Ear Infection

Overview

Ear infections occur when the pocket of air located in the middle ear becomes infected with a virus or bacteria. While these infections can develop in anyone, they are more common in children, and often develop after a cold, allergic reaction or other illness.

People with ear infections may experience impaired hearing, fluid leaking from the ear, and an intense pain in the ear, particularly while lying down. When a child has an ear infection, parents may notice the child is more restless or fussy than usual, cries more than normal, or pulls repeatedly at the affected ear.

Ear infections that do not resolve on their own are commonly treated with antibiotics. Your doctor may also recommend over-the-counter pain relievers.

It is important to consult a doctor when symptoms that worsen over time, as ear infections can lead to rare but serious complications. Call your doctor if the pain is extreme, is accompanied by a fever, or if fluid is leaking from the ear. 

Ear infection causes

Ear infections often occur when an illness, infection, allergy or other irritation causes swelling in the sinuses and ear passages. This swelling can cause viruses and bacteria to become trapped in the ears, leading to an infection.

The Eustachian tube is a narrow passageway in the ear that allows air inhaled through the nose to pass through to the middle ear. When functioning normally, the Eustachian tube maintains a clean and dry middle-ear space. When the tube becomes clogged, however, the middle ear becomes a welcome environment for an infection to take hold.

Ear infection risk factors

The following factors may increase one’s likelihood of developing an ear infection:

• Fall and winter seasons, when colds and flus are more common
• High pollen counts in the spring, for people who are affected by seasonal allergies
• Living in an environment with poor air quality, such as with high levels of pollution or tobacco smoke

Children may be more likely to develop ear infections if they:

• Are under two years of age
• Attend daycare or preschool, where they are more likely to acquire infections that can lead to ear infections
• Have a cleft palate
• Are bottle-fed as an infant or are fed while lying down

Ear infection symptoms

Adults with ear infections may experience:

• Pain in the ear
• Impaired hearing
• Fluid leaking from the ear

Children with ear infections may experience:

• Pain in the ear, particularly while lying down
• Headaches
• Decreased appetite
• Fluid leaking from the ear
• A fever over 100 F
• Trouble sleeping
• Trouble balancing

Parents may also notice that a child with an ear infection:

• Is restless, fussy, or agitated
• Cries more than normal
• Pulls the affected ear
• Does not seem to hear or respond to noises like normal

Ear infection complications

Complications following ear infections are uncommon but can be serious. Ear infections that are recurrent or are left untreated can lead to:

• Hearing loss
• A torn eardrum
• Infection that spreads through the body
• Meningitis
• Paralysis of facial nerves

Ear infection prevention

Adults can avoid ear infections by:

• Staying away from tobacco smoke
• Practicing good hand hygiene to avoid respiratory infections that can lead to ear infections

Ear infections in young children can be prevented by:

• Breast-feeding your infant
• Avoiding bottle-feeding your infant while the baby is lying down
• Making sure your child is up to date on vaccinations

Ear infection diagnosis

When diagnosing an ear infection, your doctor will likely:

• Review your symptoms
• Provide a physical examination
• Look into the ears with a lighted tool called a pneumatic otoscope

If your ear infections are recurring, your doctor may provide further diagnostic tests to determine whether a more complex condition is present.

Ear infection treatment

Some ear infections go away on their own. If symptoms worsen within one to two days, you may want to seek medical treatment to clear the infection and to alleviate pain.

Most ear infections are treated with antibiotics. To mitigate pain, our may recommend:

• Over-the-counter pain relievers such as ibuprofen or acetaminophen
• Anesthetic ear drops

When to seek care

Call your doctor if you are experiencing symptoms of an ear infection.

If you are a parent, call your child’s doctor if your child:

• Has extreme ear pain
• Is younger than six months old
• Has symptoms that persist past one day
• Has fluid leaking from the ear
• Seems irritable or restless after recovering from a cold or other illness

Next Steps

Children who experience frequent, recurring ear infections may benefit from a myringotomy—a procedure in which small tubes are placed in the ears to drain fluids and prevent future infections. Consult your child’s doctor if your child’s ear infections become increasingly frequent.