Pus from the ear of the child again. How is otitis externa different from otitis media? Folk recipes for the treatment of purulent otitis media

Purulent otitis occurs in every third baby of an 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 a variety of reasons. The most common of these are bacterial infections. Currently, there is a huge variety of bacteria that 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 the development of bacterial inflammation and the appearance of severe edema.

Myxoid tissue disappears only by the end of the first month of a baby's life. It can remain for a longer time only in premature and weakened babies. In such babies, it usually persists for 6-12 months of their life. This clinical situation leads to persistent persistence of adverse symptoms in an infant for 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.

Taking into account the duration of the onset of adverse symptoms, doctors distinguish several clinical variants of 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 period of time.

Frequent deterioration in the well-being of the baby should alert parents. As a rule, recurrent purulent otitis is a manifestation of a pronounced disruption 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 in the presence of a primary focus of the disease, which can be located in different internal organs.

Congenital forms of purulent otitis are much less common. In this case, infection occurs even in the period of intrauterine 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 of the fetus much less frequently.

Congenital purulent otitis media in newborn babies is often bilateral.

Symptoms

Purulent otitis media can manifest itself in different ways. The severity of the manifestation of 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 cannot 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, fatigue. Sick children eat poorly, their appetite is significantly reduced or even completely disappears.

Babies begin 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 which brings them great 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, the normal parameters of the general blood test change significantly. 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.

A significant disadvantage of this study is 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 can be manifested by complete hearing loss.

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

The transition to the anatomical structures of the inner ear is also a fairly common complication of purulent otitis media. 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.

Treatment

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

To achieve a good effect from the ongoing therapy, the use of a whole complex of various means is required. 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.

Antibacterial agents can be administered in different ways. 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 other. 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.

Purulent otitis occurs in children very often, especially in small, newborns. Purulent discharge from the ear causes a lot of anxiety to the child and mother. The ear canal of a child is shorter and wider than that of an adult, so bacteria and germs can more easily enter the ear, causing inflammation. Purulent otitis is associated, as a rule, with a bacterial lesion of the middle ear, which requires mandatory treatment and observation.

Pus from the ear of a child: causes

Features of the development of purulent otitis in a child

In any case, purulent discharge from the ear is associated with internal inflammatory processes, so the pediatrician will almost immediately diagnose "otitis".

Pus from the ear of a child is discharged due to a bacterial infection that has affected the mucous membranes of the middle ear.

It can occur for various reasons:

• As a complication of another disease. Otitis can be a consequence of any infectious disease: SARS, sinusitis, rhinitis, tonsillitis. Inflammation in a small child quickly spreads to the auditory tube, causing purulent processes.
• After catarrhal otitis. Untreated catarrhal otitis media, which does not cause suppuration, is usually accompanied only by pain, can eventually turn into an acute purulent form. This happens quite quickly, especially if the baby is being treated for a long time without the help of a doctor, with home remedies, and the mother was unaware of pain in the ear.
• Anatomical features of the structure of the ear and nose in children. If the structure of the nasal passages, septum, auditory canal and tube of the middle ear is incorrect from birth, contributing to the penetration of pathogenic microorganisms, the likelihood of getting sick with purulent otitis media in childhood increases several times.
• Injury. The infection can also penetrate the middle ear after an injury: from a blow or collision, when a foreign body gets into the ear (and this happens quite often in childhood), when diving to a depth without protection, with chemical burns after washing with solutions and drops.
• In the inflammatory process, under the action of pathogenic bacteria, pus begins to accumulate in the middle ear cavity, which sooner or later breaks out. But the purulent stage of otitis is most often not the first. At first, there is a slight inflammation and pain, pus accumulates inside, and it breaks through already with severe inflammation. In some cases, pus flows out of the ear along with blood.

The risk of purulent otitis media increases significantly if the child is born prematurely and with low weight, if he has a hereditary predisposition to ear diseases, the child has a weakened immune system, there are cranial anomalies, a tendency to allergies, or he is on artificial feeding instead of breastfeeding.

Other symptoms of purulent otitis. When is a doctor needed?

Dangerous signs of purulent otitis in a child

Pus from the ear is a clear sign of otitis media. Purulent discharge definitely requires medical attention. It is impossible to treat a child with purulent otitis with folk remedies without consulting a ENT specialist and a pediatrician.

In addition to pus, parents may notice other symptoms of purulent otitis media, which appear both before and after the appearance of purulent discharge:

• Elevated temperature. With otitis media, the temperature can rise to 39-40 degrees. If you constantly knock it down, you can miss one of the most important signs of incipient otitis media. If a child has been given an antipyretic, the doctor should be informed.
• Noise in ears. With otitis, the child has noise in the ear, there is a feeling of congestion, transfusion of fluid inside. A baby may not always report such a symptom, but he may be worried, capricious.
• Ear pain and headache. Small children who cannot report ear pain are very restless, do not sleep well, may scratch the sore ear, cry. Pain with otitis media is often shooting or aching, radiating to the jaw, eye.

If otitis media is not a complication of another infectious disease, it can appear very unexpectedly in the apparent health of the child. The presence of temperature in a child, lack of appetite, poor sleep, anxiety, crying are reasons to see a doctor. Only an experienced doctor will be able to determine the cause of the child's anxiety, make a diagnosis and prescribe treatment.

It is advisable to consult a doctor even before the appearance of pus, since it can accumulate inside the ear for quite a long time without causing a perforation of the membrane.

Accumulations of pus cause severe pain. Sometimes otitis is preceded by diseases of the nose and throat, which must be treated in order to prevent complications. In an infant, you can notice a movement of the eyes towards the sore ear, attempts to take it with your hands, rub your ear against the pillow. During breastfeeding and sucking, the pain, as a rule, intensifies, the child throws the breast, starts to cry.

