrhalis, and the most resistant strains of S. pneumoniae. Only 4 antimicrobial agents meet these requirements: Augmentin(amoxicillin-clavulanate), cefdinir, cefuroxime axetil and ceftriaxone(injection).

Since the high concentration of amoxicillin in the body acts on most strains of S. pneumoniae, and the addition of clavulanate increases the effective antibacterial spectrum of amoxicillin, Augmentin is especially well suited as a second line drug.

Cefdinir has shown broad therapeutic efficacy, is generally well tolerated in taste, and can be taken once daily.

Ceftriaxone and cefuroxime axetil have important limitations for use in young children. Currently, cefuroxime axetil suspension has an unpleasant taste. Treatment with ceftriaxone entails pain from intramuscular injection. However, the use of ceftriaxone is acceptable in severe cases of suppurative otitis media when oral treatment is not possible.

Clarithromycin and azithromycin have only limited activity against resistant strains of S. pneumoniae and strains of H. influenzae. Clindamycin effective against many strains of S. pneumoniae, including resistant strains, but not active against H. influenzae or M. catarrhalis. Therefore, it should be prescribed for patients who have penicillin-resistant pneumococcal infections.

The remaining antimicrobial agents that have traditionally been used in the treatment of otitis media have such a significant disadvantage in efficacy against resistant organisms that their benefits rarely outweigh the potential side effects or complications. These include cefprozil, cefaclor, loracarbef, cefixime. Cefpodoxime has shown reasonable efficacy in some studies, but is generally poorly received due to its taste.

Conclusion

Purulent otitis is a common childhood disease. The child may have hearing loss, speech problems and developmental delays. This disease is not to be taken lightly. To maintain the health of the child, you should contact the specialists in a timely manner.

Symptoms and treatment of purulent otitis in a child

Purulent otitis occurs in every third baby early age. Usually this pathology proceeds quite hard and is accompanied by the appearance of many of the most unfavorable symptoms. How to cope with this disease, this article will help you figure it out.

Causes

The inflammatory process that affects the middle ear cavity often leads to the development of purulent otitis media.

This form of the disease can be caused by the most various reasons. The most common of these are bacterial infections. There is currently great amount a variety of bacteria, which can lead to the formation of pus in the middle ear cavity.

This pathology can be both primary and appear as a result of complications of other bacterial infections.

A newborn baby has certain features of the development of purulent otitis media. They are associated with the presence of a special myxoid tissue in the middle ear cavity. This element is quite sensitive to development bacterial inflammation and severe edema.

Myxoid tissue disappears only by the end of the first month of a baby's life. She can stay longer long time only in premature and debilitated babies. In such babies, it usually persists for 6-12 months of their life. This clinical situation leads to the persistence of adverse symptoms in baby quite a long time.

They also lead to the development of the disease certain features of the structure of the Eustachian tube in babies. This structural element, which is part of the ear, is shorter in children. This feature contributes to a more rapid spread of the inflammatory process to all nearby organs. The size of the Eustachian tube increases as the child grows.

Given the duration of the onset of adverse symptoms, doctors distinguish several clinical options. this disease. The first developed disease is called acute. As a rule, in children, the development of this clinical variant is caused by various bacterial and much less commonly viral or fungal infections.

Chronization of the process ensures the transition of an acute form into a chronic one. This variant of the disease is very unfavorable. It is accompanied by a successive change of periods of complete well-being and exacerbations.

In most cases, the inflammatory process affects only one side. Bilateral purulent otitis media are much less common.

Pediatric otolaryngologists also distinguish recurrent forms of the disease. In this case, exacerbations of the disease occur within a fairly short span time.

Frequent deterioration in the well-being of the baby should alert parents. As a rule, recurrent purulent otitis is a manifestation pronounced violation work of the immune system.

Infection can enter the middle ear cavity in many ways. The most common option is through the Eustachian tube. In this situation, pathogens enter the ear cavity through existing anatomical communications with the nose.

Improper hygiene procedures contribute to the penetration of a secondary infection from the external environment through the outer ear. The spread of bacteria through the blood occurs when there is primary focus disease, which can be located in different internal organs.

Congenital forms of purulent otitis are much less common. In this case, infection occurs during prenatal development. Predominantly staphylococcal or streptococcal bacterial flora contributes to the appearance of adverse symptoms of the disease in infants.

Anaerobic microorganisms lead to intrauterine infection fruit is much rarer.

Congenital purulent otitis media in newborn babies is often bilateral.

Purulent otitis media can manifest itself in different ways. The severity of the manifestation clinical signs depends on the initial well-being of the child. Weakened babies endure this disease most severely.

The well-being of newborn babies suffering from purulent otitis media suffers significantly. Quite often, the treatment of sick babies is carried out in a hospital.

The classic manifestation of this disease is the appearance of pain in the ear. With a unilateral process, pain appears only on one side.

The spread of infection to the other half of the face contributes to the appearance of pain there. The severity of the sensation of pain can be different and depends on whether this form of the disease is acute or chronic.

Acute inflammation is characterized by the appearance of a pronounced pain syndrome. Many children note that the nature of the pain can be “shooting”.

A pronounced inflammatory process leads to a significant increase in body temperature. In most cases, it reaches 38-39.5. A more severe course of the disease is accompanied by an increase in body temperature above 40 degrees.

Inflammation in the middle ear leads to severe hearing loss. If the child has only a one-sided lesion, then he hears speech and distinguishes voices.

With a bilateral process, hearing is significantly impaired. Children attending school or other educational institutions are unable to attend classes because they have significant difficulty in recognizing sounds.

The sick child looks very ill. A pronounced inflammatory process leads to the fact that the baby feels severe weakness, rapid fatigue. Sick children eat poorly, their appetite is significantly reduced or even completely disappears.

Babies start to refuse breastfeeding and are rather poorly applied to the mother's breast.

Exacerbation of purulent chronic otitis usually proceeds somewhat easier. In some babies, the disease can develop even without a significant increase in body temperature.

Toddlers feel "gurgling" or "transfusion" in the area of the affected ear. This symptom often increases with a change in body position.

Congestion in the affected ear during exacerbation of chronic otitis media usually has an increasing intensity. In some babies, suppuration becomes almost permanent.

The amount of fluid discharged from the ear can be different. The long course of the disease contributes to the development of a persistent disturbance in the perception of sounds.

Many children note that in the affected ear they feel severe itching that brings them severe discomfort. Also, the sick child develops hypersensitivity to any tactile touch of the affected area.

Complicating the course of the disease is the appearance of a headache that appears on the side of the damaged ear.

The behavior of a sick child changes significantly. The kid becomes more lethargic, naughty. Quite often, a child loses his usual interest in his favorite toys.

Children begin to rub the affected ear against the pillow more, as they feel severe itching. Toddlers of a very young age often touch the affected ear. This symptom should alert parents and motivate them to contact the child for medical advice.

Diagnostics

Carrying out diagnostic measures and treatment of purulent otitis pediatric otolaryngologist. To determine the inflammatory process in the cavity of the ears, the doctor conducts an extended clinical examination and examination using a special medical instrument. This study is called an otoscopy. With this visual test, you can determine the presence of pus in the middle ear cavity.

To determine the cause of the disease, laboratory tests are required.

With purulent otitis media significantly change normal performance general blood test. A huge number of leukocytes appear in it, the leukocyte formula changes, and the ESR also increases.

In some cases, pediatric otolaryngologists carry out bacteriological culture of the contents obtained from the cavity of the affected ear. This test is very specific and allows you to accurately identify the infectious agent of the disease.

Significant minus this study- the duration of the analysis. It may take 5-7 days to get the results of this lab test.

Effects

Purulent otitis is quite often dangerous. The most severe course is observed in babies of a very young age. The spread of inflammation leads to damage to nearby organs.

The most dangerous complication of the disease is the entry of pus into the meninges. This condition leads to the development of meningitis or meningoencephalitis.

A common complication of purulent otitis media is hearing loss. In the most severe cases, a violation of the perception of sounds can be expressed significantly. This symptom may appear total loss hearing.

In children, this can lead to decrease in memory and intelligence. In young children this pathological condition contributes to a pronounced lag in mental development.

The transition to the anatomical structures of the inner ear is also quite frequent complication purulent otitis. This pathological condition is called labyrinthitis.

The severe course of this pathology can lead to the development of the most dangerous complications, manifested by damage to the bone tissue of the temporal bone and even paralysis of the facial nerve.

Therapy of purulent otitis media can be carried out using various medicines. The most common method of treatment is the appointment of drugs.

To achieve a good effect from the therapy, the use of a whole complex is required. various means. The purpose of taking these drugs is to eliminate all adverse symptoms and improve hearing.

The basic method of treatment is the appointment of antibacterial drugs. These funds are assigned to the course admission. Usually 7-10 days are enough to eliminate all adverse symptoms.

The elimination of pathogens from the cavity of the affected ears is an important strategic goal of therapy. For this, antibiotics are used, which have a wide range of effects.

be introduced antibacterial agents may be different. In the moderate course of the disease, drugs are used in the form of tablets or suspensions.

