Many people are interested in whether it can be otitis without temperature. Indeed, the classic symptoms of this pathology in the minds of most people are high fever and pain. But in fact, in some forms of the disease, the temperature may remain normal or increase slightly.
Types and causes of the disease
Many do not understand whether otitis occurs without fever. To begin with, it should be noted that otitis media is an inflammatory disease in one of the departments of the ear. From an anatomical point of view, the ear really consists of several departments that perform different functions, and inflammation can begin in any of them.
The auricle is the so-called outer ear that picks up vibrations of sound and directs them into the ear canal, ending in the eardrum. Inflammation of this department is otitis externa. Without pain and temperature, just this form of the disease most often occurs. Although pain can occur, but mainly with pressure.
The middle ear begins behind the eardrum. Its main function is to conduct sound. It consists of a tympanic cavity, in which small sound bones are located - the so-called stirrup, hammer, and anvil. Otitis media without temperature occurs mainly at the beginning of the disease.
Behind the base, the stapes begins the inner ear, which is a complex system of channels. Actually, it is here that the auditory organ itself, called the cochlea, is located because of the specific shape of the channels filled with hair cells and a specific fluid. Otitis media rarely occurs without fever. And most often it is a complication of otitis media.
Otitis externa
Considering otitis without temperature in a child, Komarovsky (a famous pediatrician) mentions primarily the external form. In adults, external otitis media also proceeds without an increase in temperature. The prevalence of this form of the disease is about 10%. The development of otitis externa occurs due to infection of the surface of the auricle with fungi or pathogenic bacteria.
Among the factors that provoke this disease include:
- hypothermia of the outer ear, which often happens during walks in frosty weather;
- mechanical injury to the sink;
- improper removal of sulfur from the ear canal;
- the ingress of water, especially already containing pathogenic bacteria, into the ear canal.
In general, pathogenic microbes in the outer ear feel quite good, since they usually create excellent conditions for their reproduction - it is warm and humid enough for this.
External otitis media often develops simultaneously with diseases such as candidiasis (if we are talking about a fungal infection), dermatitis, furunculosis. The latter means that there is inflammation of the sebaceous glands.
The main symptom of external otitis media is pain that occurs when pressure is applied to a problem area. Hearing loss does not occur. External otitis without temperature in an adult is a fairly common phenomenon, but in children it also develops without heat. The exception is those cases when the inflammation gradually spreads to the eardrum or when purulent processes begin.
The diagnosis in any case should be made by the doctor. Usually, an inspection using a special device, an otoscope, is enough for this.
Treatment is selected depending on which particular infection caused the disease. As a rule, the doctor prescribes antibiotics and antiseptics, and not in the form of tablets, but in the form of ear drops. For example, such products as Otinum or Otipaks, as well as Polydex, have proven themselves well. If the infection does not affect the ear canal itself, then appropriate ointments and creams can be used, including those with glucocorticosteroids.
Is it possible to walk with otitis without temperature, if we are talking about inflammation of the outer ear - this question is asked especially often. After all, as already mentioned, hypothermia contributes to the development of this disease. In fact, if there is no frost on the street, and the patient is dressed for the weather, there will be no harm from walking in the fresh air.
Nevertheless, treatment of external otitis media needs to be given special attention, since complications are possible with it - the transition of inflammation to the middle ear, and this is a more serious pathology.
Otitis media in adults
The most common form in children and adults is otitis media. Many believe that it develops only with a cold. Indeed, very often it becomes a consequence of ARVI. Among the factors provoking it also include hypothermia, including those caused by drafts, bacterial and fungal infections. With a severe cold, otitis media can be a consequence of the accumulation of mucus in the ear cavity. In such cases, air does not circulate well in the nasopharynx, and mucus enters the ear very easily.
With colds, the temperature may rise. But otitis media can be caused not only by it. There is, for example, the concept of "aerootite" - this form of the disease develops when pressure drops occur during take-off or landing, although there are no problems with the flight itself. The form of otitis media experienced by divers is approximately the same mechanism (this is called the swimmer’s ear). Due to pressure drops over time, the effects of constant microtraumas appear inside the ear, the mucous membrane is irritated, produces mucus and fluid in large quantities, which leads to an inflammatory process and pain, but without temperature.
