Ear Infections

Written by Bree Normandin and Marijane Leonard | Published on July 18, 2012
Medically Reviewed by George Krucik, MD

Overview

An ear infection occurs when a bacterial or viral infection affects the middle ear—the sections of your ear just behind the eardrum. Ear infections can be painful because of inflammation and fluid build up in the middle ear.

Ear infections can be chronic or acute. Acute ear infections are painful but short in duration. Chronic ear infections do not clear up, or they recur many times. Chronic ear infections can cause permanent damage to the middle and inner ear.

What Causes an Ear Infection?

Ear infections occur when one of your Eustachian tubes becomes swollen or blocked and fluid builds up in your middle ear. Eustachian tubes are small tubes that run from each ear directly to the back of the throat. The causes of Eustachian tube blockage include:

  • allergies
  • colds
  • sinus infections
  • excess mucus
  • tobacco smoking
  • infected or swollen adenoids (tissue near your tonsils that trap harmful bacteria and viruses)

Risk Factors for Ear Infections

Ear infections occur most commonly in young children because they have short and narrow Eustachian tubes. Infants who are bottle-fed also have a higher incidence of ear infections than their breastfed counterparts. Other factors that increase the risk of developing an ear infection are:

  • altitude changes
  • climate changes
  • exposure to cigarette smoke
  • pacifier use
  • recent illness or ear infection

What Are the Symptoms of Ear Infections?

A few of the common symptoms of ear infections include:

  • mild pain or discomfort inside the ear
  • a feeling of pressure inside the ear that persists
  • fussiness in young infants
  • pus-like ear drainage
  • hearing loss

These symptoms might persist or come and go. Symptoms may occur in one or both ears. Chronic ear infection symptoms may be less noticeable than those of acute ear infections.

Children younger than six months who have a fever or ear infection symptoms should see a doctor. Always seek medical attention if your child has a fever higher than 102 degrees or severe ear pain.

How Are Ear Infections Diagnosed?

Your healthcare provider will examine your ears with an instrument called an otoscope that has a light and magnifying lens. Examination may reveal:

  • redness, air bubbles, or pus-like fluid inside the middle ear
  • fluid draining from the middle ear
  • a perforation in the eardrum
  • a bulging or collapsed eardrum

If your infection is advanced, your doctor may take a sample of the fluid inside your ear and test it to determine whether certain types of antibiotic resistant bacteria are present. He or she may also order a computed tomography (CT) scan of your head to determine if the infection has spread beyond the middle ear. Finally, you may need a hearing test, especially if you are suffering from chronic ear infections.

How Are Ear Infections Treated?

Most mild ear infections clear up without intervention. Some of the following methods are effective in relieving the symptoms of a mild ear infection:

  • applying a warm cloth to the affected ear
  • taking over-the-counter pain medication such as ibuprofen or acetaminophen
  • using over-the-counter or prescription ear drops to relieve pain
  • taking over-the-counter decongestants such as pseudoephedrine.

If your symptoms get worse or do not improve, you should schedule an appointment with your doctor. He or she may prescribe antibiotics if your ear infection is chronic or does not appear to be improving. If a child under the age of 2 presents with ear infection symptoms, a doctor will likely give him or her antibiotics as well. It is important to finish your entire course of antibiotics if they are prescribed.

Surgery may be an option if your ear infection is not eliminated with the usual medical treatments or if you have many ear infections over a short period of time. Most often, tubes are placed in the ears to allow fluid to drain out. In cases that involve enlarged adenoids, surgical removal of the adenoids may be necessary.

What Can Be Expected in the Long Term?

Ear infections usually clear up without intervention, but they may recur. The following rare but serious complications may follow an ear infection:

  • hearing loss
  • speech or language delay in children
  • mastoiditis (an infection of the mastoid bone in the skull)
  • meningitis (a bacterial infection of the membranes covering the brain and spinal cord)
  • a ruptured ear drum

How Can Ear Infections Be Prevented?

The following practices have been proven to reduce the risk of ear infection:

  • washing your hands often
  • avoiding overly crowded areas
  • forgoing pacifiers with infants and small children
  • breast-feeding infants
  • avoiding secondhand smoke
  • keeping immunizations up-to-date
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