Severe forms of the disease require an appointment already antibiotic injections. The most commonly prescribed remedies include: "Amoxicillin", "Augmentin", "Flemoxin", "Cefuroxime" and others. The multiplicity, course dosages and duration of treatment are determined by the attending physician.

Purulent otitis often occurs after a prolonged runny nose. To normalize nasal breathing in this situation, vasoconstrictor nasal drops or sprays are prescribed. They are appointed for 4-5 days up to 2-3 times a day. These drugs also improve the pressure in the Eustachian tube, which leads to a decrease in edema. These drugs include: "Sanorin", "Galazolin", "Nazol", "Otrivin" and others.

Various antipyretics are used to normalize high body temperature. In pediatric practice, drugs based on paracetamol or ibuprofen are most often used.

These drugs have a lower risk of developing unwanted side effects. These drugs should be used when the body temperature rises above 38 degrees.

Quite often, various ear drops are used to treat purulent forms of otitis media at home. They help to eliminate the pain syndrome that has arisen in the affected ear, and also have a pronounced antiseptic effect.

The course use of these drugs also has a strong anti-inflammatory effect. As such drugs in pediatric practice are used: "Otipaks", "Sofradex", "Otofa".

Purulent forms of the disease are quite common in children with signs of immunodeficiency. To restore the optimal functioning of the immune system, doctors prescribe specific medications to sick babies.

"Viferon" and multivitamin complexes with a course application will achieve a lasting positive effect.

Dads and mothers should remember that the use of all drugs must be agreed with the attending physician.

Many of the remedies that are used for treatment cannot be used if there is a perforation (pathological hole) in the eardrum. Such a clinical condition can often occur with purulent otitis media. The most dangerous in this case are ear drops that are applied topically.

In some cases, conservative drug therapy does not lead to the achievement of the effect. In this situation, surgical treatment may already be required. Such operations can reduce excess pressure inside the ear cavity, as well as eliminate severe inflammation. Such surgical treatment is carried out pediatric otolaryngologists.

In some cases, conservative drug therapy does not lead to the achievement of the effect. In this situation, surgical treatment may already be required. Such operations can reduce excess pressure inside the ear cavity, as well as eliminate severe inflammation. Such surgical treatment is carried out by pediatric otolaryngologists.

The removal of pus from the ear cavity is called a puncture. It is carried out by a doctor using a special tool. Local anesthesia is used for anesthesia.

After completing the entire procedure, a gauze turunda soaked in a solution of disinfectants is introduced into the affected ear. After the operation, doctors recommend that the child not wet the ear for several days and prescribe a number of drugs that help to finally cope with inflammation.

In the treatment of chronic suppurative otitis important role plays physiotherapy. Methods of such therapy allow to eliminate severe inflammation in the area of the affected ear, and also have a positive effect on the immune system.

Physiotherapeutic methods of treatment are applied already in the period of subsidence acute period disease, when there is no purulent discharge from the ear. Laser therapy, UHF - therapy and pneumomassage of the tympanic membrane- most frequent methods, which are used in the treatment of purulent otitis in children of different ages.

You can learn more about how to treat otitis media from Dr. Komarovsky in the next video.

Purulent otitis media in children: how to recognize and cure

According to statistics, purulent otitis media is diagnosed in every third child under the age of three. Such a high incidence is due to the anatomical features of the structure of the ear. In order to recognize the pathology in time and begin its treatment, parents need to know about the causes and symptoms of this disease.

What is suppurative otitis media

Purulent otitis media is an inflammation of the mucous membrane of the middle ear, which is accompanied by the formation and accumulation of pus. Usually, pathology develops as a complication after a viral or bacterial infection but can also occur as an independent disease.

The specificity of the disease in children of different ages

In newborns, the ear cavity is filled with a special myxoid tissue, which creates favorable conditions for the reproduction of bacteria, increasing the risk of developing otitis media.

Starting from 2–3 weeks of age, myxoid tissue gradually resolves, but in weakened and premature babies it can persist throughout the first year of life. In addition, the Eustachian tube in young children is narrow, short and straight, which contributes to its blockage and facilitates the penetration of pathogens into the ear cavity.

It is interesting! With age, the structure of the ear changes, so the likelihood of developing purulent otitis media drops sharply.

Purulent otitis media happens:

acute - occurs in children more often than other types of ear inflammation. It is successfully treated and usually does not cause complications. But untimely diagnosis and premature discontinuation of drugs often cause the disease to become recurrent or chronic;
recurrent - occurs several times in a short period of time. In this case, it is necessary to find out and eliminate the causes that provoke the disease;
chronic - characterized by non-scarring damage to the eardrum and periodic formation and leakage of pus. This type of disease is dangerous complications.

Depending on whether one or both ears are affected, inflammation can be:

Dr. Komarovsky about otitis - video

Causes and ways of infection

There are three ways to get an infection in the ear:

with blood flow - typical for measles, diphtheria, scarlet fever;
through the Eustachian tube - most common. This is how bacteria from the nasopharynx penetrate into the ear cavity;
through the external auditory canal - possible if the eardrum is damaged, for example, due to improper ear hygiene.

The cause of purulent otitis media can be a variety of bacteria or fungi, and the former account for 80% of all cases of the disease.

The following causes of otitis media are distinguished:

infection from a mother diagnosed with mastitis, pyelonephritis or other infectious diseases;
SARS, measles, scarlet fever, diphtheria and other childhood diseases;
inflammation of the adenoids, nasal polyps, chronic tonsillitis or other problems with the nasopharynx;
allergy;
reduced immunity;
hypothermia, stress;
avitaminosis;
damage to the eardrum;
sudden changes in atmospheric pressure;
frequent contact with water.

In newborns, amniotic fluid may be in the ear cavity, and infants are likely to develop inflammation due to food entering the eardrum cavity through the auditory tube when regurgitation. Young mothers should be aware of this danger and monitor the quality of the mixture, the sterility of dishes and ensure free nasal breathing baby.

At risk are premature babies, as well as babies lagging behind in psychomotor development, weight gain, suffering from diathesis, rickets, and bronchopulmonary pathology.

The main symptom of otitis media is ear pain. But depending on the type of disease, the symptoms of the disease may differ.

Signs of purulent otitis media depending on the type of disease - table

severe pain in the ear;
high body temperature;
temporary hearing loss;
signs of intoxication of the body;
discharge of pus from the ear.

moderate increasing pain in the ear;
congestion, noise, feeling of "liquid transfusion" in the ear;
prolonged suppuration;
irreversible hearing loss.

High fever is an optional symptom acute inflammation ear. In rare cases, the disease proceeds without it. But even if the child does not have a fever, if otitis media is suspected, the baby still needs to be shown to the doctor for correct setting diagnosis and appropriate treatment.

Otitis due to a fungal infection is primarily characterized by:

itching in the ear canal;
increased sensitivity of the skin of the ear;
headache on the side of the affected ear.

In this case, purulent discharge can be of different colors depending on the causative agent of the disease.

Babies usually refuse to eat because suckling causes severe pain. They do not sleep well, act up a lot, constantly rub their ear against the pillow or touch it with their hand. According to these characteristic signs, parents may suspect otitis media in a child.

Stages of disease development

The severity of certain symptoms different stages illness is different. Acute purulent otitis is divided into three periods depending on the condition of the eardrum.

The period before perforation (rupture) is the most painless, accompanied by fever and intoxication of the body, and can last from several hours to 2–3 days. Often, with timely therapy, the disease can be cured during this period.
Rupture / puncture of the eardrum - characterized by sharp decline temperature, absence of pain, decrease in intoxication of the body. You can understand that a rupture has occurred by the appearance of purulent discharge from the ear, which is called otorrhea. In the early days they are quite plentiful, but in the future their number is reduced. This period lasts 5-7 days, after which the body starts recovery processes.
Restoration of the tympanic membrane - all symptoms of the disease gradually disappear, and the tympanic membrane itself begins to scar. Perforations up to 1 mm in size close quickly and leave no marks. Larger holes do not heal as quickly, so you may need to see a specialist during the recovery period.

The total duration of the disease usually does not exceed 2-3 weeks. An increase in time may indicate the development of complications.

Hearing loss after otitis media can be observed for 2-3 months after recovery.

Diagnostic methods

To identify purulent otitis media and determine the treatment regimen, different diagnostic methods are used.

Otoscopy is a visual examination of the eardrum. Allows you to determine the presence and amount of pus in the ear, as well as other pathological changes in the thin physiological membrane that separates the outer and middle departments: thickening, hyperemia (redness), protrusion or perforation.

If you suspect the development of intracranial complications due to purulent otitis, a consultation with a neurologist is necessary.

There are two main areas of treatment of purulent otitis media:

conservative - the use of drugs;
surgical - puncture of the eardrum.

conservative

Conservative treatment is aimed at restoring the patency of the auditory tube, eliminating the symptoms of the disease, relieving inflammation, and destroying bacteria with the help of drugs. Groups of drugs used in pediatrics, their trade names and purpose are shown in the table.

