Causes | Otitis media

Causes

Otitis media is usually caused by bacteria. These reach the middle ear via the so-called Eustachian tube (named after Bartolomeo Eustachius, 1520-1574). The Eustachian tube is an approximately 3-4 cm long and 3-4 mm wide connection between the nasopharynx and the middle ear.

The function of this connecting channel, also known as the “tuba auditiva”, is to ventilate the middle ear. The normally blocked passage is supplied by its own muscles, whose contraction when chewing, yawning or swallowing causes the tube to open.The most common bacteria that cause middle ear inflammation in children are pneumococcus (these are also the dreaded pathogens of pneumonia – medically: pneumonia and purulent meningitis – medically: meningitis) and haemophilus influenzae (this germ also occurs in the mucous membrane of the throat in healthy people, so mostly only children whose immune system does not yet contain sufficient of the body’s own protective proteins, so-called antibodies, against which rod-shaped bacteria have formed). In adults, other pathogens are more common, e.g.

those that belong to the Gram stainable (i.e. Gram-positive), round and therefore to the group of pathogens known as cocci. In most cases the inflammation of the middle ear occurs unilaterally. However, different viruses can also be the cause of middle ear infection; in this case, both ears are usually affected. These viruses include the typical causes of colds (the so-called respiratory syncytial viruses and adenoviruses) and flu viruses (medical: influenza and parainfluenza viruses).

How contagious is an inflammation of the middle ear?

Is otitis media contagious? Yes and no. An inflammation of the middle ear as such is not contagious.

However, the underlying cause of otitis media can be contagious. Some forms of otitis media are infectious, i.e. they are caused by an infection with viruses or bacteria. Children in particular are often affected.

The most common types are pneumococcus, staphylococci, streptococci and influenza. More often it is bacterial than viral pathogens that cause middle ear infections. In an infection of the upper respiratory tract, the pathogens reach the middle ear via the nasopharynx.

This means that in the case of a flu or a cold, the pathogens in the ear can cause an inflammation of the middle ear. Colds and flu-like infections are contagious. The cause of otitis media is therefore contagious, but not the otitis media as such.

Pathogens can also reach the ear via the bloodstream or, in the case of external eardrum damage, also from the outside, for example through bath water. Inflammations of the middle ear also occur in the context of general diseases such as scarlet fever and measles. These diseases are also contagious and can ultimately cause otitis media in the person who has been infected with them.

Measles, scarlet fever and flu are particularly common and are associated with these infectious diseases. Children in particular are often infected with pathogens in kindergarten or at school and therefore more often develop an infectious inflammation of the middle ear. As a rule, an inflammation of the middle ear heals on its own after a few days.

Bacterial infections can be combated with the help of antibiotics. Nasal sprays and anti-inflammatory painkillers such as ibuprofen can help relieve the symptoms. Children are particularly often affected by middle ear infections.

This is more often an acute rather than a chronic course of the disease. Inflammation of the middle ear in children is usually associated with a cold, flu or measles. Scarlet fever in children is also often associated with middle ear infection.

However, children and babies are more susceptible to middle ear inflammation than adults. This is due to the fact that the so-called ear trumpet, or Eustachi tube, is particularly narrow in children and therefore swells up more easily. It is the connecting passage between the middle ear and the nasopharynx.

Pus and inflammatory secretions can thus no longer drain from the ear so easily. Children often suffer from middle ear infections between the ages of four and six, but babies also suffer from middle ear infections at least once during the first three years of life. The cause of middle ear infection in infants and babies is in most cases a previous flu-like infection.

The symptoms can be divided into unspecific and specific ear symptoms. Non-specific symptoms are a weakened general condition and, for example, fever. In addition, there are the typical cold symptoms such as cough, rhinitis, loss of appetite and headaches.

Inflammation of the middle ear typically leads to very severe ear pain and a feeling of pressure on the ears. It also leads to hearing loss. This is especially difficult to detect in babies.

However, they tend to touch the irritated ear more often and are generally more whiny. Furthermore, they sleep restlessly and drink little or not at all.It can also be observed that infants prefer to lie on their sick side and move their head restlessly back and forth. The good news is that middle ear infections usually heal spontaneously after a few days.

Only antipyretic agents such as ibuprofen are prescribed for treatment. These effectively relieve the pain so that the children can sleep and eat well again. Their general condition improves so quickly.

Sometimes, however, an antibiotic is unavoidable. Parents should make sure that the antibiotic is taken in full so that all pathogens are killed. It is important to ensure a sufficient fluid intake to prevent fluid loss in case of fever.

This is especially important for babies, as fluid loss is much more severe than in adults. Decongestant nasal sprays improve breathing and the drainage of inflammatory secretions, such as Nasic® nasal spray for children. Overall, therefore, otitis media in children is something quite normal and occurs more frequently.

However, close monitoring by the pediatrician is necessary to prevent possible complications. Inflammation of the middle ear can in very rare cases spread to the meninges. However, parents should not worry too much about this, because in most cases middle ear infections in children subside spontaneously and without complications after a few days.

Overall, middle ear infection in children is therefore something quite normal and occurs more frequently. However, close monitoring by the pediatrician is necessary to prevent possible complications. In very rare cases, middle ear infections can spread to the meninges. However, parents should not worry too much about this, because in most cases middle ear infections in children subside spontaneously and without complications after a few days.