A severe form of otitis media can also be accompanied by symptoms such as vomiting, tilting the head back, tension in the fontanel (in children under one year old), and diarrhea. When these signs appear, you need to call an ambulance. It is worth remembering that catarrhal otitis can turn into a purulent form within one or two days, so it is necessary to diagnose and start treatment as early as possible.

Drug treatment: drugs, types and description

Effective treatment of purulent otitis media can only be prescribed by a doctor

Any drugs should be prescribed to the child by a doctor. Medicines, especially antibiotics, have age restrictions and contraindications. The duration of the course of treatment is also determined by the doctor.

It is very important to recognize otitis in time and not put cotton swabs with boric alcohol, as they will only increase inflammation.

Medications:

• Antibiotics. The doctor should choose the antibiotic and its dosage. Depending on the age and condition of the child, the pediatrician (or ENT) will select the appropriate drug in the form of a syrup with a minimum of side effects. Often young children are prescribed Amoxiclav, Sumamed, Ecomed. They are sold in the form of suspensions and have a pleasant taste. Antibiotics are given 1-3 times a day at the same time, observing the dosage prescribed by the doctor. Often, mothers are afraid to give an antibiotic to an infant due to side effects, but it is impossible to overcome a bacterial infection in other ways. If you follow the rules of admission, continue to breastfeed your baby and give prescribed probiotics to prevent dysbacteriosis, all side effects will be minimized.
• Ear drops. Ear drops have strict age restrictions. Very small, newborn children are not recommended to drip them in any dosage due to the high risk of side effects. Anti-inflammatory and anesthetic drops such as Otipax can be prescribed in infancy. They simultaneously relieve unpleasant symptoms and reduce inflammation. Drops with antibiotics, for example, Tsipromed, are prescribed for severe otitis media in children older than a year. Combined ear drops, such as Polydex, are prescribed for children from 2.5 years old.
• Antipyretic drugs. Since otitis media often has a fever, your doctor may prescribe antipyretic drugs. However, if the temperature persists for more than 3-4 days while taking antibiotics, you should inform your doctor. Among children's antipyretic drugs, Nurofen and Panadol syrups are the most popular. They have a pleasant taste, are well tolerated by children at any age. The dosage is determined according to the instructions, taking into account the weight. Cefekon suppositories can also be used as an antipyretic drug. They quickly relieve the temperature and, unlike syrup, do not cause regurgitation in infants. Do not give a small child drugs such as Aspirin and Analgin. They act aggressively on the gastric mucosa and can cause various side effects.

Folk recipes for the treatment of purulent otitis media

The best folk recipes and tips

Treatment of purulent otitis exclusively by traditional medicine without consulting a doctor can lead to very sad consequences, up to meningitis and death. Folk remedies should be prescribed by a doctor as part of the treatment. Some remedies and herbs are contraindicated for young children and can cause a severe allergic reaction.

You can not try on a child untested or suspicious recipes, advice from friends and neighbors. If a visit to the doctor is currently impossible for some reason and at hand without any drugs, you can resort to the safest and most proven methods of treating and relieving pain in otitis media.

• You can't warm up your ear. No warming procedures for purulent otitis are unacceptable. You should not, out of habit, bury boric alcohol in the child's ear, this can cause a burn. You can apply tampons with alcohol to the ear only with external otitis media.
• Often otitis in a child is accompanied by various other ENT diseases. Nasal rinsing can alleviate the situation. A small child can rinse his nose with a pipette using a soda solution or with special drops of Otrivin, Aqua Maris, but in no case with a stream of water. If a child has mucus in his nose, it must be removed with an aspirator or a baby pear.
• Sometimes it is recommended to bury the juice of baked onions in the ear. Onion juice is also mixed with butter and a swab with this mixture is inserted into the ear with purulent otitis media. It is difficult to say how safe this method is for a small child. In infancy and newborn age, it is better to abandon this method of treating otitis media, so as not to cause a burn of the mucous membrane and increase inflammation.
• Relatively safe for a child is a decoction of bay leaves. A couple of leaves should be boiled in water, insisted for 2-3 hours and dripped into each ear. Bay leaf has an anti-inflammatory effect.
• Natural almond oil has an analgesic effect. It can be instilled into the ear in a small amount.

There are folk recipes with burning paper in the child's ear, instillation of alcohol tinctures. Such advice is recommended to be avoided and always consult a doctor about the treatment and methods chosen.

Possible Complications

Dangerous consequences of purulent otitis media

Acute purulent otitis media quickly flows into a chronic form if left untreated.

Purulent otitis in a child is an insidious disease, which at first is easy to confuse with a common cold, but the consequences of otitis media can be very serious:

• Deafness. In severe cases, hearing loss may be irreversible. After the illness, a slight hearing loss can persist for up to 3 months, but then hearing should return to normal. If the hearing remains low for long enough, the child may need further testing and treatment.
• Perforation of the tympanic membrane. Perforation of the tympanic membrane can be both a cause and a consequence of otitis media. In the inflammatory process in the middle ear, the outflow of fluid is disturbed, it accumulates and presses on the eardrum, which can lead to its rupture. Pus begins to stand out after perforation, causing hearing loss, tinnitus. The main danger of such a gap is the absence of a barrier between the middle ear and the external environment. As a result, inflammation can increase and spread to nearby tissues.
• Meningitis. A very dangerous disease associated with inflammation of the membranes of the brain. With purulent otitis media, the likelihood that the infection will spread to the membranes of the brain is quite large, so a disease such as otitis media cannot be started. It is believed that meningitis occurs most often in children. The first signs of this disease are high fever, decreased appetite, thirst, cyanosis in the mouth, pale skin, and headaches. Then the child begins to react sharply to light and noise, headaches intensify, vomiting and convulsions begin. Meningitis develops very quickly, death, if untreated, occurs within 1-2 days, so when the first signs appear, you need to call an ambulance.
• Mastoiditis. This is an inflammation of the mucous and bone tissue of the temporal bone. Swelling appears in the temple area, headaches intensify, body temperature rises. This is the most common consequence of otitis media.

