Bullous otitis in children and adults: treatment, symptoms

Viral diseases, especially during a flu epidemic, greatly weaken the body. The immune system cannot cope with the load, which often leads to complications and the spread of infection, and this is how bullous otitis occurs - a secondary pathology of the auricle with pronounced painful symptoms.

In most cases, otitis media affects young children due to the structure of the ear, but it also occurs in adults. Let's figure out what kind of disease this is and how to treat it effectively to avoid complications.

Types of bullous otitis

Bullous otitis is an inflammation of the ear of a viral nature. Unlike ordinary otitis, it occurs as a secondary reaction of the body to an infection. It is characterized by the formation in the ear canal of small bubbles filled with serous fluid or ichor - the so-called bullae.

The peak incidence occurs during the epidemiological period, so the pathology is often called influenza otitis.

Depending on the location of the inflammatory process, the following are distinguished:

Viral otitis media

Hearing is one of the most important senses, so its loss creates a lot of problems in human life. Hearing loss is caused by many factors, and if measures are not taken promptly, viral otitis media is no exception. As a rule, this pathology occurs spontaneously and is characterized by a rapid course with clearly distinguishable expressions.

Causes of otitis media in children

Viral otitis media cannot develop on its own; as a rule, it is a consequence of previous or concurrent respiratory diseases.

A decrease in protection is guaranteed to lead to the phenomenon that the infectious process from the throat or nose will spread to the ear or ears.

The mechanism of occurrence of this viral disease in a child differs from the mechanism of occurrence of a viral infection in adults in the rapidity of its course and aggravated manifestations.

The main predisposing factors for viral ear infections are:

hypothermia;
decreased body defenses;
somatic ailments;
special structure of organs - sinuses, nose, nasopharynx, ears;
exhaustion;
bad conditions;
the presence of parallel pathologies;
frequent respiratory relapses.

Among the reasons why a viral ear infection begins to develop, otitis media in a healthy child often includes the first visit to kindergarten.

In public institutions where there are many children, staphylococcal or streptococcal infections often occur, which first cause a runny nose, and then, as a consequence, an infection - ear inflammation.

The infection has another name - bullous otitis media, since the disease begins with the formation of vesicles filled with exudate inside the ear - bullae. Among other things, bullous acute otitis media, which begins spontaneously in young children, can develop into a purulent infection if left untreated.

Hypothermia.

Clinical signs

It is worth noting that ear infections can develop against the background of influenza, ARVI, and other viral diseases.

If a child falls ill with a respiratory disease, it is necessary to carefully examine the ear or ears along with the throat and nose to see if there is an infection in the ear, since influenza or acute respiratory viral infections rarely affect the child’s ears, and the lack of treatment for otitis media causes serious consequences. If there is an infection in the ears, the sign that you should first pay attention to is pain. If otitis media is caused by a viral outbreak of herpes, the ear will be filled with bubbles, they will be whitish in color and small in size. When the influenza virus is the provocateur, there will be blisters in the ear with bubbles, the size of peas, about three in number, with a serous-bloody consistency.

The main symptoms in a child:

unilateral or bilateral pain syndrome;
increased body temperature;
general weakness;
lethargy;
accompanying symptoms – runny nose, cough, wheezing;
lack of appetite;
itching

Viral acute otitis media can develop in weakened children for five days without any special manifestations, but body hyperthermia will be present. In adults, the latent form lasts longer - during the underlying illness, the ear or ears may not bother you for up to a week.

Important: if you suspect this disease, you cannot start treatment on your own. Your doctor should tell you in detail how to cure ear disease or eliminate any ear infection. You cannot ignore the signs of viral infectious otitis, even if the symptoms are just beginning and do not cause serious inconvenience.

Increased body temperature.

How to distinguish viral otitis from bacterial

The clinical picture of both pathologies is practically the same. Methods for identifying the disease also have a common foundation. The main difference is that viral otitis is born under the influence of a virus - herpes, parainfluenza, ARVI, influenza, rubella, Epstein-Barr virus. Bacterial otitis is a consequence of a bacterial infection:

thermal effects;
mechanical damage;
chemical injuries;
dermatitis;
eczema;
lack of personal hygiene;
fungal diseases;
allergy.