Many believe that otitis media develops mainly in the cold. Indeed, hypothermia in winter is more likely, but an inflammatory process can occur at any time of the year. It is clear that in wet and windy weather its probability is much higher. But in the summer, with temperature changes, transitions to a room with air conditioning, this is also quite possible.
The main symptom of the disease is pain. However, they themselves do not yet speak about the development of otitis media. The fact is that pain can occur with various injuries, its cause may be sulfur cork, it may be associated with inflammation of the facial nerve or with diseases of the teeth. It happens that pain is accompanied by inflammation of the salivary glands. So the diagnosis must certainly be made by the doctor.
So, inflammation of the middle ear is accompanied by painful sensations. Moreover, the pain can be both acute and shooting. Pain is not always felt directly in the ear. It can give to the crown of the head or temple. Sometimes the pain is pulsating in nature, then subsides, then intensifies. There may be a feeling of stuffiness in the ear, sometimes there is a phenomenon of autophony, the characteristic audibility of one’s own voice, but most often only an indefinite noise is heard, and the hearing deteriorates. Otitis may also be accompanied by swelling of the tissues and headaches. If there is no SARS or the flu, then the temperature may not rise.
To relieve puffiness, adults are prescribed glucocorticosteroids, for example, prednisone or hydrocortisone. As for the funds directly from otitis media, since it is most often caused by a bacterial infection, antibiotics of the penicillin, cephalosporin or macrolide series are prescribed in such cases. However, cephalosporin is considered an ototoxic drug, it can not be instilled directly into the ear, especially if there is damage to the eardrum. As for antiseptics, miramistin is considered the best choice.
Otitis media in babies
Is there otitis without a temperature in a child? This question is often asked by parents. In fact, if there is no SARS, then such a situation is quite possible. Moreover, in children of the first year of life, otitis media can be associated even with teething. It provokes swelling of the nasal mucosa, which leads to the development of the inflammatory process. Therefore, when teething, you need to be especially careful and try to clean the mucus from the nasal passages as often as possible so that it does not get into the middle ear.
In older children, the causes of otitis media will be the same as in adults, that is, colds and sudden changes in pressure on the eardrum (like the swimmer’s ear and aerootitis mentioned above). Mechanical injuries are also possible, especially in children, who often pick in the ear with a pencil or other similar object. Parents should follow this, explain that this should not be done.
Thus, in children, otitis media is very rarely an independent disease, and most often develops as a consequence of acute respiratory viral infections or colds. Why is this happening? Not all children are good at blowing their nose, and with a runny nose they begin to sniff especially actively. As a result, mucus with pathogenic microbes or a virus enters the lumen of the Eustachian tube. This leads to the inflammatory process in the middle ear.
In children, this disease develops more often than in adults. This is due to the fact that the Eustachian tube in the child is much narrower, and therefore any diseases associated with impaired patency are more likely to occur. The development of otitis is also facilitated by the fact that babies cry more often, sniff noses, and many children have enlarged adenoids, which leads to squeezing the Eustachian tube.
The most common causative agents of otitis media in children are pathogenic bacteria such as hemophilus bacillus, pneumococci and moraxella. Viral and fungal infections occur less frequently.
Otitis media never goes unnoticed. At the first stage of the disease, severe enough pain occurs, hearing impairment can be observed. Until bacteria enter the tympanum, there may not be temperature. The hit rate can be different - sometimes this happens after a few hours, but it can take several days. When bacteria begin to multiply in the tympanic cavity, otitis media passes into a purulent form. At this stage, the pain increases, there is an increase in temperature.
When the tympanic cavity is filled with mucus, the pressure on the membrane rises, and after some time its rupture may occur. Purulent fluid seeps out through the opening hole through the auditory canal. When this happens, the temperature drops again, the pain decreases.
At this stage, many parents believe that the child has already recovered and treatment can be stopped, but in fact this is not so, and antibiotics and ear drops should be used exactly as much as the doctor said. In general, drugs are taken until discharge from the ear continues, as this indicates that pathogenic bacteria still remain in the tympanic cavity.
