Understanding Ear Infections: Diagnosis and Treatment
How Are Ear Infections Diagnosed?
If you or your child has an earache that is accompanied (in some cases) by a stuffy or runny nose and a sore throat and fever, it is likely that the ear pain is due to an ear infection.
Your doctor will examine the eardrum with an instrument called an otoscope for signs of infection -- not an easy task if the patient is a fussy infant. The doctor may also check for blockage or filling of the middle ear using a pneumatic otoscope, which blows a little air at the eardrum. This air should cause the eardrum to move a little back and forth. If fluid is present, the eardrum will not move as readily.
Another test for ear infections is tympanometry, which uses sound and air pressure to check for fluid in the middle ear. If needed, an audiologist will perform a hearing test to determine if there is hearing loss.
On rare occasions, when the person is quite ill, a doctor may make an opening in the eardrum, draw out a sample of fluid from the middle ear to culture the sample in a lab. This more extreme measure is usually used only for serious or particularly stubborn infections.
What Are the Treatments for Ear Infections?
The goal of treatment for most doctors is to rid the middle ear of infection before more serious complications set in. Treatment usually involves eliminating the causes of the ear infection and killing any invading bacteria in the Eustachian tube.
Medicine for Ear Infections
An ear infection is often caused by a virus, in which case the only relief doctors can offer is treatment of the symptoms. To ease the pain of an ear infection, your doctor may recommend a pain reliever, typically acetaminophen or ibuprofen, which also helps reduce a fever. Aspirin should be avoided in children because of the threat of Reye's syndrome. Pain can also be reduced by using gentle heat from a heating pad, but be very careful when using heating pads with children.
Sometimes, it is difficult for your doctor to tell with an otoscope alone if the ear infection is caused by a virus or bacteria, so deciding on a proper course of treatment isn't always easy. A debate over using antibiotics (bacteria-killing drugs) to treat middle ear infections arose in the 1990’s as more bacteria became resistant to antibiotics. Some doctors initially treat only the symptoms of an ear infection, without antibiotics, a response that has been supported by several studies.
But many doctors, particularly in the U.S., are concerned that without antibiotics, bacteria lurking inside the middle ear can grow out of control, possibly causing hearing loss or mastoiditis. After all, they point out, these complications have become rare, largely as a result of antibiotic therapy. To be on the safe side, many American doctors treat all ear infections as if bacteria are present.