A middle ear infection, also known as acute otitis media, is an infection of your middle ear. This space behind your eardrum contains tiny vibrating bones and the air-filled space between them. Ear infections are more common in children than in adults.

Ear infections are often self-healing; the treatment can begin with pain management and monitoring. Sometimes may require antibiotics to treat the infection. Unfortunately, multiple ear infections are common in some people, leading to hearing problems or other serious complications.

Ear Infection Symptoms

Symptoms of an ear infection usually appear quickly.

Ear Infection Symptoms in Children

Children often experience the following signs and symptoms:

  • Especially when you are lying down, ear pain
  • Pulling at or tugging on an ear
  • Trouble sleeping
  • More crying than usual
  • Fussiness
  • Problems hearing and responding to sounds
  • Balance loss
  • Fever above 100 F (38 C or higher)
  • Drainage of fluid from the ears
  • Headache
  • Appetite loss

Ear Infection Symptoms in Adults

The following are common signs and symptoms for adults:

  • Pain in the ear
  • Drainage of fluid from the ears
  • Hearing problems

When should you see a doctor?

Ear infections can be a sign of many conditions. Therefore, it is important to receive prompt treatment and a diagnosis. If your child is experiencing the following symptoms, get in touch with your doctor immediately.

  • The symptoms last more than one day
  • A child younger than six months old may have symptoms
  • Severe ear pain can be severe
  • After a cold or another upper respiratory infection, your infant or toddler may become sleepy or irritable.
  • The ear may be leaking fluid, pus, or bloody fluid.


A virus or bacterium can cause a middle ear infection ( Trusted source). The infection is often caused by a virus or bacterium in the middle ear.

Role of the eustachian tube

The eustachian tube is a pair of narrow tubes that run from the middle ear to the back of your throat, just behind the nasal passages. The tube’s throat ends open and close to:

  • Can adjust Air pressure in the middle of the ear
  • Refresh the ear
  • Should drain Normal secretions from the middle of the ear 

Fluids can build up in the middle of the ear from blocked eustachian tubes. The fluid may become infected and lead to an ear infection.

Children’s eustachian tubes are more narrow and horizontal than adults, making it more difficult for them to drain and more susceptible to becoming clogged.

The role of adenoids

Two small, overlapping tissue pads at the back of your nose are called Adenoids. They are believed to play an essential role in your immune system activity.

Adenoids are located near the openings of the Eustachian tubes, which can cause swelling. It could lead to middle ear infections. Children have more adenoids than adults, so swelling and irritation can lead to ear infections.

Similar conditions

The following conditions may affect the middle ear.

  • Otitis media without effusion, swelling, and fluid buildup in the middle of the ear. It could be because fluid buildup persists even after an ear infection has cleared. A dysfunctional or non-infectious blockage could also cause it in the eustachian tube.
  • Chronic medial otitis media (or effusion) is a condition in which fluid remains in the middle of the ear and returns without bacterial or viral infection. Children are more susceptible to ear infections, which can lead to hearing loss.
  • Chronic, suppurative media otitis media is an ear infection that won’t heal with the standard treatments. This could lead to a hole or ringing in the eardrum.

Risk factors

Ear infections are possible due to the following risk factors:

  • Age. Children aged six months to 2 years are more likely to get ear infections due to the shape and size of their Eustachian tube and their developing immune system.
  • Group child-care. Children cared for in group settings have a higher chance of getting ear and cold infections than children left at home. Children in group settings are more likely to get the common cold.
  • Infant feeding. Babies who eat from a bottle, mainly while lying down, have more ear infections than breastfed babies.
  • Seasonal factors. Most common in the fall and winter. Seasonal allergies can increase the risk of ear infections with high pollen counts.
  • Low-quality air. High pollution levels and tobacco smoke can increase the chance of developing ear infections.
  • Alaska Native heritage. Infections of the ears are more common in Alaska Natives.
  • Cleft palate. It may be more difficult to drain the eustachian tubes in children with cleft palates.


Most ear infections don’t cause long-term complications. However, recurrent ear infections can cause serious complications.

  • Hearing loss. Mild hearing impairment. It is pretty common to have mild hearing loss after an ear infection. However, it will usually improve once the infection has cleared. Fluid in the middle ear or ear infections that occur repeatedly may cause more severe hearing loss. Permanent hearing loss can occur if there is permanent damage to the eardrum and other structures in the middle ear.
  • Speech and developmental delays. Infants and toddlers may struggle with speech, social, and developmental skills.
  • The infection spreads to other tissues. Mastoiditis is an infection of the mastoid (the bony protrusion behind your ear). The infection can cause bone damage and pus-filled cyst formation. Rarely, severe middle ear infections can spread to other tissues within the skull, such as the brain and membranes surrounding it (meningitis).
  • Tearing the eardrum. Most tears of the eardrum heal in 72 hours. Sometimes, surgery may be necessary.


These tips can help reduce your risk of getting ear infections.

  • Avoid common colds. Please encourage your children to wash their hands often and thoroughly. Remind them to share food and drink utensils. Your children should not cough or sneeze into your elbow. Limit the time your child spends with group child care. Having a child care facility with fewer children may be more beneficial. If your child is ill, keep them home from school or child care.
  • Don’t smoke in the home. Smoke-free living is a must when you are away from your home.
  • Breastfeed your baby—for at least six months. Breast milk may contain antibodies that can protect against ear infections.
  • When bottle-feeding, keep your baby upright. Don’t put a bottle in the baby’s mouth if they lie down. You should not place bottles in your baby’s crib.
  • Discuss vaccinations with your doctor. Get advice from your doctor on the best vaccinations for your child. Ear infections can be prevented by seasonal flu shots, pneumococcal, and other bacterial vaccinations.
  • Ear wax removal

Ear Infection Treatment

You can treat some ear infections without antibiotics. The best treatment for your child will depend on several factors, such as your child’s age or severity.


Ear infections are usually treated within a few days. Most infections disappear on their own after one to two weeks. However, the American Academy of Pediatrics and American Academy of Family Physicians suggest a wait-and-see approach for:

  • Children aged 6-24 months may experience mild middle ear pain for up to 48 hours.
  • Children aged 24 months or older who experience mild middle ear pain for less than 48 hours and have a temperature of less than 102.2 F (39 C) may be afflicted.

There is some evidence that antibiotics may benefit children suffering from ear infections. However, antibiotics should not be used too often as bacteria can become resistant. Discuss the risks and benefits of antibiotics with your doctor.

How to manage pain

Your doctor can advise you about ways to reduce the pain caused by an ear infection. The following are some possible options:

  • Pain medication. To relieve pain, your doctor may recommend the use of acetaminophen (Tylenol and others) or ibuprofen (“Advil, Motrin IB, and others). Follow the instructions on the label. It would be best not to give aspirin to children or teens. Aspirin is linked to Reye’s syndrome, so children and teens with symptoms like chickenpox or flu should not be given aspirin. If you have any concerns, talk to your doctor.
  • Anesthesia drops. These can relieve pain if the eardrum has no tear or a hole.


A healthy ear includes inner, middle and outer ear. Infected ear – a condition in which there is inflammation and fluid. Try not to use any metal for cleaning ear.

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