Could I Have an Infection?

Do you feel under the weather? Have you been running a fever? Do you have pain? Is your appetite decreased? Are you more tired than usual? If so, you might have an infection. There are many types of common infections such as wounds, skin, throat (strep), bladder, sinus, and ear. Infections are caused by bacteria that have invaded your body usually after a viral illness as you are more susceptible to bacteria due to a weakened immune system.

Bacteria love warm, dark, moist places, and the ear is one of the most common occurrences of an infection. Ear infections can occur in both children and adults. They usually occur after a viral cold and cause discomfort, sharp pain, fever, and difficulty hearing. Although ear infections are not contagious, the virus that you caught before the ear infection occurred, can be contagious to others. An inner ear infection is also known as otitis media. When you have a painful episode, it is known as acute otitis media. An outer ear infection is known as otitis externa. Otitis externa is when your ear canal is swollen and infected. It is also known as swimmer’s ear.

Who is at Risk for Infection?

Everyone is at risk for ear infections, but babies and children are more at risk due to immature immune systems as well as short straight ear tubes (eustachian tubes). There are quite a few risk factors for recurrent ear infections and they include:

• Day care attendance
• Smoker present in the home
• Bottle feeding
• Male gender
• Use of a pacifier
• Family history of ear infections
• History of asthma or large tonsils
• Seasonal allergy sufferers
• Swimming (otitis externa and otitis media)
• Recent upper respiratory infection (URI), also known as the common cold

What Will My Doctor Ask Me?

Your doctor will ask you a lot of questions regarding your symptoms or that of your child. He/she will focus on the chief complaint of the ear and any associated symptoms that have been occurring with the ear discomfort. Some of the most common questions you will be asked include:

• When did you notice the symptoms?
• How long have you been feeling discomfort?
• Have you been running a fever and if so, what was the highest temperature reading you got?
• Are you experiencing ear pain?
• On a scale of one to ten with ten being the worst pain ever, what is your pain rating?
• Is your child more irritable than usual?
• Have you been dizzy or noticed any hearing loss in the affected ear?
• Has there been any drainage from the affected ear?
• Have you noticed any other symptoms such as a sore throat, cough, nasal congestion, or a headache?
• Do you or your child experience seasonal allergies?
• Does anyone in your home smoke?
• Is the infant or child eating appropriately?

Treatment of Infections

If your doctor determines you have an infection, whether they cultured your blood or other secretions, found it via bloodwork, or treated you based on your symptoms, you will be given an antibiotic. Depending on the severity of the infection, the antibiotic may be a shot, oral, or through a vein. If the antibiotic has to be given through a vein, then you would have to be admitted to the hospital, and that would be considered a severe and concerning infection.

Treatment of Ear Infections

Antibiotics

The treatment of ear infections is usually with an oral antibiotic, but there are times when antibiotic ear drops would be used depending on the type of ear infection you developed. If you have developed an infection of the outer ear and canal, your doctor will most likely put you on antibiotic ear drops such as Cortisporin, Floxin, or Ciprodex. If you have an infection of the inner ear, your doctor will put you on an oral antibiotic such as Amoxicillin, Augmentin, or Zithromax. Always tell your doctor if you have any allergies to medication as this will play a significant role into his/her plan of care for you.

Pain Relievers

Pain is a factor that plays into your treatment as well. There are no ear drops for pain. If you are experiencing pain while being treated for an ear infection, your doctor will recommend taking an analgesic (pain reliever) such Acetaminophen (Tylenol) or Ibuprofen (Motrin, Advil) per the package directions. This will relieve the pain you are experiencing until the antibiotic has cleared the bacteria and the infection has resolved.

What do I Need to Know about Infections/Ear Infections? – Patient Education

• After the antibiotics have been completed, and the ear pain is gone, you may still experience some pressure and popping in your ear. This is entirely normal. There is extra fluid from the infection sitting behind your ear drum, and it has to be absorbed by your body over time. You will notice the popping for an additional two weeks after you have completed the antibiotics.
• Make sure to complete all of the antibiotic, even if you start to feel better or you no longer have the pain and discomfort in your ear. This is important as the bacteria will ultimately not be killed and re-infection could occur. Also, by not finishing the antibiotic, you are contributing to antibiotic resistance in which the antibiotic will no longer work for the disease in which it is specified.

Emergency Warning Signs/When to Follow Up

• Follow-up with your doctor if you have not had any relief in forty-eight to seventy-two hours of starting the antibiotic.
• Call 911 or have someone take you to the emergency room if you develop hives, swelling of the mouth, throat, lips, or tongue (anaphylaxis) after starting the antibiotic.
• Go to the emergency room immediately if you are worsening in any way. Symptoms to look for include running a high fever, pain and redness behind your outer ear (mastoid), vision changes, extreme dizziness, nausea and vomiting, loss of balance, weakness in half your face, hearing loss, or a severe headache and stiff neck.