Diagnosis and treatment of purulent otitis media in a child

Purulent otitis is an inflammatory phenomenon of an infectious nature, which is localized mainly in the air cavities of the middle ear. Physiologically, the development of purulent otitis in a child is due to the peculiarities of the process of formation of the hearing organs. In particular, the development of the Eustachian tubes lasts up to 5 years and underdevelopment leads to the unhindered penetration of various pathogens of infectious diseases into the middle ear, tympanic cavity.

Causes of the disease

In babies who have not yet reached the age of one, bilateral otitis media is predominantly diagnosed, which in 20% of cases turns into a purulent form.

The main reasons for the development of purulent otitis media in children are:

fetal pathology (due to bad habits of the mother during pregnancy or past infectious diseases);
difficult childbirth;
prematurity;
instability of immunity;
diseases of the upper respiratory tract of any kind;
consequences of acute catarrhal otitis;
inflammation of the adenoids;
transferred infectious diseases, the consequence of which is a decrease in the protective properties of the immune system;
proliferation of myxoid tissue in the middle ear.

Also, the reason that can provoke the development of purulent otitis media in a child is a decrease in the body's resistance against the background of renal failure or diabetes mellitus.

Disease classification

There is a species difference in purulent otitis according to the nature of the course and the type of inflammatory process.

By the nature of the flow

On this basis, purulent otitis media is divided into:

Spicy. It is a consequence of a cold. It is usually easily treated and does not lead to complications.
Chronic. It develops as a result of improper treatment of an acute illness.
Recurrent. It is characterized by frequent manifestations throughout the year and is observed in children from 2 to 5 years.

Depending on the type of inflammation

There are three gradations of purulent otitis media:

Otitis externa. This is an inflammation of the area between the eardrum and the external auditory canal.
Otitis media, during which parts of the ear canal between the labyrinth and the tympanic membrane are affected.
Otitis media, also called labyrinthitis.

The main symptoms and methods of treatment of purulent otitis media in children are described in a video from the Doctor Doktorit channel.

Stages of the course of the disease and symptoms

In order to start treatment in a timely manner, it is necessary to know the symptoms and signs of inflammation of the middle ear.

Acute purulent otitis in children can occur in three successive stages:

Preperforative. It is characterized by an increasing inflammatory process and can last from 2 to 72 hours. The child complains of pain in the ear area, there is an increase in body temperature.
Perforated. At this stage, there is a rupture of the tissues of the eardrum, in which there is an outflow of pus and mucus. The duration of the stage is up to 7 days. The baby's health improves, the temperature gradually decreases.
Reparative. The final stage of the disease, in which hearing is restored and inflammation subsides. The rehabilitation process takes up to 2 weeks, during which the scarring of the membrane occurs.

Among the most striking manifestations of symptoms, doctors note:

the appearance of shooting or sharp pain in the ear;
a sharp increase in body temperature up to 39 degrees;
hearing loss;
the appearance of vomiting;
causeless dizziness;
blanching of the surface of the skin;
excessive sweating;
apathetic behavior;
the appearance of purulent discharge from the ear.

These symptoms are common, but the chronic and relapsing forms have additional distinguishing features.

permanent hearing loss;
systematic discharge that does not have a pronounced odor or color;
persistent deformity of the tympanic membrane

the presence of a slight perforation of the membrane;
profuse mucous discharge;
mild pain and ear congestion

Signs that indicate the urgency of treatment are:

causeless capriciousness of the baby;
lack of appetite in infancy, since the sucking process leads to increased pain;
the appearance of painful sensations with pressure in the area of the ear tragus;
presence of otorrhea or discharge from the ear.

Diagnosis of the disease

The diagnosis is made exclusively by an otolaryngologist. A set of measures is being taken to determine the exact cause of the disease and prescribe the correct therapy.

Diagnostics includes the following examinations:

Cleaning the ear canals for endoscopic examination, examination of the ear cavity, nose and nasopharynx.
Computed tomography of the temporal region and X-ray examination.
Audiological procedures and examination of the patient's vestibular apparatus.
Removal of exudate or secreted fluid into the cavity of the auditory canal. The process is otherwise known as the Valsalva maneuver.
Conducting a laboratory analysis of secretions for their susceptibility to medicines.
Determination of the qualitative state of the immune system.

Stages of disease treatment

Treatment steps include:

Appointment of warming procedures.
The implementation of a surgical operation in advanced cases or if there was no perforation of the eardrum. This reduces pressure and relieves pain.
Taking antibiotics and nasal vasodilators.
Ear cleaning.
Preventive measures necessary to prevent the risk of recurrence or chronic form.

If surgery is required, two types of procedures are performed:

Tympanostomy. It is prescribed in the absence of a positive result of drug treatment. The operation consists in introducing a special outlet tube into the cavity of the ear canal to facilitate the outflow of escudate.
Myringotomy. Opening the eardrum, which is used for acute pain and the presence of pronounced symptoms.

The main measure in the treatment of a purulent form is the removal of fluid accumulation in the ear canal. How effective further treatment will be depends on this procedure. Experts do not recommend using cotton swabs or matches as tools for cleaning the ear, since there is a high probability of damage to the eardrum or injury to the mucous membrane.

Physiotherapy

One of the most effective methods in the treatment of purulent otitis in children is the use of physiotherapy:

UHF procedures. The impact is carried out using high-frequency currents. Conductive plates are placed around the mastoid process and on the temples.
Carrying out pneumomassage. An air type of massage is used with the help of a special APMU compressor.
Use of ultraviolet lamps. The tympanic membrane, mastoid process and external passage are exposed to irradiation.
Ionogalvanization or electrophoresis. Using this technique, it is possible to deliver the necessary drugs, such as zinc sulfate or antibiotics, to the ear.

The use of physiotherapy techniques is recommended only as a concomitant treatment and is not the only way to cope with the disease.

For the treatment of purulent otitis media, regardless of its form and causes of appearance, the following drugs are used:

Pain relievers and antispasmodics are used to relieve pain. If there is a high temperature, antipyretic drugs are prescribed. Nurofen is allowed to be given from three months, the minimum dosage is 50 mg 3 times a day. Paracetamol is used at a dosage of 10-15 mg per kilogram of weight starting from 3 months.
Anti-inflammatory and analgesic drugs, which include Otipax drops (3-4 drops 3 times a day), Otinum (3-4 drops 3 times a day). Their use allows you to temporarily get rid of discomfort and reduce inflammation.
Vasoconstrictor drugs. These are Tizin drops (from 2 to 6 years at a concentration of 0.05%, one injection twice a day), Nazivin for children (1-3 drops three times a day for children from one to 6 years old), Otrivin sprays (for children under 12 years at a concentration of 0.05% only as prescribed by a doctor). Their use is designed to eliminate swelling of the mucous membranes, which helps to improve the outflow of exudate and restore ear function.
An effective method of treating a purulent form is the use of antibiotics. Amoxicillin is prescribed at a dosage of 20 mg per kilogram of body weight from the first year of life. Ceftriaxone is used at 20-30 mg per kilogram per day. For children over 12, the dosage is 80 mg per kilogram of body weight. Their task is to destroy the bacteria that are the source of the disease.
Means to increase immunity. This can be Viferon gel (3-5 times a day is applied to the surface of the mucous membranes by 0.5 cm), Immunorix (one bottle per day) and vitamin complexes. They serve to strengthen the protective properties of the immune system.

Local treatment

Local procedures include warming up, which is carried out by means of compresses and the use of turundas with anti-inflammatory drugs applied to them.

The compress is applied in the following way:

A cotton bandage is made from several layers of material. Its size should be slightly larger than the surface of the auricle.
An incision is made in the middle for the ear.
Gauze is wetted with warm vodka or alcohol diluted 1:1 with water.
A compress is applied.
A layer of cotton wool, wax paper or just fabric is placed on top to create a greenhouse effect.
The bandage is worn for 3-4 hours.

Direct instillation of drops into the ear, especially on an alcohol basis, is undesirable. Therefore, it is recommended to use turundas. These are pieces of cotton wool twisted into a tight tourniquet, which are moistened with a medicinal solution.

Folk remedies

There are many folk recipes for the treatment of otitis media in children. They are mainly based on the use of alcoholic infusions of herbs.

Among the most available methods are:

Sagebrush. One teaspoon of wormwood flowers should be infused with rubbing alcohol for a week. The resulting solution is injected into the ear by means of cotton flagella, which simply need to be dipped into the composition. The use of this herb, according to reviews, is good for pain relief.
Walnut. Walnut leaves are finely chopped and poured with vegetable oil. The mixture is stored tightly closed in a cool place for a month. During treatment, it is required to apply the agent in the ear with cotton swabs moistened with 1 drop of the composition. The substances that make up the leaves of the tree have an antimicrobial effect.
Onion. It is used for treatment in the form of drops. Onion juice, squeezed into saline through gauze in proportions of 1: 3, can be instilled into the ear 3 drops three times a day, provided that the eardrum is intact.
Bay leaf. The leaves are small and pour boiling water. Let it brew for an hour. With the resulting decoction, cotton swabs are made at the rate of 8-10 drops in each ear 3-5 times a day.
Aloe juice. The juice squeezed from the leaves is instilled into the ear 4 drops several times a day. At a young age, the juice is recommended to be diluted with water. Treatment with this method is also allowed with an intact eardrum.