Purulent otitis in a child proceeds very quickly and requires immediate treatment. With timely and proper treatment, the risk of complications can be minimized.

Prevention

The best prevention of otitis in children is to strengthen the immune system. It is the absence of colds, strong immunity and an abundance of vitamins that help the body cope with any infection. In a newborn and infant, immunity largely depends on breastfeeding. The longer the mother breastfeeds the child, the stronger his immunity. It is possible to harden a child from the first months of life, but this does not mean that he should immediately be accustomed to low temperatures. Air and sunbathing will be enough.

The room in which the child is located should be regularly ventilated, and wet cleaning should be carried out in it. Most often, children begin to get sick in the cold season. The reason for this is not only frost, but also heating in houses, which dries out the air, creating favorable conditions for the reproduction of bacteria. It is advisable to put a humidifier in the child's room.

If, nevertheless, the child is ill, it is necessary to start treating a cold before it flows into a more serious disease such as otitis media.

It is not necessary to believe that a cold goes away on its own in seven days, treatment is still necessary. The nose of a sick child should be regularly washed with moisturizing solutions such as Aqua Maris and Otrivin, remove the liquid and make sure that it does not thicken.

Useful video - Purulent otitis media in a child: causes and treatment.

Be sure to remove the snot from the child during illness. For this, there are convenient nasal aspirators and baby pears. If the mucus in the nose accumulates, it will get into the throat, the infection will spread further. The child must drink enough. Even he is breastfed, in addition to breast milk, he must drink water, and after 5 months, baby teas and juices. A sufficient amount of liquid helps the body fight infections, increasing its protective properties, and improves bowel function.

In infants, inflammation in the ear can begin after bathing and getting water in there. Before bathing, it is advisable to insert cotton swabs into the ears and make sure that water does not flow there. Older children are not recommended to dive into the river water in summer. The child needs to clean his ears regularly, but very carefully so as not to damage the eardrum. It is best to use special children's cotton buds with a limiter.

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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 the likelihood of 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 media 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.

This is a dangerous pathology, since the process of speech formation, as well as the psycho-emotional state, can 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.

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 the airways, the parent simultaneously opens these nostrils. 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.

There are several stages of acute purulent inflammation of the ear in children.

Stages of development of the disease:

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.

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.

If there are no complications, then the diagnosis of the disease is not difficult. The doctor will conduct a general examination, make 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 a laboratory test for secretions (to 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.

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.

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.

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.

How does catarrhal angina manifest itself in children? Find out the answer right now.

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 will tell in this video:

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Sometimes an adult or a child develops pus in the ear. Such discharge from the ear canal is yellowish-brown in color and is characterized by an extremely unpleasant odor. Often this phenomenon is accompanied by severe pain. What diseases can pus in the ears indicate? And how to deal with an unpleasant state?

Main reasons

Why does pus form in the ear? The main reason leading to suppuration is the effect of bacteria and viruses. Such microorganisms are initially found in the larynx. Through the Eustachian tube, they move freely into the cavity located behind the eardrum.

If a person suffers from allergies, has a cold, then such a pipe is clogged. As a result, a normal outflow of mucus is simply impossible. A similar picture is observed in children suffering from the growth of adenoids. Since the mucus is not excreted naturally, pathogens begin to accumulate. And this inevitably leads to the fact that the patient has pus in the ears.

Most often, such a problem is faced by people whose immunity is very weakened. Purulent discharge from the ear cavity is often observed in children. This is due to age characteristics. Babies have a wider and shorter auditory tube. That is why it is much easier for pathogens to penetrate it.

So, if pus flows from the ear, what diseases can we talk about?

Purulent otitis media

This is the most common reason. Purulent otitis media is an unpleasant pathology in which the mucous membrane of the middle ear becomes inflamed.

Most often, the disease is provoked by the following sources:

1. Various viruses, infections. Often, pus in the ear is a complication of tonsillitis, flu.
2. Certain pathologies of the nasopharynx, nose. The basis of the formation of pus may be rhinitis, curvature of the septum, proliferation of adenoids.
3. The ingress of milk in an infant into the ear canal. This situation can lead to infection.
4. Hypothermia. The development of purulent otitis media most often occurs in the summer, after swimming in ponds. The inflammatory process provoked by hypothermia leads to the development of the disease.
5. Injury. This reason is mainly characteristic of children. An unsuccessful cleaning of the ears, as a result of which the septum is damaged, or an object inserted into the ear by a small discoverer, leads to the formation of pus.
6. Surgical interventions. Of course, patients who have undergone operations in the nasopharynx and nose are at risk.

The symptoms of this disease are as follows:

• pain appears in the ear, most intensely making itself felt at night;
• the patient's health is seriously deteriorating;
• pus appears, initially at night;
• dried discharge is observed in the sink;
• with the development of inflammation, pus begins to simply flow out of the ear;
• swelling is observed;
• the temperature rises;
• headache occurs;
• hearing is reduced.

Sometimes the pathology proceeds in a chronic form. With such a disease, there may be no discomfort, including pain.

Treatment Methods

Of course, the question arises: if pus is found in the ears - what to do? It is absolutely not recommended to attempt self-treatment if a person has purulent otitis media in the acute stage. This pathology can lead to meningitis. Therefore, it is extremely important to contact Laura in a timely manner.

The doctor will prescribe the patient a course of antibiotic therapy. The most commonly used drug is Amoxicillin. It is strictly forbidden in the presence of pus to apply warm compresses to the sore ear. Do not use any drops on your own.

In the case of chronic otitis, the doctor will initially cleanse the cavity of pus. The patient will be recommended special antibacterial drops. And further methods of treatment depend on the size of the hole in the membrane. For small sizes, a film of artificial fabric is used. Under it, the wound of the week for 2-3 is completely tightened. If the hole is large enough, then tympanoplasty (surgical repair of the membrane) is performed.

