Otitis media is another name for a middle-ear infection. It means aninfection behind your eardrum. This kind of ear infection can happen afterany condition that keeps fluid from draining from the middle ear. Theseconditions include allergies, a cold, a sore throat, or a respiratoryinfection.
Middle-ear infections are common in children, but they can also happen inadults. An ear infection in an adult may mean a more serious problem thanin a child. So you may need additional tests. If you have an ear infection,you should see your health care provider for treatment.
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Otitis media with effusion. Fluid (effusion) and mucus build up in the middle ear after the infection goes away. You may feel like your middle ear is full. This can continue for months and may affect your hearing.
Chronic otitis media with effusion. Fluid (effusion) remains in the middle ear for a long time. Or it builds up again and again, even though there is no infection. This type of middle-ear infection may be hard to treat. It may also affect your hearing.
The middle ear connects to the throat by a canal called the eustachiantube. This tube helps even out the pressure between the outer ear and theinner ear. A cold or allergy can irritate the tube or cause the area aroundit to swell. This can keep fluid from draining from the middle ear. Thefluid builds up behind the eardrum. Bacteria and viruses can grow in thisfluid. The bacteria and viruses cause the middle-ear infection.
Sometimes fluid stays in the middle ear even after you take antibiotics andthe infection goes away. In this case, your health care provider maysuggest that a small tube be placed in your ear. The tube is put at theopening of the eardrum. The tube keeps fluid from building up and relievespressure in the middle ear. It can also help you hear better. This surgeryis called myringotomy. It is not often done in adults.
Most cases of viral conjunctivitis are mild. The infection will usually clear up in 7 to 14 days without treatment and without any long-term consequences. However, in some cases, viral conjunctivitis can take 2 to 3 weeks or more to clear up.
Your doctor may prescribe an antibiotic, usually given topically as eye drops or ointment, for bacterial conjunctivitis. Antibiotics may help shorten the length of infection, reduce complications, and reduce the spread to others. Antibiotics may be necessary in the following cases:
Dr. Wang: An outer ear infection, or otitis externa, is the type we most frequently encounter in adults. These can strike anyone at any age, with or without a history of ear infections. Outer ear infections are also known as swimmer's ear, because they are typically caused by the introduction of moisture from outside the body. The ear canal is a warm, moist area of the body, the perfect breeding ground for bacterial or fungal growth and an easy entry point for moisture to enter. Adults who are more predisposed to getting otitis externa include those with eczema of the ear canal and those who frequently insert cotton swabs into their ear canal.
Dr. Wang: Earwax is a natural way for your body to trap and slow the growth of bacteria that may have entered your ear. When you apply cotton swabs, you often wind up pushing earwax further into the ear canal. This impacted wax can then trap water or moisture deep in the canal, setting you up for an infection.
Dr. Wang: Correct. Use of Q-Tips can cause not only outer ear infections, but also trauma of the ear canal or eardrum, which can affect hearing and cause other types of infection and ear pain. Also, part of the swab can break off, leaving a foreign body in your ear that needs to be removed. It's a common reason for ER visits, actually. If you feel you have a buildup of ear wax, I recommend applying a tissue or soft thin cloth to your finger and wiping gently around the entrance to the ear. There are also over-the-counter ear wax removal kits from Debrox that are safe to use, when used as directed.
Dr. Wang: You can usually feel it if there's some water in your ear, right? If you notice that, turn your head to the side and try to shake the water out or let it drain out. You can also place a tissue paper or thin dry cloth around your finger and wipe outside the opening of your ear with your head turned sideways. If you still feel it, or have a history of getting a lot of outer ear infections, use drops to dry out your ears. You can buy Swim-EAR or other brands over the counter, or you can look up how to make your own by mixing together rubbing alcohol and vinegar. A cool or warm hair dryer may also be effective.