Also, ear infections of bacterial origin can occur as a complication of viral otitis.

Treatment methods

In order to determine which virus caused the disease, the otolaryngologist conducts a comprehensive examination:

blood serology for the presence of viral antibodies;
otomicroscopy;
bacterial culture of ear exudate;
death sample;
audiometry;
tympanometry.

In addition to laboratory tests, the doctor examines the ear to determine whether the bullae are viral.

When choosing the optimal means, medications, antiviral drugs for otitis media, they should be taken into account as a matter of priority, depending on the origin of the disease. To facilitate access to the painful area, the first step is to prescribe medications to eliminate pain.

To increase the body's resistance, the use of immunostimulants is indicated. If a severe course is observed, and there is a suspicion of hearing loss, it would be advisable to prescribe glucocorticosteroids.

The blisters are opened followed by the use of antiseptic agents.

Anti-edema medications and antiviral agents are recommended. Antiseptics are used to treat the tympanic cavity. Children are prescribed antibiotics to prevent the development of purulent otitis media. If the disease affects a child under one year of age, hospitalization cannot be refused due to the fact that the pathology is fraught with complications.

Local help consists of instilling anti-inflammatory drops. Antibacterial drops are recommended. Tampons or lotions inside the ear soaked in an astringent are also indicated. If there is an ear infection of bacterial origin, antibiotics are prescribed. Combine an antibiotic and a corticosteroid.

Otomicroscopy.

Folk remedies

Along with drug treatment, it is recommended to use medicinal plants. The following collection has good recommendations:

one part of the sequence;
four parts of yarrow;
two parts calendula;
four parts of plantain flowers;
four parts of eucalyptus leaves,
two parts each of pine needles and licorice root.

Mix the collection, then pour one teaspoon with 200 grams of boiling water and leave for half an hour. Drink throughout the day for a period of two or three weeks. With otitis, the body's resistance increases, the inflammatory process decreases, and prevents the appearance of purulent infection. The remaining mixture is heated and applied as a compress.

The following tincture is allowed for instillation:

plantain;
mint;
eucalyptus;
Sophora japonica daisy;
calendula.

A tincture of lemon balm and celandine is also prepared.

Heat sixty grams of vodka, dilute it with water, moisten the cloth, apply plastic film, cut it so that the structure fits through the ear - the cloth is applied to the parotid area, and the shell protrudes above the bandage. A thick layer of cotton wool is placed on top of the polyethylene and secured with a bandage. The auricle remains open, and a swab soaked in a weak alcohol solution is placed inside.

Treatment with folk remedies.

Pharmacy drugs

Despite the acceptable effect of using traditional medicine, pharmaceutical medications that should be taken should be known to every patient:

immunostimulants – Imunorix;
corticosteroids – Polydex;
for pain – Nurofen, Ketorol, Paracetamol, Ibuklin;
antiseptics – Lysozyme;
against bacterial infection - Ceforuxin, Erythromycin, Amoxicillin, Ciprofloxacin;
against viruses - Ingavirin, Kagocel, Tsitovir 3, Viferon;
against edema - Lasix, calcium chloride, Diazolin.

For local help, ointments and drops are used. Miramistin ointment, Otinum drops, Otipax, astringent - Burov's liquid.

Possible complications

If high virulence of the flora is recorded, there is a concern that the acute process may develop into a chronic form.

In this case, a purulent ear infection develops, the infection moves deeper, and bacteria damage the cavity located near the eardrum.

Thus, treatment becomes very difficult, since the pathology becomes insensitive to antibiotics and most drugs that could eliminate the mild stage.

One of the most common complications is damage to the facial nerve. Hearing loss or sensorineural pathology is also noted as irreversible consequences.

The transition to a chronic form leads to a labor-intensive treatment process and a long hospital stay. Often surgery becomes necessary.

The result of improper or self-treatment is an irreversible process of hearing loss for the child.

Damage to the facial nerve.