Development of furunculosis

Pus in the ears in an adult can result from a variety of reasons. Sometimes the appearance of boils leads to its appearance. This disease is most often caused by staphylococci.

Furunculosis develops, as a rule, as a result of the following factors:

• penetration into the ear canal of water;
• shell combing;
• poor hygiene.

The disease is characterized by the following symptoms:

• severe pain in the ear cavity;
• discomfort increases during chewing or talking;
• itching in the sink
• the presence of discharge from the ear cavity, green or yellow (indicate the opening of the boil).

Furunculosis therapy

How to treat pus in the ear in this case? It should be said that without consulting a doctor it is extremely dangerous to take any methods of dealing with the disease. Therefore, without delaying the visit, contact a specialist.

Most often, the doctor prescribes such therapy:

• thermal procedures (it is recommended to apply a heating pad to the affected ear);
• analgesics;
• local remedies (on a tampon, ichthyol ointment is placed in the sink for 12 hours);
• antibiotics, with a deterioration in general well-being (drugs: "Flucloxacillin", "Amoxicillin").

The appearance of otomycosis

The fungus can also provoke pus in the ears in an adult. It is this pathology that is called otomycosis in medicine. The disease is characterized by the penetration of the fungus into the outer region of the ear, as well as the walls of the ear canal. This pathology tends to spread over time. In this case, deeper tissues are affected.

Otomycosis leads to violations of metabolic processes, weakening of the whole organism, the occurrence of vitamin deficiency (hypovitaminosis).

Symptoms of the disease appear as the disease progresses. At the initial stage, the pathology practically does not manifest itself. The symptoms are almost invisible. As soon as otomycosis becomes acute, the patient has such complaints:

• strong pain;
• the ear swells;
• cheesy white discharge from the ear can be observed;
• hearing is reduced;
• brown purulent discharge flows from the sink.

Treatment of otomycosis

Everyone understands: if it was the fungus that provoked pus in the ear, what to do in this case. Of course, pathology should be treated with special antifungal agents.

But do not rush to undertake therapy on your own. It is very important to correctly identify the causative agent of the disease and choose adequate therapy. For these purposes, the doctor will take a swab from the ear cavity. According to the results of the study, competent treatment will be selected.

Also, remember: otomycosis is an extremely insidious pathology. If the necessary treatment is not taken in a timely manner, the disease can become chronic. In this case, it will become very difficult to completely cure it.

Development of cholesteatoma

This is an extremely severe pathology. Cholesteatoma is characterized by the appearance of a tumor in the ear, which has a layered structure. In the center of such a formation is a core containing a yellowish-white liquid, with a putrid unpleasant odor.

This pathology is most often characterized by congenital origin. Its development is based on various disorders in the temporal zone.

Pathology is characterized by:

• the presence of pain in the ear area;
• pus in the ear;
• hearing loss.

Methods of dealing with the disease

Self-treatment is out of the question. If pus in the ears is provoked by cholesteatoma, treatment is prescribed exclusively by professional doctors.

With this disease, surgical intervention is undertaken. The operation is aimed at removing all the affected or infected bone tissue. To save the ear, doctors perform one of the interventions, depending on the spread of the disease: mastoidectomy, atticoanthrotomy, atticotomy.

If during the operation it is possible to connect the external auditory canal with the postoperative cavity, then the discharge from the shell will continue. Such a clinic is observed until the cavity is covered with skin.

Other reasons

Most often, it is the above diseases that become the source of pus in the ear cavity. However, these are not the only reasons that can provoke such an unpleasant phenomenon.

Sometimes the patient has pus from the ear as a result of such pathologies:

1. Various injuries. Very often they lead to the development of an inflammatory process in the sink, against which pus is formed in the cavity.
2. Polyps. This pathology is evidenced by the discharge of a purulent-bloody nature.
3. infectious meningitis. In some cases, pus flowing from the ear cavity is a symptom of an extremely serious illness.
4. Various pathologies of the ears and eyes.

Diagnostic methods

As you already understood, regardless of whether there is pus from the ear in a child or in an adult, the first thing to do is to consult a doctor. Only a specialist can correctly identify the nature of such a phenomenon.

The doctor may suspect a pathology for the following signs:

1. Pain in the ear, accompanied by purulent discharge, most often indicates the development of otitis media in the patient, in an acute form.
2. In a patient who is fond of swimming, or affected by seborrheic eczema, otitis externa is most often diagnosed.
3. A previous operation in the temple area or a head injury may indicate liquorrhea.
4. With perforation of the membrane or chronic dysfunction of the auditory tube, an assumption arises about the presence of cholesteatoma.

To make a diagnosis, of course, a physical examination will be performed. Otoscopy allows you to determine the perforation of the membrane, to identify the symptoms of otitis externa, to notice a foreign body in the cavity. If necessary, the patient will be assigned additional methods of research.

Conclusion

The appearance of pus in the ear cavity is an extremely negative symptom that can indicate a variety of diseases. But remember: it signals a problem in the body. So be sure to pay attention to it. And to avoid serious consequences, contact your doctor immediately and start adequate treatment.

Purulent otitis is quite common in children, and this disease is often recurrent. Provoking factors can be infectious diseases, weakening of the immune system, enlarged adenoids.

In any case, the symptoms of the disease should be the basis for contacting a specialist. Only a doctor can prescribe an effective treatment that will help defeat this disease.

Purulent otitis media in a child

This term is understood as a purulent lesion of the middle ear - a component of the auditory system, the main link of which is the tympanic cavity. It is a small space in the temporal bone that is responsible for processing sound vibrations.

The appearance of purulent otitis in children can cause problems in the formation of speech. Often, this disease disrupts psycho-emotional development, creates difficulties with the perception of information and reduces the quality of life.

