Why Acute otitis media is more common in infants and young children than in adults?
1) Eustachian tube is wider, shorter and more horizontal than in adults making it easier to transmit infection to the middle ear.
2) More common causes of acute otitis media: Adenoiditis, Tonsillitis, Exanthemata, and contaminated milk may enter the Eustachian tube when feeding in the supine position.
3) Lowered resistance due to: teething, Gastrointestinal troubles, Artificial feeding, and immune system not well developed.
Symptoms of Acute otitis media in infants and young children
General: More severe general constitutional symptoms than in adults.
Vomiting and diarrhea may occur.
Local: The child cries, does not sleep, moves his/her head and pulls the ears.
- Diffuse congestion.
- Bulging and perforation occur later than in adults due to thicker drum and more obliquity of the drum, so complications are more common.
- Don’t wait for bulging as it occurs late.
- Myringotomy is indicated if pain and fever persists for more than 48 hours despite medical treatment.