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Ear Infection Diagnosis

Ear infection diagnosis is usually rather straightforward.

A physician can diagnose and treat ear infections. [© Shutterstock, 2010]
© Shutterstock, 2010
A physician can diagnose and treat ear infections.

Ear Infection Diagnosis

Ear infection diagnosis is usually rather straightforward, with the main symptom for both middle ear and outer ear infections being pain in the ear. Doctors can usually determine the type of infection by simply examining the ear. Although diagnosis is generally straightforward, sometimes a patient may have symptoms of an outer ear infection when the actual cause is a middle ear infection.

Indications of Middle Ear Infection

Parents often think that when a child tugs on the ear, it is a sign of ear infection. But observing this behavior in a child is not a reliable way to diagnose an infection. The University of Maryland Medical Center notes studies have shown children tug on their ears in equal numbers when visiting the doctor whether or not they have an ear infection. However, at-home diagnosis of middle ear infection may be possible with the help of an electric ear monitor. This type of monitor is available at pharmacies and can detect fluid behind the eardrum, which is present with a middle ear infection.

Accurate diagnosis, though, should be left up to a doctor. Before diagnosing an ear infection, the doctor will ask about any history of infection, will look for symptoms of a cold or allergies and will examine the patients sinuses, throat, neck and lungs. The doctor will also look for inflammation in the ear with an otoscope, a lighted instrument with magnification. An infected ear may also be red or dull and contain air bubbles or fluid behind the eardrum. The doctor will also look for signs of a hole in the eardrum.

If fluid has been in the middle ear for an extended period of time, additional tests may be in order. Such tests may include a tympanometry test and an acoustic reflectometry test, both of which measure the amount of fluid in the ear but in different ways. During a tympanometry test, a doctor inserts a special plug into the patients ear, which alters the ears air pressure. A mechanism then measures the amount of movement in the eardrum in response to the change in pressure. An acoustic reflectometry test measures the way different sound frequencies are reflected off the inside of the ear to determine how much fluid is inside.

Two Types of Middle Ear Infection

In addition to making a general diagnosis of middle ear infection, or otitis media, doctors must determine whether a patient has acute otitis media or otitis media with effusion. Acute otitis media is a short, painful middle ear infection that is characterized by swelling in parts of the ear, as well as trapped fluid and mucus in the ear. Otitis media with effusion, or middle ear infection with fluid, occurs when fluid remains in the ear after the infection has resolved. With fluid left in the ear, there is a greater risk developing another infection. Therefore, treatment may be required in order to remove the fluid.

The American Academy of Pediatrics recommends doctors use pneumatic otoscopy to accurately distinguishing between the two types of infection. A pneumatic otoscope is an instrument that blows air into the eardrum to test for movement. If the eardrum does not move very much, there is likely fluid behind the eardrum, indicating otitis media with effusion.

Indications of Outer Ear Infection

According to Oregon Health & Sciences University, an outer ear infection is the most common childhood illness in the United States. When an individual has an outer ear infection, commonly called swimmers ear, touching or moving the outer ear can prove rather painful. A doctor will diagnose this condition by asking some questions and examining the ear canal with an otoscope. The doctor will look to see if the ear appears red and swollen inside. The ear canal might also appear scaly or flaky, and the eardrum may be red.

The doctor will then examine the condition of the eardrum to see whether it is damaged. If the eardrum is blocked, the doctor may have to first clear the ear canal in order to perform the examination. A damaged or torn eardrum will mean a referral to an ear, nose and throat specialist, who will perform further tests and examinations to determine whether the primary infection site is in the outer or middle ear. Occasionally, a sample of discharge from the ear must be analyzed to accurately determine the cause of infection. For example, this may be necessary in cases wherein a course of treatment does not lead to symptom improvement.

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