With a purulent form of otitis media, the mucous membrane of the ear becomes inflamed, which is accompanied by the production and accumulation of pus. This type of disease is much more dangerous than catarrhal, as it can cause hearing loss and intracranial complications.

Causes

The main cause of the purulent form of otitis media is inflammation of the nasopharynx, the appearance of adenoids, chronic forms of rhinitis and acute respiratory viral infections. All these pathologies lead to an excess amount of mucus in the nose.

With a strong blowing of the nose, these secretions penetrate the Eustachian tube and block it. As a result, ventilation is disturbed, which leads to infection and inflammation of the ear mucosa.

When the inflammatory fluid is released, the child develops pain and hearing deteriorates. Bacteria that enter the middle ear begin to actively develop. As a result, after a few days or even hours, the baby has purulent discharge.

Illustration of changes in the ear during suppurative otitis

Then his state of health seriously deteriorates - the temperature rises, the pain syndrome increases. With strong pressure on the eardrum, it ruptures, which leads to the outflow of pus.

This disease is much more often diagnosed in children than in adults. This is due to objective reasons:

1. The Eustachian tube in a child is much narrower than in an adult. Therefore, violations of its patency occur much more often.
2. Many children have enlarged adenoids. These formations lead to compression of the Eustachian tube, which makes the lumen in it much smaller.
3. Children are more likely than adults to suffer from acute viral infections.

In addition, there are additional factors that significantly increase the risk of developing purulent otitis media in a child. These include the following:

• hypothermia;
• lack of vitamins;
• prolonged use of antibacterial drugs;
• penetration of fluid into the ear;
• decrease in the body's defenses.

Symptoms

The appearance of purulent otitis in children is accompanied by severe pain in the ears. This symptom is accompanied by constant tearfulness. The pain may be cutting, aching or throbbing.

At night, discomfort increases significantly, causing sleep disturbances. In addition, children often experience the following symptoms:

• pallor of the skin;
• general weakness;
• hearing loss;
• purulent discharge with bloody impurities;
• temperature increase.

If you ask the baby what exactly hurts, he will point to the ear. It is much more difficult to identify pathology in infants.

With purulent otitis media, newborn babies constantly cry, they have serious problems with sleep. The following symptoms may also appear:

• refusal to eat;
• the occurrence of gag reflexes;
• the child's attempts to lie on his side, where the affected ear is located.

With this type of otitis in babies, the temperature increases. This is considered a reason to call an ambulance, since there is a threat of serious complications.

How to recognize

The doctor identifies the disease on the basis of complaints, anamnesis and otoscopy data. Typically, the following types of studies are prescribed:

1. General examination, endoscopic examination of the ear cavity, nose and nasopharynx - usually performed after the canals have been cleaned.
2. Audiological and vestibular examination.
3. Valsalva maneuver - in this case, the exudate is pushed into the ear canal.
4. Laboratory analysis of the secret - is carried out to assess susceptibility to antimicrobial agents.
5. Assessment of the state of immunity.
6. Computed tomography and radiography.

Kinds

There are a number of varieties of purulent otitis in children, each of which is characterized by some features.

Spicy

The acute form of the disease is accompanied by severe pain and leads to the appearance of purulent discharge in the ear cavity. If you do not immediately start adequate treatment, there is a risk of chronicity of the process. It is characterized by a persistent lesion of the eardrum. Also, the child may gradually lose hearing.

double sided

This form of purulent otitis is characterized by an inflammatory lesion of both ears. This is a very serious disease that poses a particular danger to young children.

Almost 90% of all otitis media are bilateral. After a few years, the number of such diseases decreases. This is due to the development of the hearing aid.

recurrent

Such a diagnosis is made if a second disease occurs after a short period of time after the first. It is the result of improper therapy or violations of the doctor's recommendations. Also, inflammation of the adenoids often leads to relapses.

Treatment

To cope with the pathology, to prevent the development of dangerous complications and hearing loss, it is necessary to diagnose the pathology in time. Treatment should be selected by a doctor depending on the stage of the disease and its manifestations, and how long it takes to treat it depends on the stage and complexity of the disease.

Medical

With purulent otitis media, especially in children under 3 years of age, antibiotics are usually prescribed. Such drugs can be used in the form of tablets, injections or suspensions - it all depends on the age of the patient and the stage of the disease.

For the treatment of this form of the disease, penicillins are most often used, as well as their combinations with clavulanic acid.

The most effective drugs include amoxicillin, augmentin, amoxiclav, etc.

If penicillins cannot be used or treatment with them does not work, cephalosporins are prescribed - ceftriaxone, cefazolin.

With the ineffectiveness of the listed funds or the presence of allergic reactions, doctors prescribe macrolides. The most popular drugs in this category include azithromycin and clarithromycin.

If a child has purulent otitis, he must be prescribed vasoconstrictor drops for the nose. With their help, it is possible to cope with the swelling of the mucous membrane and make the lumen of the auditory tube wider. Usually doctors prescribe galazolin, otrivin, naphthyzinum.

To combat swelling of the mucous membranes, antihistamines are often used. The most effective drugs from this group include claritin, tavegil, loratadine.

With intense pain syndrome, anti-inflammatory drugs are prescribed - paracetamol or ibuprofen. These drugs also help reduce fever. The doctor may prescribe tablets, syrup or suppositories.

In the absence of perforation of the eardrum, drops are prescribed in the ear. Otipax has an excellent anti-inflammatory and analgesic effect. This harmless drug can be used even for babies.

If the baby has a chronic form of purulent otitis, he is shown the use of immunomodulators. These include viferon, biological products, restorative drugs.

Folk methods

Before using any folk remedy at home, be sure to consult a pediatrician and an otolaryngologist.

When purulent otitis appears, a lot of foods with vitamin C should be included in the baby's diet. It helps to strengthen the immune system and ensures a quick recovery. This substance is present in kiwi, sweet pepper, citrus fruits.