Prevention of otitis media

For infants, the danger lies in improper feeding, since with mother's milk the child receives not only nutrients, but also possible infections of the mother, which significantly reduces the baby's protective properties. Therefore, the first important factor in prevention is maternal health and proper feeding.

The common dangers for the occurrence of otitis media for both adults and children are respiratory diseases, therefore, to prevent pathologies, it is necessary to systematically strengthen the general immune system - consume only high-quality products, and do not resort to the help of unknown medications without a doctor’s prescription.

Also, you should not provoke the occurrence of other diseases - avoid hypothermia.

Among other things, prolonged exposure to the sun can lead to overheating of the body, and then a sharp decrease in body temperature, which is also fraught with the development of respiratory pathologies. Promptly remove the adenoids.

To increase resistance, an important condition is the consumption of foods rich in vitamins and nutrients. keep your nose and ears clean - avoid contamination.

What is viral otitis and how to treat it, detailed information is in the video.

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Source: https://nasmork.net/virusnyj-otit/

How does infection occur?

Bullous otitis is called viral because it develops against the background of a viral infection. Appears during the period of attenuation of the underlying disease:

flu;
herpes;
measles;

rubella;
ARVI;
mononucleosis.

Otitis media is more of a complication than an independent pathology. What happens in the body?

Viruses penetrate the blood and spread through the circulatory system; due to the close location of all ENT organs, they quickly enter through the nasopharynx into the ear canal.

Inflammation begins in the tissues, which over time is complicated by a bacterial infection. But this does not always happen; appropriate conditions are necessary for the virus to spread. Predisposing factors are:

low immune defense;
severe somatic diseases;
incorrect anatomical structure of the ear;
frequent colds;

uncontrolled chronic pathologies;
bad habits;
unbalanced diet;
unfavorable environmental and living conditions.

According to statistics, an outbreak of bullous otitis is recorded during an influenza epidemic. Complex therapy of the underlying disease is required to prevent complications.

“Bullous otitis in infants occurs very rapidly. The Eustachian tube at this age is much shorter and wider, pathogenic microflora is quickly carried into the ear. Unformed immunity adds to the problem. Treatment should be prompt, preferably in a hospital.”
Elena Vetochkina, pediatric ENT

Symptoms

The clinical picture of viral otitis is similar to ordinary acute otitis, so it is difficult to distinguish it on your own. The disease is characterized by:

itching and tension in the ear;
stuffiness in one ear;
painful sensations during swallowing;
sharp pain when pressing on the lobe;
serous discharge;
increased body temperature;
headache and dizziness.

A characteristic symptom of the bullous form is blisters filled with exudate. But they are not always visible during a superficial examination; instrumental diagnostics are required.

In childhood, especially while the child cannot voice complaints, you should pay attention to the following signs:

causeless crying;
constant head movements;
attempts to rub and touch the painful ear;
refusal to eat, in particular breastfeeding, due to severe pain;
poor and restless sleep;
increased body temperature;
nasal congestion;
bloody discharge from the ear.

In infants, there is a significant increase in symptoms at night.

If you suspect otitis in your baby, you should immediately call a pediatrician or go to the clinic. Self-diagnosis and treatment are prohibited.

In adults, the picture of the disease is usually blurry. Any discomfort in the ears is a reason to consult an otolaryngologist.

Diagnostic methods

Signs in a child

Diagnosis begins with a questioning of the patient and a visual examination of the hearing organs by an ENT doctor. To clarify the diagnosis, the following procedures are prescribed:

X-ray of the temporal lobe;
antibody test;
CT;
otomicroscopy;
bacterial culture of discharge from the ear.

If necessary, other tests are prescribed. The entire period of treatment for otitis takes place under regular monitoring of the patient’s hearing using audio or tympanometry (assessment of the condition of the eardrum using a probe).

Diagnostic methods

An accurate diagnosis in most cases is made based on visual examination. Using an otoscope, the doctor examines the internal structures of the ear.