Dr. Wang: Most ENT doctors and primary care physicians will prescribe antibiotic ear drops only. Typically, oral antibiotics are not necessary, and we like to avoid overprescribing them so they continue to work when we actually need them. Occasionally, the opening of the ear may be too inflamed or sticky to get the drops in, so we have to stick a little wick in there to get the drops where they need to go. The provider may prescribe oral antibiotics if the outer ear infection is really severe.
Dr. Wang: Frontline treatment for middle ear infections is a course of oral antibiotics. Sometimes steroids can be added if the pain is severe, which doesn't help resolve the infection any faster but can reduce the inflammation and pressure causing the pain. If you've been on standard treatments for several days but your ear still aches or feels full, you should be referred to an ENT, who may recommend different medications or elect to lance the eardrum to remove the fluid. If you keep getting middle ear infections, you may have to have ear tubes placed in your ears, just like we do with children.
Dr. Wang: They function pretty much the same for kids as adults. You still have to have relative water precautions. You can swim but it may be safest to use ear plugs or a swim band to keep water out. The main difference is adults typically do fine with ear tube placement in the office. There's no need for an OR or general anesthesia like there traditionally has been for kids. Actually, there's a new procedure for placing ear tubes in kids that allows us to do it super quickly with local anesthesia only. So now we can do that in clinic as well.
Dr. Wang: There's a procedure I've been doing for a few years called Eustachian tube dilation. Using endoscopic guidance through the nose, you insert a balloon in the Eustachian tube, blow it up and leave it there for up to two minutes. This can address the Eustachian tube dysfunction that leads to middle ear infections. I've found it works in about 50% of patients, so it doesn't work for everyone. But it's so noninvasive, it's a good place to start with certain patients who are good candidates for it. There's also a new drug that is almost like a gel that you can squirt into the ear canal. It slowly dissolves and may be easier to get into those really clogged areas than traditional drops.
Dr. Wang: There is something called an inner ear infection. Inner ear infections are pretty different from outer and middle ear infections, and much rarer overall. We see them primarily in adults. Inner ear infections typically present with hearing loss, vertigo, dizziness, nausea and vomiting. If you have these symptoms, you should rest, avoid driving, sudden movements and alcohol. Inner ear infections will usually clear up in several days on their own, but if symptoms don't go away, you should call your primary care provider or ENT doctor. Note: If you have sudden hearing loss in one ear, get in to see your doctor immediately or call 911, because tests need to be performed immediately.
Dr. Wang: Do not stick anything in your ears! Also, if you have diabetes, be very careful with ear infections. They might be much more persistent, painful and treatment resistant. If this happens to you, really prioritize getting your blood sugar under control, because that can greatly affect your body's ability to shake the infection.
Question What are the rates and associated patient characteristics of discontinuation of antipsychotic medications (APMs) among older adults following infection-related hospitalization?
Findings In this cohort study of 5835 patients in the US, we observed discontinuation rates of only 11% for new atypical APM users and 52% for new haloperidol users by 30 days after initiation following infection-related hospitalization. Dementia and prolonged hospitalization were inversely associated with haloperidol and atypical APM discontinuation.
Meaning These findings suggest that contrary to clinical recommendations, APM discontinuation rates following infection-related hospitalization are low and are lower for atypical APMs than for haloperidol.
Importance There are limited data on discontinuation rates of antipsychotic medications (APMs) used to treat delirium due to acute hospitalization in the routine care of older adults.
Conclusions and Relevance The findings of this cohort study suggest that the discontinuation rate of newly initiated APMs for delirium following infection-related hospitalization was lower in atypical APM users than in haloperidol users, with prolonged hospitalization and dementia as major associated variables. The discontinuation rate was substantially higher in recent years for haloperidol but not for atypical APMs.
While otitis externa can clear up by itself, this can take several weeks without treatment. Your GP can usually prescribe medicated ear drops that speed up the healing process. These usually need to be taken several times a day for about a week.
A middle ear infection (also called otitis media) is an infection behind your eardrum. It can happen after any condition that traps fluid in the middle ear, such as a cold, allergies, sore throat, or respiratory infection. Middle ear infections are common in children, but they can be more serious when they happen in adults. be457b7860
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