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Acute Otitis Media

Otitis is an infectious inflammation of the middle ear. This disease often occurs in children (though it often manifests among adolescents). Mostly it is a complication of respiratory tract infections.


Otitis is most commonly caused by staphylococci, streptococci, pseudomonas and other bacteria. Less common causes include viruses and fungi. Typically otitis is acquired when an infection of the upper respiratory tract is present (cold, sinusitis, tonsillitis). Rarely otitis might be acquired when the eardrum (tympanic membrane) ruptures.

Signs and Symptoms

Otitis is classified into three stages:

  • The first stage is called catarrhal stage. In this stage the ear pain is very strong, nagging, sometimes of shooting nature. An increase in temperature, shivering and worsening of hearing may occur.
  • The second stage is called purulent stage. In this stage the middle ear is filled with pus. The pain becomes throbbing, loss of hearing occurs. The pus might flow from the ruptured eardrum. If this happens the pain calms down and general condition gets better.
  • The third stage is called convalescence stage. The inflammation weakens, the ear becomes clean of pus and hearing becomes normal.

In cases of viral otitis the pain does not go away when the eardrum ruptures. Necrotic inflammation is a rare complication of otitis. In this case long lasting inflammation spreads, reaches mastoid bone (a part of the scull behind the ear) and causes necrosis.


Otitis is treated by otorhinolaryngologists (ORL). It is usually diagnosed via visualization of the tympanic membrane (otoscopy) in combination with the appropriate clinical history. Different changes of the eardrum that correspond to appropriate stage of the illness might be noticed during otoscopy. Sometimes special examination of the hearing function is necessary.


Otitis is mainly treated using antibiotics. Amoxicillin is used most commonly. Sometimes the infectious agent is cultured and after that the most appropriate antibiotic is chosen. Also symptomatic treatment (pain killers, inhibitors of secretion) is prescribed. In cases of viral otitis only symptomatic treatment is administered. Local treatment – compresses, physiotherapy – might also be used.


The prognosis of otitis is mostly good. Of course, you should see a doctor immediately, because complicated otitis could damage the function hearing.


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