Swelling, redness, deformation of the eardrum, bullae are clear signs of bullous otitis. Additionally, laboratory and hardware diagnostics are prescribed:

clinical blood test - shows the presence of an inflammatory process, increased levels of leukocytes and ESR;
bacterial culture for pathogenic microflora - analysis of exudate reveals the type of pathogen and the presence of bacteria in the ear canal;
enzyme immunoassay of blood - determines specific antibodies to pathogenic microorganisms;
otomicroscopy - a detailed examination of the ear canal with a special microscope for perforation of the eardrum and the general condition of the tissues;
audiometry – sound tests to measure hearing acuity using live speech or an audiometer;
impedance testing - checking the degree of hearing impairment using air pressure;
radiography, magnetic resonance imaging of the temporal region - auxiliary diagnostics for identifying intracranial complications.

The examination is painless, but quite informative, but allows you to quickly make the correct diagnosis and select effective treatment.

Symptoms

With bullous otitis media, the vesicles are localized on the eardrum and on the walls of the ear canal, usually close to the membrane. Like any abscess, bullae that appear in the ear canal cause discomfort. Often the disease is accompanied by mild pain in the ear canal, which can also be felt as localized in the depths of the ear.

In size, bullae can range from very small - about 1 mm in diameter - to very large - the size of a pea. With a large bulla, painful and unpleasant sensations increase and can go beyond the limits of what is relatively tolerable. This is especially true for children, in whom pain is always perceived acutely.

One of the pronounced symptoms of otitis in the bullous form is itching in the ear, which increases every day. The itching stops after the bulla ruptures, which may be accompanied by slight watery and sanguineous discharge from the ear canal. The bulla may not rupture, but dissolve on its own.

Thus, bullous otitis media is characterized by the following symptoms, localized in the external auditory canal:

Unpleasant sensations
Pain
Itching
Ear discharge

If bullous otitis develops against the background of an infectious disease, then additional symptoms occur, such as increased body temperature, weakness and malaise, and indigestion.

Treatment methods

Bullous otitis media is successfully treated conservatively. Local remedies and systemic drugs are used to comprehensively eliminate the cause and painful symptoms.

Drug therapy includes:

Group of drugs	Purpose	Name of medicine
Nonsteroidal anti-inflammatory drugs, NSAIDs	Pain reliever, relieve fever, reduce inflammation	Ibuklin, Nurofen, Ibuprofen, Paracetamol
Antiviral, immunomodulators	Activate the body's defenses and fight viruses	Nazoferon, Interferon, Laferon
Antibiotics	Destroy bacterial microflora, prevent purulent complications	Amoxicillin, Ciprofloxacin, Augmentin
Antiseptics	Disinfect the ear cavity after voluntary or surgical opening of bullae	Chlorhexidine, Miramistin, Lysozyme
Antihistamines	Relieves allergic reactions, relieves swelling of tissues	Suprastin, Claritin, Fenistil
Antimicrobial	Cleans the ear canal, reduces inflammation	Anauran, Otinum, Otipax

For a speedy recovery, it is recommended to stay in bed and take vitamin complexes. Under favorable conditions, the disease completely recedes after 10-14 days.

“An important recommendation to parents: do not self-medicate your baby. Do not try to examine your ears with cotton swabs or other objects, do not use boric alcohol or ear drops. Without a doctor’s recommendation, you cannot make warm compresses, especially alcohol ones. Thermal procedures can aggravate inflammation and cause suppuration. And wrong actions can cause irreversible hearing damage.”
Tatyana Kotova, otolaryngologist

Treatment options

To get rid of bullous otitis, complex methods of local and systemic therapy are used:

Pain relief with Nurofen, ketonal, or another non-steroidal anti-inflammatory drug;
Antiviral ointments Acyclovir or Zovirax, as well as drops for the ears and nose;
Miramistin for ear disinfection;
Immunomodulators, vitamins - in order to increase the body’s resistance to pathogenic flora;
Opening of bullous papules and vesicles;
If a bacterial infection occurs, the doctor prescribes antibiotics;
Laser therapy and physiotherapy are prescribed as necessary.

It is unacceptable to use traditional medicine methods without the permission of a doctor: warming compresses, drops made at home from calendula, celandine, aloe, and other plants.