Folk remedies can also be only a treatment that accompanies the main one. Before using prescriptions, consult with a specialist.

Complications of purulent otitis media

With untimely treatment or non-compliance with the methods of therapy prescribed by the doctor, purulent otitis media in a child is dangerous with the following complications:

damage to the bone tissue behind the ear cartilage;
development of otogenic sepsis;
hearing loss or significant reduction;
rupture of the eardrum;
acquisition of a chronic form;
the occurrence of choleosteatoma or tumor;
infection of the outer lining of the brain.

Prevention

To prevent the disease, preventive measures should be taken, the focus of which should cover the prevention of colds.

Prevention methods include:

Avoid visiting crowded places.
Correctly remove accumulated mucus in the nose for colds or rhinitis.
Prevent water from entering the ears when bathing a child.
Strengthen immunity.

Photo gallery

The gallery contains photos various forms purulent otitis in children.

Dr. Komarovsky, in his series of programs, talks in detail about purulent otitis media in children and gives advice on treating the disease. You can find out more from the video from the Doctor Komarovsky channel.

Purulent otitis in a child: how not to start a dangerous disease

It is called purulent otitis inflammatory disease middle ear, in which there is a discharge of pus from the ear canal. Pathology is mainly found in children, it manifests itself as a complication after suffering acute respiratory infections or untreated rhinitis. But sometimes the ears become inflamed for no apparent reason. The disease represents serious danger for the health of the child. With untimely treatment, pus may enter the brain, which leads to extremely negative consequences.

Description and types of pathology

The disease is based on acute purulent inflammation of the mucous membrane of the middle ear, sometimes all its departments. Pathology has a viral or bacterial nature, less often - fungal. If you do not take action in time, there will be a rupture of the eardrum.

The development of otitis media in children is promoted by viral (SARS, colds, measles, influenza) and bacterial (scarlet fever) diseases in advanced form.

Purulent otitis media - an inflammatory disease that is accompanied by the release of pus

According to the nature of the course, otitis occurs:

Sharp. The child feels severe pain, and pus flows from the ear cavity. Acute purulent otitis media mainly affects children under three years of age, due to anatomical features. The Eustachian tubes in a baby are shorter, so the accumulation of mucus in them passes much faster than in an adult.
Chronic. This happens with untimely or improper treatment. The chronic course is characterized by a persistent lesion of the eardrum, constant or periodic discharge of pus. Children also experience hearing loss.
Recurrent. Such a diagnosis is made if, after a short period of time, the disease recurs. This form of otitis is the result of improper treatment or violations of the doctor's recommendations. The disease recurs with adenoiditis.

Depending on whether both ears are affected or one, the inflammatory process can be:

Unilateral. Inflammation develops on one side.
bilateral. In advanced cases, the disease passes to both ears. Bilateral otitis media is more common in infants due to the low ability of the auditory tube to resist microorganisms. Since the baby is constantly in a horizontal position, the liquid stagnates. With age, the risk of developing this form of otitis media decreases due to the development of the hearing aid.

All forms of the disease are characterized by a common symptom - pain in the ear. If older children are able to complain of discomfort, then parents should guess that the baby has a problem by his behavior.

Otitis in children under one year old often has undercurrent, therefore, there are problems with the diagnosis. If the baby is worried about something, he starts to turn his head, refuses to eat, does not want to breastfeed. Children can pull on their ears, but such actions do not always indicate a disease, perhaps it's just a habit.

Video: Dr. Komarovsky about the signs and treatment of otitis media

Causes and risk factors

Each ENT disease is accompanied by increased mucus production. As its amount increases, with an unfortunate set of circumstances, mucus enters the Eustachian tube, disrupting the ventilation of the tympanic cavity.

The causes of the disease are as follows:

complications after SARS, tonsillitis, respiratory diseases;
untreated catarrhal otitis;
physiological features of the structure of the child's ear - the auditory tube in children is narrow and short, its location contributes to the penetration of bacteria;
inflamed adenoids - growths squeeze the Eustachian tube, which changes the pressure in the ear and develops an inflammatory process;
injury.

In addition, some additional factors significantly increase the risk of developing the disease in a child:

hypothermia;
vitamin deficiency;
long-term antibiotic treatment;
liquid getting into the ear canal;
decrease in immunity.

Symptoms of purulent otitis media

It is easier to suspect the development of a purulent form of otitis at the initial stage in children 2–3 years old, since they themselves can complain of ear pain. In addition to discomfort in the ear, parents should pay attention to such signs:

temperature rise (up to 39 ºС);
skin blanching;
increased sweating;
restless or apathetic behavior;
hearing loss;
excretion of pus.

In some cases, the disease can proceed without fever. At the same time, his symptoms are mild, but persist for a long time. If you do not take timely treatment, the disease will turn into a chronic form.

It is much more difficult to timely diagnose the disease in a baby under one year old. Parents should be alert for the following symptoms:

restless behavior of the child;
temperature rise;
refusal of the breast or nipple, as the pain intensifies when sucking;
desire to lie on the affected side.

There is a simple way to help determine the presence of otitis media in infants. You just need to press your finger on the tragus. After these actions, the baby may scream, cry, or pull the hands to his ear. This behavior indicates the development of otitis media.

Small children with purulent otitis media can pull on the ear

There are three stages of purulent otitis media:

Catarrhal. The edema of the mucous membrane of the ear increases, purulent masses accumulate and put pressure on the nerve endings of the membrane. As a result, the child has acute pain, which intensifies in the evening. The baby feels weak, loses appetite, his temperature rises. There may be noise and congestion in the ears.
Perforated. At this stage, the tympanic membrane ruptures, pus is released from the ear canal, sometimes with impurities of mucus and blood. The general well-being of the baby improves, pain decreases, fever subsides. Pus is released within a week, after which the disease passes into the next stage.
Reparative. The formation of pus decreases and stops, the opening of the eardrum spontaneously scars, hearing is restored. This stage lasts about 14 days.

As a rule, otitis in children occurs in an acute form. At timely diagnosis and correctly selected tactics of treatment, the disease can be eliminated quickly and without consequences.

But if the treatment was not started on time or was carried out only until the pain syndrome ceased, then the disease can become chronic, which is characterized by:

incessant or periodic outflow of purulent masses from the ear;
persistent perforation of the eardrum;
periodic pain;
tinnitus, congestion;
hearing loss.

Diagnosis of purulent otitis media

If there are signs of otitis, you need to contact a pediatric otolaryngologist. Since the disease is often accompanied by other ENT pathologies, a complete otolaryngological examination will be required.

To establish an accurate diagnosis will help such studies:

Otoscopy. The most common and publicly available research method, during which the eardrum is examined. Otoscopy allows you to detect signs of pathology: thickening, retraction, perforation of the tympanic membrane, the presence of pus in the ear canal. It may be necessary to take the contents for analysis to determine which bacteria caused the development of the disease.
X-ray of the temporal bones. Allows you to detect a violation of the pneumatization of the middle ear cavities, which occurs as a result of thickening of the mucous membrane and the presence of pus. To clarify the diagnosis, CT of the temporal bones may be needed. Such studies are necessary in the complicated course of the disease.
Audiometry. Used for recurrent or chronic form otitis, allows you to explore the auditory functions.

Otoscopy is the most common and widely available research method for otitis

Treatment Methods

Treatment of the disease is usually carried out at home, but under the supervision of a physician. Drug therapy is aimed at fighting bacteria, relieving pain, relieving swelling, reducing inflammation and lowering temperature.

How to recognize and cure purulent otitis media in children?

Such a pathology as purulent otitis occurs mainly in childhood, and often the disease becomes recurrent. Factors contributing to the development of the disease can be very diverse: from the common cold to the weakened functioning of the protective functions of the body.

Even the most subtle symptoms of purulent otitis in a child should be the basis for visiting a competent specialist, because this disease is very dangerous, especially in childhood. Next, we will talk about ways to determine and treat such a pathology in childhood.

Purulent otitis in children

Purulent otitis media- an ailment that develops in the middle part of the human ear, namely in the tympanic cavity. This is a small space in the temporal bone responsible for receiving and processing incoming sounds.

With this form of the disease, an inflammatory lesion of the mucous membrane in the ear occurs, while the formation and accumulation of purulent masses is observed.

Reference. This disease is considered much more dangerous compared to catarrhal form, as it can provoke hearing loss and various intracranial complications.