Even if there is no temperature, otitis media in a child is manifested by severe pain. Kids become moody, they cry, lose their appetite, cannot sleep. Older children complain of congestion, of vague tinnitus. Many pediatricians advise parents to conduct a home test - pressure on the tragus, which provokes increased pain (the child in this case will respond with crying or can tell parents that the pain has intensified).
Drug treatment of otitis media in children
Treatment of otitis media without temperature differs only in that in this case it is not necessary to give the child antipyretic drugs. In any case, until recently, antibiotics were considered the preferred option, although theoretically, otitis media can pass without them. Currently, it has been proven that bacterial infection causes inflammation in 60% of cases, and in the rest it is caused by viruses that are not affected by antibiotics. Therefore, when prescribing antibiotics, the doctor assesses the health status of the child, analyzes factors such as the presence or absence of temperature, the nature of the pain, the age of the baby.
Even if it is otitis in an infant without a fever, the doctor will most likely prescribe an antibiotic, in the form of tablets or suspensions, since the injections are worse for babies, and the effectiveness in the injection form is not higher. Such drugs are certainly prescribed in the presence of purulent discharge. True, purulent otitis without temperature in a child usually does not leak, but is accompanied by fever and generally requires hospitalization. This form of the disease may also require tympanocentesis, that is, a puncture of the tympanic membrane to cleanse pus. Fortunately, the latter is not required so often.
In treatment with antibiotics, including infants, Amoxicillin + Clavulanate is used, since it is considered the safest, and in addition, it affects almost all bacteria that can cause otitis media.
If the temperature does not rise, and the child is already two years old, the doctor can prescribe only ear drops, for the most part, these are mainly the antiseptics mentioned above containing alcohol, for example, Otipaks.
But if they do not relieve the pain, then the doctor will prescribe non-steroidal anti-inflammatory drugs. This is mainly ibuprofen - in the form of a children's Nurofen, produced in the form of syrup. Many believe that if there is no temperature, such a drug is useless, but it is not so - it will relieve inflammation and pain, although it will not be able to completely eliminate its cause.
If it is necessary to improve patency of the auditory tube, then vasoconstrictive drops are used, for example, Otrivin. They are usually used to treat a runny nose, but are also suitable for these purposes.
If there is otitis in a child without fever, treatment will be effective only with proper use of ear drops. The medicine needs to be warmed up a little. The child should be placed on its side and instilled 3-4 drops in the ear canal. Doctors recommend moving the auricle slightly so that the drug reaches the eardrum faster. After that, you need to wait 1-2 minutes and only after that move to the other ear. In the presence of discharge from the ear, it is impossible to apply the mentioned drops.
At the same time, rhinitis itself is also very important to treat in order to relieve swelling of the auditory tube and nasal mucosa. Then the exudate will come out naturally, and this will prevent the development of a purulent form. To do this, it is important to rinse your nose. But this must be done very carefully so that the liquid does not enter the middle ear through the auditory tube, because this will only aggravate the inflammation.
It is very important to ensure that during runny nose the mucus does not thicken and clog the Eustachian tube. To do this, it is necessary to ensure sufficient humidity in the room, frequent ventilation, it is also important that there is no shortage of fluid in the body, that is, the child should drink enough clean water. And you also need to observe moderation when blowing your nose so that there are no pressure drops.
Physiotherapeutic methods for otitis media
In order to prevent hearing loss, pipe blowing and pneumatic massage are performed. Traditional methods such as ultraviolet radiation (UV) and UHF therapy give good results. In recent years, such a procedure as laser therapy has been popular. It is important to remember that all of these methods can only be used if the patient does not have a fever.
Such procedures are usually done in the clinic, as well as warming compresses. By the way, without the permission of the doctor, such compresses can not be done at all, since in some cases they can lead to the development of quite serious complications.
Surgical interventions and prevention of otitis media
If the child encounters otitis media more than three times within six months, the doctor may prescribe an ear shunt. To do this, a very small incision is made in the eardrum, and fluid is sucked out of the ear through it. A small tube is inserted into this incision, through which the accumulated liquid seeps out for some time.