If a child is sick, it is also forbidden to take pills and use the remedies that neighbor children received for otitis media; drugs and procedures for treatment are always prescribed individually for each patient.

Pharmacy drugs

Conservative therapy for bullous otitis involves the use of various pharmaceutical groups, depending on the symptoms. At the initial stage, the patient is prescribed antipyretic and painkillers (Analgin, Paracetamol, Ibuprofen) in combination with Otipax, Otinum or other similar drops.

The following may also be prescribed:

immunomodulators. For example, Interferon;
antihistamines (Claritin, Suprastin) are used to reduce itching;
in case of bacterial infection, antibiotics are indicated (Amoxicillin, Augmentin, Cefuroxime);
antibacterial drops (Anauran, Sofradex, Normax). Not only destroy pathogenic microorganisms, but also relieve inflammation, have an analgesic and anti-allergic effect;
antiseptics are used to clean the ear canal: hydrogen peroxide, boric acid;
nasal breathing will help restore vasoconstrictors: Nazivin, Sanorin;
corticosteroids (Polydex) stop inflammation in tissues.

All drug names are given for informational purposes. Taking them without a doctor’s prescription is unacceptable!

Drug treatment can be supplemented with physical therapy.

Cephalosporins Division

To cure viral otitis media, drops are needed that destroy bacteria. Antibacterial drops suppress bacterial activity and also have an anti-inflammatory effect. They have analgesic properties, antifungal effects and cope well with allergic reactions. If a disease such as viral otitis occurs, only a doctor can prescribe treatment. There is no need to self-medicate so as not to harm yourself. If treatment is not started on time, hearing loss is possible. If necessary, the doctor can open the bull. After opening it needs to be processed. Treatment should be carried out with antiseptic ointments.
In order to clean the ear canal of secretions, tampons are made from gauze, and turunds, which are flagella, are used to clean the ear cavity. They are moistened in a solution of furatsilin or hydrogen peroxide. Such procedures give a good effect. If you instill a 3% boric acid solution into the ear for such a disease, the healing process will go faster.
To restore the sharpness of your hearing, you need to restore the Eustachian tube. For this treatment the following is prescribed:

blowing the auditory tubes using a Politzer balloon, this washing procedure goes through the nostril;
lavage and catheterization;
use vasodilating nasal drops or spray. With their help, rhinitis is cured and nasal breathing is restored to normal.

Folk remedies for treating otitis

Onions with butter. For purulent otitis media, prepare a pulp or juice from onions, add a little flaxseed oil or butter. Insert the freshly prepared mixture with a tampon into the ear. Chamomile. For otitis media, you need to rinse with a warm infusion of chamomile - 1 teaspoon of dry herb to 1 glass of hot water. Let it brew and strain. If the pain is very severe, you need to consult a doctor, as the inflammatory process can spread to the periosteum and cause inflammation of the meninges. So be very careful.

Collection. Mix angelica, spiked lavender, peppermint - 3 tablespoons each, sweet clover - 2 tablespoons, ivy bud (POISON!) - 1 tablespoon. Pour the mixture into 0.5 liters of boiling water, but it is better to insist on vodka. Moisten the swab and place it in the sore ear. Use only externally for otitis media and hearing loss.

Juice from walnut leaves. For purulent otitis, instill 3 drops in 1 ear into the ear.

Juice from fresh basil leaves. Instill 7-10 drops into the sore ear several times a day.

Sweet clover herb and chamomile flowers. Take in equal parts. Pour 2 tablespoons of the mixture into 1 cup of boiling water, leave for 30 minutes, then strain. Soak a cloth in the infusion, squeeze lightly, and apply as a compress.

Rhizome of common calamus, oak bark, rhizome of cinquefoil erect, thyme herb. Take in equal parts. Wrap 2 tablespoons of the mixture in a cloth, place in a glass of boiling water for 3-4 minutes, then squeeze. Apply poultices 3-4 times a day.