The appearance of purulent otitis media in a child can cause problems with the formation of speech function. There are cases when such a disease causes disturbances in psycho-emotional development, difficulties with the perception of information, which significantly reduces the level of quality of life.

This type of pathology develops much more often in children than in adults.. This phenomenon occurs due to the following objective reasons:

auditory tube the baby has a slightly different shape and size than the adult. It is shorter, narrower and does not have a curvature, which facilitates the penetration of various pathogenic bacteria into the ear cavity;
many children have the presence of enlarged adenoids, which compress the auditory tube, thereby disrupting its patency;
children are more susceptible frequent respiratory problems.

In addition, there are also additional factors, significantly increasing the risk of developing an inflammatory process in the baby's ear. These include:

Hypothermia.
Deficiency in vitamins.
Fluid in the ears.
Weakening of protective functions.
Prolonged use of antibiotics.

What does purulent otitis media look like in a child: photo

The main cause of the disease are various inflammatory processes in the nasal cavity and throat, adenoids, chronic rhinitis, respiratory diseases, viral infections.

This leads to the formation of an excessive amount of mucous masses in the nasal cavity.

This mucus, during a strong blowing of the nose, can enter the auditory tube and clog it.. As a result, there is a violation of ventilation and further spread of infection, which ultimately leads to the development of an inflammatory process in the middle part of the ear.

Important! Parents must teach their baby to blow their nose correctly, that is, alternately from each nostril and without making excessive efforts.

The scheme of development of purulent otitis media in children is as follows:

manifestation of the primary symptoms of the disease- there is a general deterioration in the condition, stuffy ears, noise;
increased pain in the ears- the pain is especially pronounced in a horizontal position on the back. The mucous membrane of the middle ear is greatly inflamed;
increased pain- the pain syndrome becomes piercing, radiating to the temporal region. Soreness when touching the mastoid process;
peak pain syndrome- Pain radiates to the ears and neck. Also, the child may have pain in the teeth, pharynx, eyes. There is an increase in body temperature. it preperforative stage, the duration of which can be from several hours to 3 days;
reduction of pain- purulent masses begin to stand out profusely from the ears, but tinnitus and hearing loss are also noted. Body temperature returns to normal. it perforative stage, in which purulent masses are released from the ear for about a week;
relief of inflammation – reparative stage, in which scarring of the perforation of the tympanic membrane occurs.

In children, the disease does not always go through all stages, quite often it ends at the preperforative stage, that is, damage to the eardrum does not occur.

Symptoms of purulent otitis media in children

The manifestation of such a pathology in childhood is characterized by severe pain in the ears.

This feature is accompanied frequent crying, the baby begins to act up and get nervous.

The nature of the pain in this case can be pulsating, shooting, cutting, aching.

Uncomfortability increases significantly at night resulting in disturbed sleep. In addition, children are noted to have such symptoms:

General weakness, lethargy, fatigue.
The skin turns pale.
Hearing loss.
Constant tinnitus.
The appearance of purulent masses with blood.
Increase in body temperature.

The situation is much more complicated with the detection of the disease in newborn babies and infants.. In this situation, parents can help determine the illness in their crumbs such changes in his behavior:

anxiety and tearfulness;
refusal to eat;
the appearance of vomiting;
the baby constantly tries to lie on its side, where the sore ear is located.

When these signs appear, parents should urgently sound the alarm, since there is a high risk of serious consequences.

Types of purulent otitis media in children

Children's purulent otitis is divided into several varieties, each of which has its own distinctive characteristics.

Experts classified this otitis media into 3 types:

Acute suppurative otitis media in children it is characterized by severe pain and leads to the formation of pus in the ear. If you do not immediately start treating the disease, then there is a threat of acquiring a chronic form of this disease, which is characterized by constant inflammation tympanic membrane and cavity. As a result, hearing may slowly deteriorate.

Bilateral purulent otitis media in a child Both ears are affected at once. This form of the disease is very dangerous, especially for early childhood. Children's otitis in almost 90% of cases are bilateral, but their number decreases with age. This is due to the development of the organ of hearing.

Recurrent suppurative otitis media- a diagnosis that is made if the disease has developed again after a short period of time after the first. This phenomenon is the result of either improper treatment or non-compliance with the therapy prescribed by the doctor. Inflammation of the adenoids also leads to repeated diseases.

How to treat purulent otitis media in children

In order to cope with the disease and prevent the appearance dangerous consequences, the child must be urgently shown to a specialist. Therapy should be selected by the ENT in accordance with the stage of the disease, its manifestations. The duration of treatment is also determined by the doctor.

Non-compliance with the treatment regimen prescribed by the doctor can provoke a relapse of the disease, as well as various complications. That is why it is very important to monitor the treatment of the baby.

Therapy is carried out in a complex manner with the use of drugs, as well as with the implementation of various procedures, the action of which contributes to speedy recovery. Let us consider in more detail these directions in the treatment of purulent otitis media in children.

Medical treatment

As a rule, with this disease, specialists prescribe a rather large list of drugs.

Judging by the numerous reviews, many mothers are very excited about such a list of drugs and try to find and cross out among them those medicines that, in their opinion, there is no need.

This is fundamentally the wrong approach., because the specialist selects exactly the complex of drugs that can effectively cope with the disease, interacting with each other.

Therefore, you should follow all the doctor's prescriptions and get by with this number of drugs, than then take countless drugs, trying to get rid of the complications of the disease as a result of the irresponsible attitude of the parents.

In the treatment of purulent otitis media in children, the following drugs are usually used:

antibiotics- are prescribed necessarily for this form of the disease, as they effectively eliminate inflammation and symptoms, including suppuration. For children, Sumamed, Augmentin, Flemoxin are usually prescribed;
ear drops- to relieve pain and eliminate inflammation of the eardrum. Usually prescribed "Otipaks", but only in the preperforative stage;
antibacterial ear drops- are prescribed to enhance the systemic antibiotic, while the previous drops are canceled. Tsipromed, Normax, Otofa are used;
vasoconstrictor nasal drops- necessary to eliminate the swelling of the Eustachian tube and normalize its functioning. Otrivin, Naphthyzin are used;
antihistamines- "Claritin", "Diazolin", "Tavegil";
painkillers and antipyretics- "Nurofen", "Ibuprofen", "Analgin".

Although many parents do their best to protect their child from treatment with antibacterial drugs, there are still ailments that cannot be treated without them. Antibiotics for purulent otitis media in children are a method of treating the disease with proven effectiveness.

Reference. Childhood up to 2 years- the circumstance in which antibiotics are prescribed to treat this form of otitis media without fail.

Non-drug treatment

Non-drug treatment begins at the restorative or reparative stage of the disease, that is, when purulent masses cease to be released from the ear cavity.

This stage of treatment is aimed at normalizing breathing through the nose and restoring the work of the Eustachian tube.. Usually used following procedures:

Also, in the treatment of the disease at this stage, the use of warm compresses, which accelerate the healing process and promote better regeneration.

Parents should be very attentive to changes in the behavior of their baby. After all, capriciousness and anxiety may indicate the development of an inflammatory process in the ears.

In this case, parents should act immediately, since the consequences of purulent otitis in children are the most serious (mastoiditis, meningitis, cholesteatoma).

Acute and chronic purulent otitis media in children and adults

Regardless of whether acute or chronic suppurative otitis media develops in a person, this condition is a potentially life-threatening condition. It is necessary to immediately consult a doctor as soon as they appear typical symptoms and signs of such pathology. Treatment at home is carried out exclusively under the supervision of the attending physician. Self Therapy, especially folk remedies, is strictly prohibited, since there is a high probability of infection spreading through the upper respiratory tract and lymphatic system.

The only cause of purulent otitis in children and adults is infection with bacterial pathogenic microflora. The ideal option for prescribing adequate treatment is to examine the contents of the ear taken during the smear. With this analysis, it is possible to identify a strain of pathogenic microflora and its sensitivity to antibiotics.

This material discusses the main symptoms of acute and chronic purulent otitis media, tells about basic principles treatment and prevention of complications. Provided all the information that will help the patient to reduce the intensity of pain, and make the recovery process easier and faster.

The cause of purulent otitis media in children and adults is one!

Studies of groups of patients with similar diseases allow doctors to talk only about the alleged risk factors in the development of a particular pathology. Fortunately, with regard to purulent otitis media in acute and chronic form, both in children and adults, the cause can only be infectious nature. One of the most common forms of pathogenic microflora is staphylococcus aureus, which can be in remission in the human body for a long time, and produce symptoms of a complication only when the immune system is weakened.

In this regard, the statement, or rather a long-term observation, may be true, saying that in the cold season, the ears must be protected from exposure to negative temperatures. And here there is a very interesting mechanism of interaction between cold and local immunity.

As you know, a special substance is produced in the human ears in a constant mode, which is able to protect the inner surface from the penetration of various pathogenic microorganisms. This is the so-called local immunity. When exposed to negative temperatures tiny capillaries in the epithelial layer sharply narrow and deprive the tissues of a full supply of oxygen, fluid and nutrients. This entails an instant stoppage of earwax production and a decrease in the reactivity of epithelial cells. The auricle and ear canal remain absolutely defenseless against the invasion of staphylococci, enterococci, Pseudomonas aeruginosa and other types of pathogens.