An excellent remedy for this form of otitis media is a decoction prepared from raspberry roots. It has pronounced anti-inflammatory properties.

The rhizome needs to be crushed, take 3 tablespoons of raw materials and add 1 liter of boiling water. The product must be infused for 12 hours. Take 3/4 cup twice a day for a month. During this time, damaged membranes will successfully heal.

Frequent purulent otitis in a child what to do

If the child often has such problems, you need to establish the causes of their occurrence. Quite often, this leads to immune failure. Therefore, treatment is carried out with the help of the introduction of gamma globulins, ascorbic acid, lysozyme, etc.

During remission, blowing of the auditory tubes is often prescribed. You can also massage the eardrum. If necessary, punctures are performed to eliminate sinusitis. The doctor may prescribe a tonsillotomy or removal of the adenoids.

How to avoid complications with purulent otitis media, an experienced doctor will tell in our video:

Prevention

To prevent the occurrence of purulent otitis, you need to deal with its prevention. It includes a number of components:

• prevention of viral infections;
• strengthening immunity;
• water procedures;
• proper nutrition;
• timely treatment of diseases of the nasopharynx.

Purulent otitis media is considered a very dangerous disorder that can cause hearing loss. To prevent this from happening, you need to contact a specialist in time and strictly adhere to his recommendations.

Purulent otitis media is an inflammation of the middle ear, which is characterized by the release of fluid mixed with pus. The disease is quite dangerous, since it is not at all easy to completely cure the disease.

Purulent otitis often develops into a recurrent form. In this case, after the end of treatment, the disease returns again. What causes provoke the onset of the disease and how to cure purulent otitis media will be considered in our article.

This ailment is one of the most dangerous diseases, since one of the most common complications is hearing loss and inflammation of the meninges. In addition, if otitis media is not treated in a timely manner, pus can get into the meninges. If we are talking about a child under one year old, a recurrent form of purulent otitis media can affect the perception of information. In this case, the child is significantly behind in development from peers.

Causes

Like any other form of ear inflammation, the onset of the disease provokes an infection. Most often, it penetrates the ear canals due to concomitant diseases. These include diseases of the nasopharynx, the presence of adenoids in a child. Consider what other factors can cause the disease:

• delayed treatment of acute otitis media;
• beriberi or low immunity;
• water in the ear
• damage to the Eustachian tube or eardrum.

It should be noted that purulent otitis media develops in children 70% more often than in adults. This is due to the fact that in children the auditory tube is immature, that is, its length is too minimal. For this reason, much more often the infection penetrates into the children's body, and the initial stage of the disease can proceed in a latent form.

Signs of the disease

Pain is the main symptom of purulent otitis media. Most often they have a pulsating or shooting character. Toward evening, the pain intensifies, as a result of which the child's sleep is disturbed. A yellowish or white fluid flows profusely from the ear. It can be liquid or thick. Additional features include the following:

• In the presence of pus in the ear passages, the child necessarily rises in temperature. With mild or moderate severity, it ranges from 37 to 37.5. If we are talking about a severe degree, in this case, the body temperature can reach 39 degrees;
• The fluid that flows from the ear may have blood impurities;
• Hearing is impaired, it is significantly reduced, in addition, extraneous noise occurs in the ear;
• The child feels weakness and aches in the body, which is due to the presence of an inflammatory process in the body.

Important: In the presence of these symptoms, in no case should a visit to a specialist be postponed.

How to recognize purulent otitis media in a child

With inflammation of the ear, the baby is constantly naughty, pulling on the sore ear.

A child over 5 years old can independently talk about what worries him, where and how it hurts. If we are talking about babies, in this case, recognizing the disease is not easy enough. Parents should be alert for the following symptoms:

• the baby constantly cries and is naughty;
• while crying, the child pulls on the ear;
• decrease or lack of appetite;
• sleep disturbance.

If these signs are present, the child should be shown to an otolaryngologist. It is enough for a qualified specialist to conduct an examination with an otoscope to diagnose this disease. In some cases, the doctor prescribes magnetic resonance imaging to make sure there are no possible complications. In some cases, the doctor prescribes a microscopic analysis of the fluid flowing from the ear. This manipulation is necessary in order to assess the susceptibility to antibacterial drugs.

Types of purulent otitis media

Purulent otitis can occur in various forms, which have some differences.

Spicy

In the presence of an acute form, the main discomfort is severe pain. A liquid with an admixture of pus flows from the ear. Untimely therapy of the acute form of the disease can lead to chronic. The child complains about the presence of fluid in the ear cavity, as well as hearing loss.

double sided

If you are worried about pain and leakage of fluid from both ears at the same time, this pathology is called bilateral purulent otitis media. This form is dangerous, since there is a high risk of becoming deaf in both ears at once.

recurrent

If you do not start treatment in a timely manner, treat purulent otitis media incorrectly or do not listen to the doctor's recommendations - the disease returns again and again after a while. In this case, the doctor makes a diagnosis of "recurrent purulent otitis"

Treatment of the disease

Therapy of purulent otitis necessarily includes taking antibiotics.

As mentioned above, the purulent form of otitis should in no case be treated at home. Once the doctor diagnoses the disease, he will prescribe treatment, which will depend on the form of the disease and its severity. Some parents are wondering how long does purulent otitis media take to heal? There is no specific answer to this question. The doctor claims that the sooner the parents bring the child to the doctor, the higher the chance of completely curing the disease in a short time without any complications.

Medical treatment

Purulent otitis media cannot be cured without the use of antibiotics. Depending on the type of pathogen and the individual characteristics of the organism, the doctor prescribes a specific drug. The following are most commonly used:

• Ceftriaxone. Injection, used in especially severe cases. The course of treatment is at least seven days;
• Amoxiclav. Suspension intended for young children. The course of treatment and dosage is negotiated by the attending physician;
• Flemoxin Solutab. Tablets to be dissolved in water. Approved for use by children from two years of age. The dosage is set by the doctor.