Rhizome of Burnet officinalis. Pour 2 tablespoons with 2 cups of boiling water, heat in a water bath for 30 minutes, leave for 15 minutes, strain. Drink 1 tablespoon 3-4 times a day for purulent otitis media.

Important!!! If you have symptoms of otitis media, you should urgently consult a doctor who will correctly diagnose and prescribe the correct treatment.

Child therapy

Treatment of viral otitis in children is carried out mainly in a hospital, which is due to the severe course of the disease at an early age. Against the background of weakened immunity, viral pathogens are associated with a bacterial infection in 90% of cases. For this reason, treatment is carried out using antibacterial agents such as Cefuroxime or Ceftriaxone.

To eliminate hyperthermia, gentle antipyretics are used, namely:

"Calpol";
"Vibrukol";
"Panadol";
"Mexalen";
"Dofalgan."

Important! It is strictly not recommended to use Aspirin, Phenacetin, Antipyrin or Analgin as antipyretics in pediatric therapy.

If a large amount of pus accumulates in the tympanic cavity, the otolaryngologist can perform paracentesis, i.e. membrane puncture. This will help evacuate the pus and alleviate the symptoms of the disease. This procedure does not entail hearing loss due to the good regenerative ability of the eardrum.

Possible consequences and complications

Influenza otitis is acute, but with timely treatment it resolves without complications. Negative consequences usually develop when you visit a doctor late or your body is weakened. Among the most dangerous are:

sensorineural hearing loss;
complete hearing loss;
purulent otitis with tissue necrosis;
meningitis;

mastoiditis;
brain abscess;
facial paralysis;
myringitis.

Such complications are rarely recorded, but they are possible if the infection is not stopped in time.

Careful diagnosis and strict adherence to medical prescriptions for bullous otitis media are the main conditions for a quick recovery and the prevention of serious hearing problems.

Prevention methods

The main factor in the development of viral otitis is low immunity. Preventive measures should be aimed at increasing the body's defenses. Then the risk of infection and otitis media will be significantly reduced, and the disease itself will pass in a mild form without consequences.

The recommendations of experts come down to several important points:

protect yourself as much as possible from viruses during a flu epidemic, wear a mask, avoid large crowds of people, and carry out preliminary vaccination;
promptly treat colds and chronic diseases;
do not take immunosuppressants or antibiotics without a doctor’s prescription;
perform proper hygiene procedures, do not use chopsticks and sharp objects;
do not overcool, wear a hat in the cold season;
do not abuse alcoholic beverages or smoking;
eat a balanced diet, eat vegetables, fruits, avoid junk food;
strengthen the body with moderate physical activity, walking in the fresh air.

Such prevention is useful not only for preventing otitis media, but also for the body as a whole.

Important conclusions: how to avoid getting infected with bullous otitis media

The viral origin of bullous otitis suggests the presence of infection in the respiratory tract. Low immunity and a weakened body contribute to the spread of the disease and the development of complications.

To protect yourself and your children from the disease, you should lead a healthy lifestyle and properly treat the flu. If an inflammatory process in the ear does occur, carry out timely complex therapy on the recommendation of an otolaryngologist.

Complications in the form of hearing impairment are unlikely with an adequate approach to maintaining your own health.

Possible complications

Untreated bullous otitis media or frequent relapses of the pathology lead to the disease becoming chronic. In this case, the signs of the disease constantly return, and the person begins to suffer from hearing loss. It is quite difficult to cure the chronic form of otitis media; the process will take a lot of time. Often it is necessary to perform surgical operations.

What consequences can happen if bullous otitis media is not treated on time?

Inflammation can spread to the facial part, resulting in paralysis and asymmetry.
Deafness appears, which cannot always be cured. With internal inflammation, the patient may experience complete deafness. Sometimes even surgery does not help restore hearing. Deafness is caused by destruction of the auditory bones, tympanic membrane, and labyrinth.
The inflammatory process in the organ of hearing is also dangerous due to loss of coordination, dizziness and headaches. These consequences are caused by the transition of inflammation to the vestibular apparatus.

In rare cases, the infection spreads to the brain, causing meningitis and an abscess. These phenomena are fraught with death.