Purulent otitis in a child: symptoms of the disease and approaches to therapy

Purulent otitis in a child: symptoms of the disease and approaches to therapy

24.05.2022 0 By admin

Purulent otitis in a child is an infectious and inflammatory lesion of the ear, accompanied by an accumulation of pus in it. It develops in children of different ages against the background of viral and bacterial infections. In the absence of therapy, it can cause severe complications. Therapeutic measures include the prescription of drugs, physiotherapy and additional procedures. Sometimes surgical treatment is required.

purulent otitis in a child
With purulent otitis media, pus accumulates in the ear.


The occurrence of purulent otitis in a child is associated with the ingress of batteries into the middle ear, usually through the Eustachian tube. The latter connects the organ of hearing and the nasal cavity. Predisposing factors:

  • transferred viral and bacterial infections of the respiratory system, leading to a decrease in immune protection;
  • catarrhal otitis in the absence of inadequate therapy or self-medication can become fertile ground for purulent complications;
  • adenoids;
  • middle ear injury.

These conditions are accompanied by the formation of an infectious focus, which leads to clinical manifestations of otitis media.

Types of pathology

Purulent otitis in a child has several classifications based on the course of the pathology and other features of the disease. Depending on whether one ear or both are affected, unilateral and bilateral otitis media are distinguished. The latter form is most common in newborns and children of the first year of life.

According to the nature of the course, the disease is divided into three types:

  • acute otitis, characterized by severe pain and the appearance of pus in the external auditory canal. Occurs in early childhood. This is due to the relatively short Eustachian tube, which creates a prerequisite for infection of the ear structures;
  • Chronic otitis is manifested by periods of exacerbation and remission. In the middle ear, inflammation is constantly observed, accompanied by the destruction of anatomical structures. It develops in children with inadequate therapy of the acute form of the disease.

Otitis in childhood often affects the middle part of the ear. In this case, damage to the eardrum occurs and pus exits through the auditory canal.

Clinical manifestations

Children older than 2-3 years with the development of the disease complain to their parents about the appearance of severe pain in the ear. In addition to the pain syndrome, the child has the following symptoms:

  • body temperature rises to 38-39 degrees;
  • possible development of “white” fever, which is accompanied by pallor and marbling of the skin;
  • moodiness, restlessness or apathy;
  • general fatigue;
  • the child begins to hear poorly;
  • pus is released from the external auditory canal of the affected ear.

The chronic variant of the disease has no pronounced manifestations. Fever and pain are absent. Parents may note a decrease in hearing acuity and anxiety of the child.

If the child is less than 1-2 years old, then he does not complain of specific symptoms. Parents watching him may notice his restlessness, refusal to feed and lack of interest in games. The body temperature rises.

Treatment is selected by an ENT doctor. Each drug has its own indications and contraindications for use. They must be taken into account when assigning.

Stages of the disease

Otitis in childhood develops in 3 stages, which differ in symptoms and duration. The first stage is catarrhal (preperforative). In the ear, swelling of the mucous membrane and the beginning of the formation of pus are detected. Lasts 3 to 5 days.

The catarrhal stage passes into the perforative stage, characterized by rupture of the eardrum due to exposure to pus. Discharge from the ear may have an admixture of blood or mucus. With a breakthrough of pus, the child feels better. Pain and fever are reduced. The duration of the perforative stage is 4-7 days. She enters the reparative phase of the disease.

The 3rd stage of repair is characterized by the restoration of the integrity of the eardrum and hearing. With adequate therapy, the negative consequences of the disease do not develop, but full recovery occurs.

Diagnostic measures

purulent otitis in a child diagnosis
Treatment begins after diagnostic measures.

Clinical guidelines for the detection and treatment of purulent otitis recommend diagnosing according to the following algorithm:

  1. Collection of complaints and external examination of the child. When pressing on the tragus of a sick child, pain intensifies. This additionally indicates damage to the middle ear.
  2. Clinical and biochemical analysis of blood. Signs of acute inflammation are revealed: leukocytosis, accelerated ESR, increased concentration of C-reactive protein and fibrinogen.
  3. Otoscopy is the “gold standard” of diagnostics. The ENT doctor gets the opportunity to visually assess the condition of the external auditory canal and the tympanic membrane. Identification of its perforation and purulent discharge confirms the diagnosis.
  4. Audiometry for the study of auditory functions in children with chronic otitis media.
  5. Target radiography of the temporal bones in the case of a complicated pathology.

Only a doctor should interpret the results of the research. Incorrect diagnosis and self-treatment lead to the progression of purulent inflammation and complications of the disease: melting of the structures of the middle ear, the transfer of infection to the temporal bone, etc.

Effective treatment

The main method of treatment is medication. In therapy, drugs of several pharmacological groups are used. The doctor selects medications that affect the pathogen and eliminate the clinical manifestations of the disease.

If a bacterial infection is detected, antibiotic treatment is prescribed. Broad-spectrum drugs are used (penicillins, cephalosporins of the 2nd and 3rd generations, etc.). Antipyretics are used to reduce body temperature. Pain can be treated with non-steroidal anti-inflammatory drugs, which can be taken orally in the form of tablets or buried in the ear.

Purulent otitis in a child is characterized by pain in the affected ear, fever and general weakness. With the timely appointment of treatment, the prognosis is favorable, since the infection is eliminated with the help of antibacterial agents. If parents have not sought medical help for a long time, then otitis media can become chronic, and also lead to complications, up to brain damage and deafness.


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