If the disease is caused by pathologies of the nasal passages, the doctor will definitely recommend using one of the following nasal drops:

• Tizin;
• Nazol for children;
• Nazivin for children;
• As a prophylaxis, a saline solution for washing the nose - Aquamaris or Aqualor - can be additionally prescribed.

Ear drops are prescribed if the integrity of the eardrum is not broken. The most commonly used therapy is:

• Otipax;
• Otinum;
• Otofa.

If we are talking about the chronic stage, the child is prescribed means to increase immunity - IRS 19, Bronchomunal, etc.

Alternative treatment

Important: These recipes can only be used if the integrity of the eardrum is not damaged.

• Finely chop the onion with a sharp knife. Using a strainer, squeeze out a small amount of onion. Mix in equal proportions with aloe juice. We dip the cotton wool, wring it out and insert it into the sore ear. We leave for several hours;
• St. John's wort flowers and lemon balm leaves are poured over with boiling water, then placed in a glass and poured with boiling water (a small amount). We leave the infusion for two hours. Next, we take a piece of gauze, dip it in the infusion and insert it into the sore ear;
• If the child does not have external damage to the ear, we dilute boric alcohol in a 1: 1 ratio with warm water. We dip the cotton wool, insert it into the ear at night.

Surgical intervention

In the event that drug treatment does not bring the desired effect, doctors assure that it is necessary to apply a small surgical intervention. The bottom line is to puncture the eardrum. This manipulation is necessary for the outflow of pus. This procedure is prescribed if there is a high risk of pus getting into the meninges.

What to do with frequent purulent otitis media in a child

Fresh fruits and vegetables for otitis.

If purulent otitis media returns again and again, in this case it is necessary to find out the cause that provokes the disease. Otolaryngologists recommend in this case to increase the child's immunity: proper nutrition, the use of complex vitamins. As a prophylaxis, a massage of the eardrum can be prescribed.

Possible Complications

Possible complications of purulent otitis media include the development of the following pathologies:

• the ingress of pus into the meninges;
• development of meningitis;
• paralysis of the facial nerve;
• brain inflammation;
• chronic hearing loss;
• hearing loss.

Prevention

• To increase the immunity of the child, it is necessary to include in the diet as much plant food, fresh vegetables and fruits as possible;
• Take vitamins and beneficial trace elements in tablets;
• Dress for the weather;
• Monitor the well-being of the child and timely seek help from medical institutions;
• During the treatment of concomitant diseases.

Conclusion

Purulent otitis in children is a dangerous disease that has serious consequences. Every parent should understand that the lack of treatment can even lead to death. For this reason, experts do not recommend self-medication and, at the first sign of pathology, go to the hospital.

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.

Causes

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 into the outer ear. This is the visible part of the organ of hearing. From the outer ear, sound waves travel 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 via 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 a 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:

1. 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.
2. 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.
3. 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 in the acute form of the disease, the amount of pus increases, as a result of which dizziness, severe pain in the head, vomiting, and 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. The mucous membrane of the auditory tube and tympanic cavity is involved in the inflammation. 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 a special medical device called a pneumatic otoscope that 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.

1. 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.

1. 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 antimicrobial available 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.

1. duration of treatment.

The duration of treatment for suppurative otitis media has historically been set at 10 days, and most efficacy studies examining antimicrobial treatment of the disease have 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, a severe episode of suppurative otitis, or if a previous case was problematic.

1. 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.

1. 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.

Purulent otitis occurs in children very often, while this disease often has a relapsing character. The main provoking factors may be: an increase in adenoids, weakening of the immune system, infectious diseases. One way or another, the symptoms of this disease should be the basis for going to the doctor. Only a specialist can prescribe an effective treatment that can help defeat this disease.

Purulent otitis: what is it?

This definition means suppurative lesion of the middle ear- one of the components of the auditory system, its main part is the tympanic cavity, which is a small space in the temporal bone responsible for converting sound signals.

The development of this disease in children can cause problems during the formation of the speech apparatus. Often this disease creates difficulties with the perception of information, disrupts psycho-emotional development and worsens the quality of life.

During otitis in children, an inflammatory process occurs in the mucous membrane of the ear, this is accompanied by the production and accumulation of pus. This form of the disease is much more dangerous than catarrhal otitis, as it can cause intracranial complications and hearing loss.

The main cause of the development of a purulent form of otitis media are the appearance of adenoids, inflammation of the nasopharynx, acute viral respiratory infections and chronic forms of rhinitis. All these diseases lead to an excessive amount of mucus in the nose.

During a strong blowing of the nose, these secretions pass into the Eustachian tube, blocking it. As a result, ventilation is disturbed, which leads to the penetration of infection and the process of inflammation in the ear mucosa.

During the release of inflammatory fluid the baby's hearing deteriorates, and pain appears. Bacteria that enter the middle ear begin to actively develop. As a result, after a few days or even hours, the child develops purulent discharge. After his state of health deteriorates significantly - the pain syndrome increases, the temperature rises. During strong pressure on the eardrum, it ruptures, this is accompanied by the outflow of pus.

This disease is much more common in children than in adults. This is due to certain reasons:

• Children are much more likely than adults to suffer from acute viral infections.
• Most babies have enlarged adenoids. These formations compress the Eustachian tube, this makes the lumen in it much smaller.
• In children, the Eustachian tube is much narrower than in an adult. Therefore, violations of its patency appear much more often.

In addition, there are additional factors that significantly increase the risk of purulent otitis media in a child. These reasons include:

• lack of vitamins;
• hypothermia;
• decreased immunity in the body;
• penetration of fluid into the ear;
• prolonged use of antibacterial agents.

