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Ear infections can be either bacterial or viral infections. They can occur in your middle ear, the part of your ear just behind your eardrum, as well as the outer and inner ear. They often clear up on their own but can be painful due to inflammation or fluid buildup.

Ear infections can be chronic or acute. Acute ear infections are painful but short in duration. Chronic ear infections either don’t clear up or recur many times. They can cause damage to the middle and inner ear, which is infrequently permanent.

Keep reading to learn about ear infections, including causes, symptoms, and treatment options.

Common symptoms of ear infections include:

These symptoms might persist or come and go. Symptoms may occur in one or both ears. Pain is usually more severe with a double ear infection, which is an infection in both ears.

Chronic ear infection symptoms may be less noticeable than those of acute ear infections.

Symptoms of an ear infection in children

Along with symptoms seen in adults, such as ear pain and drainage, young children and babies may show other signs of an ear infection, such as:

Usually, ear infections last fewer than 3 days, but they can persist for up to a week.

Children younger than 6 months who have a fever or other ear infection symptoms should see a doctor. Seek medical attention if your child has a fever higher than 102°F (39°C) or severe ear pain.

Ear infections are caused by viruses or bacteria, particularly the bacteria Streptococcus pneumoniaeor Haemophilus influenzae. They often result from a blockage of your Eustachian tubes, which causes fluid to build up in your middle ear. Eustachian tubes are small tubes that run from each of your ears directly to the back of your throat.

Causes of Eustachian tube blockage include:

Ear infections can also develop from infected adenoids. Your adenoids are glands on the roof of your mouth behind your nose that help protect your body from infections. Infections can spread from these glands to the nearby ends of your Eustachian tubes.

Risk factors for ear infections

Ear infections occur most commonly in young children because they have short and narrow Eustachian tubes. About 80 percent of children develop an acute ear infection at some point.

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
  • changes in temperature and humidity
  • exposure to cigarette smoke
  • pacifier use
  • recent illness or ear infection
  • being male
  • low birth weight
  • lack of access to healthcare
  • being in daycare

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

  • hearing loss
  • speech or language delay in children, which is more common when there is chronic fluid in the middle ear
  • mastoiditis (an infection of the mastoid bone in the skull)
  • meningitis (a bacterial infection of the membranes covering the brain and spinal cord)
  • ruptured eardrum

While most mild ear infections clear up without intervention, the following treatments can also help:

Home treatment

These methods are effective in relieving the symptoms of a mild ear infection:

Medical treatment

If your symptoms get worse or don’t improve, see a doctor. They may prescribe antibiotics if your ear infection is bacterial, chronic, or doesn’t appear to be improving.

Antibiotics don’t help treat viral infections.

Medical treatment in children

Doctors often take a wait-and-see approach when treating ear infections in children to avoid over-prescribing antibiotics, which can lead to antibiotic resistance.

A doctor may sometimes write you a prescription for antibiotics if symptoms are severe or don’t resolve within 2 to 3 days. Alternatively, they may write you a prescription but recommend waiting first to see if your child’s symptoms get better after 2 to 3 days.

It’s important to finish your entire prescription. Often, a 7- or 10-day prescription of amoxicillin is prescribed.

You shouldn’t give children aspirin without their doctor’s instruction. Aspirin is a preventable risk factor for developing Reyes’ syndrome, a rare disorder that causes brain and liver damage.

Surgery

Surgery may be an option if your ear infection isn’t eliminated with the usual medical treatments or if you have many ear infections over a short period.

Most often, ear tubes are placed in your ears to allow fluid to drain out. These tubes are surgically inserted into your eardrums. They eventually fall out and the holes heal over. Sometimes these holes need to be closed surgically.

A myringotomy surgery is another option. During this procedure, a doctor creates a small hole in your eardrum to let fluid drain and to relieve pain. The incision heals within a few days.

In cases that involve enlarged adenoids, surgical removal of your adenoids may be recommended.

The Centers for Disease Control and Prevention recommends seeing a doctor when your child has:

  • a fever over 102.2°F
  • pus, discharge, or fluid leaking from your ear
  • worsening symptoms
  • symptoms for more than 2 to 3 days
  • hearing loss
  • other concerning symptoms

For adults, it’s a good idea to visit a doctor if your symptoms last longer than 2 or 3 days, or you have severe pain or a fever.

A healthcare professional will consider your symptoms and examine your ears with an instrument called an otoscope that has a light and magnifying lens. The 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

This exam is rarely painful, but some children may be bothered.

Additional tests

Other tests include:

  • Fluid sample. 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.
  • Computed tomography (CT) scan. Your doctor may order a CT scan of your head to determine if the infection has spread beyond your middle ear.
  • Blood tests. Blood tests can check your immune function.
  • Tympanometry. Tympanometry allows doctors to measure how well your eardrum responds to changes in air pressure inside your ear.
  • Acoustic reflectometry. This test measures how much sound is reflected back from your eardrum to indirectly measure the amount of fluid in your ear.
  • Hearing test. You may need a hearing test, especially if you have chronic ear infections.

The following practices may reduce the risk of ear infection:

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

Ear infections are caused by bacteria or viruses in your middle ear, which is the part of your ear behind your eardrum. Most ear infections clear up within about 3 days, but severe infections may need to be treated with antibiotics.

Ear infections are most common in children. It’s important to see a doctor if you or your child develop severe pain, a fever over 102.2°F, ear drainage, or other concerning symptoms.