But hypothermia is not enough, because the introduction of an infectious agent from the air is very difficult, especially in the cold season. At negative temperatures, bacteria lose their ability to aggressiveness. Therefore, the second the most important factor occurrence similar disease- the presence of a focus of a chronic inflammatory process in the oropharyngeal cavity.

In children, the causes of acute suppurative otitis media can be the following conditions:

chronic tonsillitis;
adenoiditis in the acute stage;
carriage of staphylococcus and streptococcus;
the presence of carious cavities in the teeth.

In some cases, the disease develops with epidparotitis, lacunar angina and paratonsillar abscess as a complication. The infection penetrates through the auditory tube into the middle ear cavity, where, without meeting proper resistance, it penetrates into the epithelial layers and causes an acute inflammatory process. The rhinotuber path is not the only one; the infection often spreads from distant foci (kidneys, bladder, heart, joints) with blood and lymph flow.

Risk factors include regular injuries of the auricle, improper hygiene care, sulfur plugs, reduced immunity for various reasons.

What are the symptoms and signs of pathology?

For a timely response, you need to know what symptoms such an ear pathology can manifest. In relation to an adult, everything is quite simple. The patient may complain of severe pain in the ear, which radiates to the occipital region. Ear congestion, hearing loss, fever, and pus are all common symptoms.

But what are the signs of acute purulent otitis media in a child, it is worthwhile to carefully understand so as not to miss a dangerous pathology. The clinical picture develops very quickly:

the baby begins to refuse the breast;
constantly crying and tilting his head towards the affected ear;
the auricle is hyperemic and edematous; when pressing on the tragus, the child reacts with increased crying;
the temperature rises rapidly and is difficult to reduce with the help of lytic agents ("Paracetamol", " Acetylsalicylic acid”, “Panadol”, “Ibuprofen”);
against the background of hyperthermia and pain syndrome, the baby may develop convulsive syndrome.

Treatment of purulent otitis in a child is provided exclusively in a hospital. Children are left at home without convulsive syndrome with a body temperature not higher than 38 degrees Celsius and no signs of the spread of infection.

Discharge from the ear canal of ichor or purulent contents may appear 36-48 hours after the first signs of the disease appear. During this time, purulent fusion of tissues occurs and, in the absence of adequate treatment, very unpleasant complications can occur. For example, melting and subsequent fusion of the eardrum is common. This threatens with hearing loss and complete hearing loss.

How does a chronic process differ from acute suppurative otitis media?

What is the difference between the recurrent stage of the pathological inflammatory process cannot be said in one word, since most often it is manifested by periodic exacerbations. With inattentive diagnosis, each case of exacerbation is diagnosed with acute purulent otitis media, without comparing the relationship between periods of remission and exacerbation. The chronic process is more easy flow, but leading to an inevitable decrease in hearing acuity. Gradually, purulent fusion of the tympanic membrane begins, which threatens with complete loss of hearing from the affected side.

Acute purulent otitis media is diagnosed much more often. In this case, the clinical picture develops acutely, and the course is accompanied by an increase in body temperature, severe pain and the rapid appearance of discharge from the auricle.

Symptoms of the disease (with photo) and its consequences

The characteristic symptoms of purulent otitis develop gradually, and at the initial stage, pain may be absent. The disease begins with general malaise. May be present headache, dizziness, slight runny nose. A day after the initial rise in temperature, acute pain occurs in the affected ear. It can be shooting, annoying, stabbing. The swelling of the surrounding tissues increases and after 2 days a yellowish or greenish liquid is released.

It should be noted that quite often acute purulent otitis media develops against the background of acute respiratory disease bacterial etiology. With a long course of inflammation, it spreads through the Eustachian tube. In this case, at the initial stage, symptoms of eustacheitis occur. This is nasal congestion and slight stupor, dizziness and constant discharge of purulent secretions from the nose.

Look at the photo for the symptoms of purulent otitis media in children and adults - a clinical picture of what the doctor will see during the initial examination of the ear canal and auricles:

And now let's talk about the consequences of purulent otitis media, they can be minor or lead to complete deafness, especially in the case of a bilateral inflammatory process. There is a division into primary and finished effects. The former include typical complications observed in the case of inadequate treatment. It can be an abscess, purulent fusion of the eardrum, sinusitis, paratonsillar abscess.

But long-term effects consist in a decrease in hearing acuity, involvement in the inflammatory process auditory nerve, violation of the biochemical balance inside the auricle.

Treatment of purulent otitis: what antibiotics, drops and medicines to use at home?

As mentioned above, the basis of this pathology is an infection with a bacterial pathogenic microflora. Accordingly, antibiotics for purulent otitis are a mandatory factor in the etiological influence. What medicines can be used - we will talk further.

To begin with, it is worth knowing that, before treating purulent otitis, it is advisable to examine the contents of the secret separated from the ear. This is done in the laboratory by seeding to identify microflora and its sensitivity to various groups of antibacterial drugs.

As a rule, the treatment of purulent otitis media is carried out at home on an outpatient basis. Inpatient therapy may be indicated if complications develop. Medicines are divided into two groups. The first includes antibacterial drugs of general and local action, the second group is drugs to eliminate negative symptoms. This may include painkillers and antipyretics, vitamins, and more.

In case of manifestation of positive dynamics within 7 days from the beginning of etiological therapy, surgical treatment of purulent otitis media is indicated in order to ensure the removal of molten tissues and the opening of internal suppuration.

Drops for purulent otitis media are used both for the purpose of negatively affecting the pathogenic microflora, and for the purpose of eliminating the pain syndrome. Used "Otipaks", "Sofrodex", "Candibiotic" and some others. Sophrodex has an excellent composition - it includes dexamethasone, which instantly eliminates swelling of soft tissues and neutralizes the pathogenic activity of bacteria. it hormonal agent. The composition also includes an antibiotic and an anesthetic drug. Instill 3-4 drops every 3 hours.

Broad-spectrum antibiotics are prescribed inside. This can be "Azithromycin" 500 mg 2 times a day for 3 days, "Ciprofloxacin" 500 mg 2 times a day for 5 days, "Amoxiclav", "Flemoxin", "Amoxicillin" and many others (dosages are indicated for an adult). It is also necessary to take antihistamines: "Suprastin", "Tavegil", "Claritin", "Diazolin", "Pipolfen" and many others. Usually for an adult they are prescribed 1 tablet 2 times a day.

This is general information about which antibiotics, drops and medicines can be used at home, treatment should only be carried out under constant supervision by the attending physician. Self-treatment can lead to very deplorable consequences.

Symptoms and treatment of purulent otitis media in children

Infection, weakened immunity, enlarged adenoids - this is far from complete list factors that can provoke the development of such a disease as purulent otitis media in a child.

This serious disease affects the middle ear, and its consequences include intracranial complications, hearing loss, impaired psycho-emotional development, difficulty in perceiving information and a general decrease in the quality of life. Therefore, it is extremely important to know the symptoms and treatment of this disease.

Risk groups and causes of development

Purulent otitis in children is very common. According to statistics, more than 80% of children under the age of three years have time to endure otitis media.

The disease in a purulent form is most common in the age category from 5 to 18 months.

The fact is that the formation of hearing organs in a child, including the Eustachian tubes in the ears, lasts up to 3-5 years. During this period, pathogens can easily penetrate into the middle ear and tympanic cavity. In babies under the age of one, in the vast majority of cases (up to 90%), bilateral otitis media is diagnosed, which turns into a purulent form in 20% of patients.

Experts note the main reasons that acute purulent otitis media develops in childhood, the following reasons:

Purulent otitis media in infants (including bilateral ones) becomes the result of intrauterine development disorders (bad habits of the mother or diseases of an infectious or viral origin that she suffered during pregnancy can provoke a pathology);
Complications during childbirth;
prematurity;
Imperfect immunity due to age;
Catarrhal otitis in acute form;
Adenoiditis (with this disease, the child's tonsils grow, which contributes to the penetration of pathogens into the Eustachian tube);
Infectious diseases leading to a decrease in immunity (for example, influenza);
Presence of remnants of myxoid tissue in the middle ear of the baby.

Characteristic symptoms

Babies who have not reached the age of two cannot yet describe the problem that worries them, so parents should be aware that when purulent otitis media develops in a child, the symptoms will be as follows:

the most dangerous symptom is otorrhea. The appearance of discharge from the ear, they are transparent, purulent, in especially severe cases, they may contain an admixture of blood. Having found these alarming signs, you should immediately seek medical help;
loss of appetite - when the child makes sucking movements, pain intensifies, so refusal to eat is possible;
the baby becomes very whiny and often naughty;
when pressing on the tragus of the ear, the child cries;
the baby tries to lie and sleep only on one side - on the side where inflammation develops.