After six months, the doctor will remove the device and the incision will heal. However, such bypass surgery does not guarantee that otitis media will never recur. Therefore, it is so important to increase the immunity of the child, to ensure that there is no hypothermia, to protect the baby from the effects of other provoking factors.
Describing otitis without temperature in a child, Komarovsky says the same. But a well-known pediatrician warns that alternative methods of treatment, ranging from hot compresses and heating pads to urinotherapy, that is, using urine, can aggravate inflammation and lead to serious complications, including purulent meningitis.
What can be done with otitis media and what cannot be
In practice, parents are often worried about the question of whether it is possible to walk with otitis without temperature. In fact, there are no contraindications to this, unless the weather is nice, there is no strong wind or frost. , , . , . , .
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Of course, in each case, parents must decide for themselves whether it is possible to walk with otitis without temperature or not, whether it is worth traveling or not. For example, if there are any complications, it is better to first show the child to the doctor, and only then decide whether to go for a walk. Fortunately, in most cases, if the otitis media was detected on time, and if the parents comply with all the doctor’s recommendations, then after a day the pain disappears, and after a week there is no trace of inflammation.
The main mistakes in the treatment of otitis media
Many parents do not know very well how otitis media runs without a child’s temperature, the symptoms do not always include severe pain, and therefore they make a mistake - they rely only on a home “test” with a click on the tragus of the ear. But in fact, he can not always give a good result. The fact is that young children simply cannot explain for themselves how they feel in one or another case. Therefore, you need to look at the behavior of the child in time to discern other symptoms.
For example, a baby can be laid on a barrel, on the side where the ear hurts, because it makes it easier for him. Some children shake their heads or rub their hand over a sore ear. In addition, symptoms of poisoning can occur with otitis media, including abdominal pain, vomiting, and diarrhea.
There are other common mistakes that should be avoided:
- Self-selection of drops. Very often, parents do not call a doctor, but simply go to the pharmacy and ask for a drop. This cannot be done. Of course, purulent otitis media does not develop in a child without temperature, but there may be damage to the eardrum, which does not appear externally, and drops in this case can only do harm.
- Incorrect administration of drops. This may be due to the fact that the drops were not previously warmed up, and when cooled, they act too slowly, and the fact that the entire bottle was immediately placed in hot water or boiling water - this could ruin the medicine. It’s best to just warm the bubble in your hand to body temperature. In addition, many parents do not withstand enough time for the drops to reach the desired site.
- Drops with antibiotics are injected into the ear if there is no opening in the membrane. This means that there is no hole on it, liquids do not pass through it, and the antibiotic simply does not get to the desired site.
- The use of folk remedies, including warming vodka compresses from several layers of gauze. The latter can be put only after consulting a doctor, a maximum of twice a day and no longer than three hours. You can not put a compress at night.
- Ignoring the common cold. Many parents do not pay enough attention to its treatment, and without this, mucus will inevitably fall into the auditory tube, causing the next round of the inflammatory process. To treat a runny nose, it is very important to teach the child to blow his nose properly, releasing the blocked nostrils in turn, in order to prevent pressure drops.
Many parents believe that since you need dry heat, you need to put on a hat or scarf and leave them even for the night. But this just cannot be done. In a dream, a child's head may sweat, and then even with a slight hint of a draft, he will catch a cold. So to treat otitis media, overheating is just as important as overcooling.
In the treatment of adults, errors may also be made. And the most important of them is that they do not treat inflammation, but wait in the hope that it will pass by itself. This cannot be done, otherwise dangerous complications such as hearing loss (or even complete loss), blood poisoning, or encephalitis can occur.
Conclusion
Otitis media without temperature is a common disease that requires skilled care. It is impossible to ignore such a problem in any case, since with the development of complications, therapy will be long and difficult.
It is also necessary to consider that only complex treatment is able to give a positive result. Self-medication and the use of unknown drugs, and especially folk remedies, are not recommended, since only a specialist, based on the results of the examination, is able to prescribe the correct therapy and help the patient as soon as possible and without harm to health.