The development of the disease in children begins to be accompanied by significant pain in the ears. This process is accompanied by constant tearfulness. Pain may be throbbing, aching or cutting.

At night, discomfort increases significantly, which provokes sleep disturbance. In addition, babies often have the following symptoms:

• general weakness;
• pallor of the skin;
• increase in temperature;
• discharge of pus with bloody impurities;
• hearing impairment.

If you ask an older child what exactly hurts, he will point to the ear. It is much more difficult to determine the disease in infants.

During illness, newborns cry all the time, they have serious sleep disturbances. You may also experience the following symptoms:

• the baby's attempts to lie on its side, on which the affected ear is located;
• the appearance of gag reflexes;
• refusal to eat.

During this form of otitis in children, the temperature rises, which is the reason for going to the ambulance, as there is a possibility of serious side effects.

Diagnosis of the disease

The doctor determines the disease on the basis of otoscopy data, anamnesis and complaints. Usually, appoint the following types of examinations:

Forms of the disease

Bilateral form of otitis media

This type of otitis in children is characterized by inflammation of both ears. This is a rather serious disease, which is of particular danger to infants.

Almost 95% of all otitis media are bilateral. After a couple of years, the number of these diseases decreases. This is due to the development of the hearing aid.

Acute form of otitis media

This type of disease leads to the formation of purulent discharge in the ear cavity and is accompanied by severe pain. If adequate treatment is not immediately carried out, then there is a high risk of chronicity of the process. Which is expressed in a stable lesion of the eardrum. In this case, the child's hearing may gradually deteriorate.

Recurrent form of otitis media

This diagnosis is established if a second disease appears within a short period of time after the first one. This disease is the result of violations of the doctor's recommendations or improper therapy. An inflammatory process in the adenoids also often leads to relapses.

Treatment

In order to cope with the disease, to prevent hearing loss and the development of dangerous complications, it is necessary to diagnose the disease in a timely manner. Treatment must be prescribed by a doctor, taking into account the stage of the disease and its manifestations, and how long it will be treated will depend on the complexity of the disease and stage.

Medical treatment

During treatment, especially in babies under 3 years old, as a rule, antibiotics are prescribed. These drugs can be prescribed in the form of suspensions, injections or tablets - everything will depend on the age of the child and the stage of the disease.

For most often used penicillins, as well as their combination with clavulanic acid. The most effective drugs include amoxiclav, augmentin, amoxicillin, etc.

If the use of penicillins is prohibited or treatment with them does not give the expected effect, then cephalosporins are prescribed - cefazolin, ceftriaxone.

In the presence of allergic reactions or the ineffectiveness of the listed drugs, doctors prescribe macrolides. The most common drugs in this group include clarithromycin and azithromycin.

If a baby is diagnosed with such a disease, he will certainly be prescribed vasoconstrictor drops for the nose. With the help of them, it is possible to make the lumen of the auditory tube wider and cope with the swelling of the mucosa. As a rule, doctors prescribe naphthyzine, otrivin, galazolin.

To combat swelling of the mucous membranes, antihistamines are also often used. The most effective drugs from this group include loratadine, tavegil, claritin.

During intense pain prescribed anti-inflammatory drugs - ibuprofen or paracetamol. These drugs also help to lower the temperature. The doctor may prescribe suppositories, syrup or tablets.

During the absence of perforation of the eardrum, ear drops are prescribed. Otipax has a fairly good analgesic and anti-inflammatory effect. This safe tool can be used even for infants.

If a child is diagnosed with chronic otitis media, then he is prohibited from using immunomodulators. These include fortifying drugs, biological products, viferon.

Before using any folk drug at home it is imperative to consult an otolaryngologist and a pediatrician.

During the development of a purulent process, it is necessary to include a large number of foods containing vitamin C in the child's daily menu, which ensures a quick recovery and strengthens the immune system. This vitamin is found in citrus fruits, sweet peppers, kiwi.

An excellent remedy for this type of otitis media is a decoction made from raspberry roots. This decoction has a pronounced anti-inflammatory effect.

The roots must be crushed, take three tablespoons of raw materials and add one liter of boiling water. This composition must be infused for 12 hours. Use 2 times a day for three quarters of a glass for one month. During this time, damaged eardrums will successfully heal.

What to do if a child has frequent otitis media?

If the baby often has these problems, then it is necessary to determine the causes of development. This pathology often leads to immune failure. Therefore, treatment is carried out by introducing lysozyme, ascorbic acid, gamma globulins, etc.

During remission, blowing of the auditory tubes is often prescribed. The eardrum may also be massaged. If necessary, punctures are performed to eliminate sinusitis. The doctor may recommend removal of the adenoids or a tonsillotomy.

Purulent masses that have accumulated in the tympanic cavity, can penetrate partially into the cavity of the inner ear, which can provoke a serous inflammatory process in this part, the inflammation can turn into a purulent stage and lead not only to complete hearing loss, but also to disorders of the vestibular apparatus.

A fairly common complication is cholesteatoma - this is a formation that releases toxic substances into the surrounding space and has a destructive effect on the nearby bone tissue. This pathology appears during a violation of the curvature of the tympanic membrane.

It is also possible the appearance of mastoiditis. During this disease, bacterial elements pass into the porous bone, which is located behind the auricle, as a result of which the bones are filled with purulent masses.

Improper treatment of otitis media provokes the transition of the disease to the chronic stage. Despite the fact that this does not happen very often in childhood, the treatment of purulent otitis media in children must be adequate and timely.

Disease prevention

In order to prevent the development of a purulent process, it is necessary to engage in its prevention, which includes a number of components:

• strengthening the immune system;
• prevention of viral diseases;
• timely treatment of diseases of the nasopharynx;
• healthy eating;
• water treatments.

Purulent otitis in children is a rather dangerous disorder that can provoke hearing loss. In order to prevent this from happening, it is necessary to contact a specialist in a timely manner and impeccably adhere to his appointments.