Older children can already talk about their feelings, so it will be much easier to determine the cause of the ailment. You should consult a specialist if you experience the following symptoms:

the ear begins to fester, discharge appears;
sharp or shooting pain in the ear;
the child becomes pale, sweating increases greatly;
the baby becomes apathetic;
fever (up to 390). In some cases, patients have otitis media without fever and, as a rule, we are talking about initial stages diseases when the symptoms are not pronounced or about pathology in a chronic form;
hearing loss, dizziness and/or vomiting may be present.

Diagnostics

If there is an uncomplicated development of the pathology, then it is not difficult to diagnose purulent otitis media in childhood. The comprehensive survey includes the following activities:

After the channels are cleared, a general inspection is carried out and endoscopy cavities of the ears, nose and nasopharynx;
X-ray examination and computed tomography of the temporal bones;
Vestibulological and audiological studies;
Pushing exudate into the ear canal (in medicine, this type of study is called the Valsalva maneuver);
Allocations are examined for the degree of susceptibility to antimicrobial agents in the laboratory;
The state of the patient's immune system is determined.

Home and medical treatment

It is unacceptable to treat purulent otitis in a baby on your own - this can lead to a number of serious complications, in especially severe cases, lead to disability or death.

The doctor may authorize home treatment only if the disease has light form and pus is not widely distributed. In this case, in addition to the recommendations of the doctor, which must be observed as accurately as possible, the following rules should be considered:

sick children should be kept in bed;
bathing is excluded;
ears should be regularly wiped with a towel or cloth dipped in boiled water at room temperature;
to clean the auricles from secretions, cotton flagella are used (you can twist them from a bandage), which must first be moistened with hydrogen peroxide (3% solution);
the child should not be supercooled, it is especially important to keep the ears warm;
plentiful drink is shown;
walks should be postponed until the moment when the baby's condition improves significantly;
warm compresses are strictly contraindicated.

How to treat purulent otitis media correctly - if the pathology is severe, then the doctor will prescribe surgical treatment - the eardrum will be dissected, and the cavities will be cleaned of pus.

Medications that experts recommend when developing the treatment of purulent otitis media in children are aimed at removing discomfort and elimination of the cause of the disease.

The most commonly prescribed drugs are::

Antipyretics

Efferalgan

3-4 times a day, 10-15 mg per 1 kg of weight with a six-hour interval

Children from 1 month to 15 years old can be taken in the form of syrup or in the form of suppositories

3-4 times a day, 10-15 mg per 1 kg of body weight

Children from 3 months to 12 years old can be taken as a suspension or in the form of rectal suppositories

1 hour after a meal, 2.5-5 ml 3-4 times a day

Suspension can be used from 1 month

Antibiotics

Amoxicillin

The dosage is determined by the attending physician, but not more than 250 mg twice a day

For children up to a year - in the form of syrup, solution, soluble tablets or suspension

Twice a day, 5 ml of suspension 125 mg

You can take this antibiotic from birth in the form of a suspension

1 tablet (preferably crushed into powder and mixed with boiled water) three times a day.

Drops with purulent otitis media

1-2 drops twice a day

It is permissible to apply to children from 1 year in the form of 0.05% drops

1-2 drops of 0.05% aqueous solution up to 3 times a day

It is possible to drip the drug into the ears with otitis media only as prescribed by the attending physician for children older than 1 year

Up to 3 drops in each ear no more than 3 times a day

Use these ear drops only as prescribed by the doctor, taking into account all side effects and contraindications

Up to two weeks of age: 6.25 mg per 1 kg of weight no more than four times a day.

Older than two weeks: 12.5 mg per 1 kg of body weight 4 times a day

It is acceptable to use for the treatment of newborns, including premature babies

2-3 drops in the ear no more than four times a day

Contraindicated in children under 7 years of age

1-2 drops in ear canals twice a day

Up to 1 year - 1-2 drops three times a day, up to 2 years - 3 drops 3 times a day

Before use, the drop must be heated to 38 degrees

Contraindicated in children under 6 months

Physiotherapy

If an ear disease is diagnosed in a baby, treatment may include a number of physiotherapeutic methods that usually show high efficiency:

Pneumomassage;
Treatment with ultra-high frequencies;
Carrying out ionogalvanization. The procedure is based on the introduction of drugs through the mucous membrane by means of a current;
Exposure to ultraviolet rays.

The opinion of Dr. Komarovsky

Dr. Komarovsky, an authoritative Russian pediatrician, recommends immediately contacting a medical facility at the first sign of otitis media to make an accurate diagnosis and develop an effective treatment strategy. To alleviate the condition of the child with inflammation and speed up the healing process, it is permissible to use drops of a vasoconstrictor action, and they need to be instilled into the nose.

If the pain is severe, it is permissible to give the baby a mild pain reliever. Ear drops can only be used as directed by a pediatrician. You need to be prepared for the fact that the treatment of otitis media will take a long time, it cannot be interrupted, since the risk of relapse is high.

Prognosis and complications

If the treatment was started in a timely manner and corresponded to the form and stage of the course of the disease, then in the vast majority of cases the prognosis will be favorable. Running acute purulent otitis media or an incorrectly selected therapeutic course can lead to the following complications:

development of hearing loss;
the formation of adhesions in the tympanic cavity;
paralysis of the facial nerve;
intracranial complications;
anthrite;
the transition of the disease to a chronic form.

Treatment of purulent otitis media in a child

In childhood, any otitis media can rightfully be considered dangerous.

But the most dangerous is the purulent form of otitis media, the symptoms of which are never hidden, but probability developing complications more than great. We will talk about the treatment of purulent otitis in a child in the article.

How to treat ARI in a child? Learn about it from our article.

Concept and characteristics

Purulent otitis in a child - photo:

Purulent otitis is considered purulent inflammation of the middle ear- that part of the auditory system, which is based on the tympanic cavity. This is that small space in the temporal bone where sound vibrations are converted.

it dangerous pathology, since the process of speech formation, as well as the psycho-emotional state, may be disturbed in children. The learning process will become more complicated, and in general, the quality of life of the baby will worsen.

Purulent otitis is characterized by inflammation of the mucous ear of a child, where pus will accumulate.

This is a severe form of pathology, since it is fraught not only with hearing complications, but also with intracranial disorders.

Causes

The tympanic cavity, as is known, is connected with the nasopharynx by the Eustachian tube. Pneumococcus, or Haemophilus influenzae, or Moxarella penetrates from the secretion of the nasal mucosa into the tympanic cavity.

Any additional conditions are usually not required for this penetration. Babies who are only a few months old may have a common runny nose with hypersecretion of the mucosa, plus which is the almost constant presence of the baby in the supine position.

In other cases, the cause of the disease may be spread of bacteria into the tympanic cavity due to enlargement of the tonsil of the nasopharynx.

It deforms the auditory tube, changes the movement of air and secretions of the nasopharyngeal mucosa.

Also provoke pathology maybe incorrect cleaning, due to which a secret is thrown into the Eustachian tube. For example, it is not uncommon for adults to put a handkerchief on a child's nose and force him to blow his nose hard by pinching both nostrils.

And then when the pressure rises in respiratory tract, the parent opens these nostrils at the same time. But the fact is that the pressure caused in this way, as if opens the entrance to the Eustachian tube, and the bacterio-composition is simply thrown into it.

It turns out that the adults themselves, with their wrong actions, provoke a serious illness.

Stages of development

There are several stages of acute purulent inflammation children's ears.

Stages of development of the disease:

Symptoms and signs

The purulent form of otitis media is always accompanied by two signs - a high temperature, as well as severe pain, extending beyond the ear.

The child may have complaints on the:

hearing impairment, the ear lays, there he hears extraneous noises and other internal sounds;
the baby feels pressure in the ear;
he deliberately keeps his head tilted so that the pain is felt less;
insomnia;
poor appetite.

If the case is severe, the child may begin vomiting, clouding of consciousness, heart rhythm disturbances. The temperature can be high, above 39 degrees. After the mark of 38.5, it is recommended to shoot it down.

Read about the symptoms and treatment of SARS in children here.

What is dangerous?

If all stages are passed, but the patient does not feel better, then complications began.

Sometimes the course of the disease can be disturbed, the perforative stage never occurs.

accumulates thick pus difficult to remove. Inflammation can spread to the temporal region.

Diagnostics

If there are no complications, then the diagnosis of the disease is not difficult. The doctor will conduct a general examination, do an endoscopy of the ear, nose and nasopharynx - all this is done after cleaning the channels.

It will take and audiological examination, this includes tympanometry, which will evaluate the activity of the auditory tube. You may also need a vestibulological study.

The doctor may also prescribe laboratory research secretions (check their susceptibility to antimicrobial agents).

Determines the doctor and the state of the immune system. Might need to do x-ray and computed tomography temporal bones.

Treatment Methods

How to treat a baby?

To relieve pain and reduce the inflammatory process in the eardrum, in the ear canal itself, children are prescribed to instill drops of Otipax.

