Why does a child get an ear infection just a few weeks after getting over one? Is it the recurrence of first infection with the same bacteria or is it due to a different organism? Did the antibiotic not work or was the wrong one prescribed?
Culturing the fluid behind the ear drum is the best way to know exactly what's causing an ear infection. Tympanocentesis (making a small hole in the ear drum) is the only way to obtain middle ear fluid. Doctors at Ben-Gurion University in Israel followed 1,077 infants, 3 to 36 months old, with ear infections. The infants had a tympanocentesis on the day of diagnosis and again four to six days later. All were treated with antibiotics. The children were followed for three to four weeks. If any developed a second ear infection, another tympanocentesis and culture were done.
They called the second infection a relapse if the second culture grew the same bacteria as the first one. It was a new infection if the bacteria was different or if no bacteria grew the first time and a bacteria grew in the second culture.
Out of the original 1077 children with ear infections, 108 had a second infection within three to four weeks of the first. Relapses occurred in only 30 (28%) of the children. The remaining 78 had infections with a different bacteria. Infections that occur within 14 days of the first one are more likely to be a true recurrence than infections occurring later, but even most of these are not.
When a child seems to have one ear infection after another, it may not be recurrences of the original infection. More likely, each infection is due to a different bacteria.
The Pediatrics Infectious Disease Journal, 3/03, pp. 209-16.
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