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Ear Infections: Diagnosis

Otitis media (OM) is a general term that refers to both acute otitis media (AOM) and otitis media with effusion (OME), which is a painless condition that occurs when fluid collects in the middle ear for a longer period of time. Swimmer’s Ear (Otitis Externa) affects the ear canal, or outer ear, and shares some symptoms with OM.

Acute Otitis Media (AOM) often begins with a cold that causes inflammation and swelling of the Eustachian tube (a narrow passage between the middle ear and the throat), allowing fluid to accumulate behind the eardrum. This trapped fluid can serve as a breeding ground for bacteria, which cause painful inflammation and a bulging of the eardrum. Pain can be worse when the baby is sucking, swallowing, or lying down.

Otitis Media with Effusion (OME) refers to the painless collection of watery or mucus-like fluid in the middle ear behind the eardrum, without symptoms of an ear infection. Most, but not all, cases of OME are diagnosed when persistent middle-ear fluid is discovered during an examination following AOM, but it can also be caused by a faulty eustachian tube, upper respiratory infections, and allergies. OME lasts an average of 40 days after AOM, but it often tends to persist longer in younger children. Unlike the signs of illness that usually accompany AOM, the main symptom of OME is diminished hearing, which can be hard to notice in babies. OME can raise the risk of repeat infections thanks to the persistent fluid. Older children may report a sense of fullness or "popping" in their ears.

Swimmer’s Ear (Otitis Externa) is an infection of the ear canal. Kids are most likely to get swimmer’s ear if they’re in bacteria-infested water, like poorly chlorinated pools, or if there’s a scratch or an irritation in the ear canal that creates a place for germs to enter. If one of your kids does end up with swimmer’s ear, you’ll likely know if he complains of one or more of these symptoms:

  • Ear pain
  • Itchiness inside the ear
  • The sensation that the ear is blocked
  • Pus-like liquid coming out of the ear (though this is less common)
  •  If the tug on the ear lobe and the pain worsens, it is likely Swimmer’s Ear

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