What is a middle ear infection?

A middle ear infection, also called otitis media, occurs when a virus or bacteria cause the area behind the eardrum to become inflamed. The condition is most common in children. According to the Lucile Packard Children’s Hospital at Stanford, middle ear infections occur in 80 percent of children by the time they reach age 3.

Most middle ear infections occur during the winter and early spring. Often, middle ear infections go away without any medication. However, you should seek medical treatment if pain persists or you have a fever.

There are two types of middle ear infections: acute otitis media (AOM) and otitis media with effusion (OME).

Acute otitis media

This type of ear infection comes on quickly and is accompanied by swelling and redness in the ear behind and around the ear drum. Fever, ear pain, and hearing impairment often occur as a result of trapped fluid and/or mucous in the middle ear.

Otitis media with effusion

After an infection goes away, sometimes mucous and fluid will continue to build up in the middle ear. This can cause the feeling of the ear being “full” and affect your ability to hear clearly.

There are a number of reasons why children get middle ear infections. They often stem from a prior infection of the respiratory tract that spreads to the ears. When the tube that connects the middle ear to the pharynx (eustachian tube) is blocked, fluid will collect behind the eardrum. Bacteria will often grow in the fluid, causing pain and infection.

There are a variety of symptoms associated with middle ear infections. Some of the most common are:

Your doctor will make sure they have your child’s medical history and will do a physical examination. During the exam, your doctor will look at the outer ear and eardrum using a lighted instrument called an otoscope to check for redness, swelling, pus, and fluid.

Your doctor might also conduct a test called tympanometry to determine whether the middle ear is working properly. For this test, a device is put inside your ear canal, changing the pressure and making the eardrum vibrate. The test measures changes in vibration and records them on a graph. Your doctor will interpret the results.

There are a number of ways to treat middle ear infections. Your doctor will base treatment on your child’s age, health, and medical history. Doctors will also consider the following:

  • the severity of the infection
  • the ability of your child to tolerate antibiotics
  • opinion or preference of the parents

Depending on the severity of the infection, your doctor may tell you that the best option is to treat the pain and wait to see if symptoms go away. Ibuprofen or another fever and pain reducer is a common treatment.

Symptoms lasting more than three days usually mean your doctor will recommend antibiotics. However, antibiotics won’t cure an infection if its caused by a virus.

Complications resulting from ear infections are rare, but they can occur. Some complications associated with middle ear infections are:

  • infection that spreads to the bones of the ear
  • infection that spreads to the fluid around the brain and spinal cord
  • permanent hearing loss
  • ruptured eardrums

There are ways to lower your child’s risk of getting ear infections:

  • Wash your hands and your child’s hands frequently.
  • If you bottle feed, always hold your baby’s bottle yourself and feed them while they’re sitting up or semi-upright. Wean them off the bottle when they turn 1 year old.
  • Avoid smoky environments.
  • Keep your child’s immunizations up-to-date.
  • Wean your child from the pacifier by the time they are 1 year old.

The American Osteopathic Association also recommends breastfeeding your baby if possible, as it can help to reduce the incidence of middle ear infections.