They are effective and quite safe at the pre-perforative stage.

Preparations and drops

When the second stage has come, the therapy regimen changes. These will be special droplets of Normaks, Otofa, or Tsipromed. Drops of Otipax or their analogues are canceled. It is important to clean the ear canal from accumulations of pus.

For this, as a rule, hydrogen peroxide is used. Then the passage is dried with a small ball of cotton, which is wound around a toothpick, pulling the patient's ear back down.

The doctor usually at this stage prescribes to the child means that dilute the mucus secretion, this is done to facilitate its discharge.

Are antibiotics needed?

Antibiotics clearly needed. Nominal purulent otitis can be cured only with their help. Antibiotic drops are instilled into the ear three times a day after preliminary procedures for cleaning the ear from accumulations of pus.

Folk remedies

Warm compress- this is how you can help a speedy recovery, but it is possible only at the third stage, when the ear is already recovering.

This happens when the pus stops flowing, antibiotics are canceled.

Treatment, which is already aimed at normalizing the nasal type of breathing and restoring the functioning of the auditory tube, can be carried out using physiotherapy heating and laser therapy.

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Pediatrician Yevgeny Komarovsky for the treatment of purulent otitis media advises the use of drugs saturated antiseptics, analgesics, local anesthetics.

He also says that in this case, antibiotic therapy is clearly indicated, as well as anti-inflammatory drugs.

Prevention

The most important advice strengthen children's immunity. The child should definitely be hardened, gradually and systematically, from an early age.

Make sure that physical education becomes a way of life for the child, that he loves it, does not shirk, that physical activities are versatile and interesting for the baby. Set an example for your child.

On cold days, always make sure that your baby has cap. Dress your child according to the weather, do not wrap excessively.

And you should not plug your ears with cotton wool, the infection gets into the ear canal anyway by the internal route, through the nose.

Care should be reasonable and physiological, because many "grandmother's" advice should be discarded.

How to avoid complications with purulent otitis media in a child? children's doctor tells in this video:

Acute otitis media in children photo

(otherwise a change is usually required antibacterial drug). Hearing loss and a feeling of fullness in the ear may remain for up to 2 weeks. after.

Acute otitis media

I. The stage of acute eustachitis, when we are dealing only with inflammation of the mucous membrane of the auditory tube and dysfunction of the latter.

Acute suppurative otitis media in children

Acute otitis media in children

Inflammation of the middle ear in children: symptoms. Acute otitis media.

Second u2014 perforative stage of acute otitis media

The most common is otitis media. And one of the most common causes of it is the flu. In most cases, otitis media affects children.

Acute otitis media in children Acute otitis media in children

Inflammation of the middle ear in children is accompanied by signs or symptoms of an ear infection:

Acute otitis media in children

4): amoxicillin/clavulanate u2013 625 mg ґ 3 times a day or clarithromycin 250 mg ґ 2 times a day (for 48 hours). With a positive effect u2013 continued.

Expectant management can only exacerbate the inflammation and dysfunction of the Eustachian tube. Grade must be taken into account when choosing an antibiotic.

In addition to the series Otitis media

Acute catarrhal otitis occurs in the middle ear

Symptoms and treatment of purulent otitis in a child

Otitis is the most common disease in our country, which almost every child has had, in some cases even more than once! One of the varieties of otitis media is purulent otitis media, which can occur both against the background of acute respiratory infections and in combination with conjunctivitis (if this disease was caused by bacteria: Haemophilus influenzae and pneumococcus). Most importantly, realizing that the child is suffering from otitis media, do not self-medicate! This can be very harmful to the baby! Treatment of otitis should take place strictly under the supervision of a doctor, while taking into account all the indications and recommendations of the doctor.

In European countries in last years vaccination of infants is being carried out, which significantly reduces the risk of illness in children who have been vaccinated. It is also known that children from birth to 5 years of age are susceptible to otitis media! The reason is the anatomical structure of the auditory canal, which is located vertically in children. Therefore, the usual acute respiratory disease, accompanied by a mandatory runny nose, is enough, and the auditory canal becomes clogged with purulent secretions, which causes inflammation and severe pain in the ear.

This is what purulent otitis media looks like in a child:

Main features

Acute pain in the ear (you can check by slightly pressing on the trestle).
An increase in temperature (if the disease progresses or is running).
If the child already has an acute respiratory disease, accompanied by nausea and vomiting.
Severe dizziness, lack of coordination (there is a vestibular apparatus nearby).
If purulent or sanious discharge flows from the ear.
If the ear hurts and the eyes are reddened (purulent bacterial otitis media is often accompanied by conjunctivitis).
Nervousness and tearfulness of the child, accompanied by palpation of the ear.
Hearing loss in children.
Headaches in young children.
Bad smell from the ear.

If all these symptoms are present, then the first action of the parents is to call the doctor, and only after that you can proceed to other measures.

Dr. Komarovsky in his program explains in detail the cause of this disease. It turns out that purulent otitis media can be caused by both bacteria and viruses. In young children, purulent otitis media becomes a very frequent companion of acute respiratory infections. Dr. Komarovsky advises every pediatrician to have an otolaryngoscope with him, so that at the first call to a sick child’s house, they can immediately determine the condition of the child’s eardrum for an appointment. effective treatment. If the parents have not yet noticed that the child is worried about the ears, but there is redness of the conjunctiva of the eyes, tearfulness, then the doctor should definitely look into the baby's ear. In children, bilateral otitis media is most common, and only one ear is affected in 20% of cases.

So, what did the parents focus on when they discovered dangerous symptoms, Dr. Komarovsky in his "School":

The first step is to call your doctor!
To alleviate the condition of the child, Dr. Komarovsky advises to drip into the baby's nose any vasoconstrictor drops intended for a child of a certain age. This will reduce the swelling of the auditory canal, which is closely associated with the nasopharynx, which will certainly alleviate the suffering of the child.
To alleviate the suffering of the child before the arrival of the pediatrician, it is necessary to anesthetize the ear and reduce the elevated body temperature, if any. To do this, you can use Ibuprofen or Paracetamol.
To reduce pain, you can apply a cotton compress: ordinary cotton wool, slightly larger than an ear, is covered with a plastic bag and applied to the sore ear. After that, you need to fix this compress with a bandage, a scarf, or put a hat on the child’s head.

If the doctor diagnosed bacterial purulent otitis, then it needs to be treated for a long time, but not difficult!

Treatment consists in the use of antibiotics inside and drip in order to accumulate them in in large numbers in the middle ear. For a child under the age of 3 years, the treatment of otitis media can last from 5 to 10 days. If a child is older than 3 years and regularly visits children's groups, then purulent otitis media should be treated for at least 10 days. Dr. Komarovsky explains this by saying that the antibiotic should accumulate in large quantities in the middle ear of the child, so that in case of re-infection, which often happens in children's groups, to protect the baby from re-infection.

So, if the doctor has diagnosed purulent otitis media, then there is no alternative to antibiotics! Dr. Komarovsky draws the attention of parents to this. There are many drugs that can successfully treat purulent otitis media. They will always be based on an antibiotic, whether it be drops or tablets.

Medical method of treatment

It turns out that purulent otitis media can be treated in two ways: medical and surgical. The course of the disease, the symptoms of the disease will tell the pediatrician the best option for your child.

Let's talk about the first method. Medical treatment children will consist in instillation of vasoconstrictor drops into the nose (Nafthyzin, Nazivin, etc.), ear drops with an antibiotic in the ear canals, at first ideal option There will be Otipax ear drops.

If, with purulent otitis, a spontaneous rupture of the eardrum occurred, followed by leakage of pus, then it will also be necessary to wash the ear canal, the introduction of drugs into the middle ear cavity through a special catheter. After recovery painful symptoms disappear, the eardrum heals, and a small scar remains at the site of the rupture, which does not affect hearing acuity in the future.

But remember: only a doctor prescribes antibiotics, drops, lotions! Dr. Komarovsky convincingly insists on this, giving sharp criticism to the means of "folk" medicine, which are often advised by grandmothers and aunts.

Surgical method of treatment

In the acute course of the disease, surgical intervention. The main symptoms indicating tough measures are acute ear pain and high fever. Dr. Komarovsky explains to the parents what the operation will consist of: this is a small incision in the eardrum, which the doctor makes in order to allow pus to flow out of the middle ear cavity. This procedure is unpleasant, but very often such treatment is the only way to save the hearing, and possibly the health of the baby.

After such a procedure, the doctor prescribes additional procedures in the form of a pneumatic massage of the membrane, UHF of the nasal passage, and even laser therapy.

Another recommendation of Dr. Komarovsky: the more often the ear passages are cleaned by the mother of the baby, the more likely the child is to get otitis media! Sulfur should remain in the ear in certain quantities, and the remnants of cotton wool and sulfur adhering to it can provoke suppuration, which means otitis externa! Take care of your kids! Do not overdo it in your efforts to surround the baby with care and "proper" care!