If you’re experiencing discomfort or pressure in your inner ear, along with pus drainage or hearing loss, it could indicate an ear infection. Consider trying over-the-counter (OTC) treatments, but if your symptoms persist, it’s best to seek advice from a doctor.

Ear infections may stem from either bacterial or viral sources and can affect the middle, outer, or inner ear. While they often resolve without intervention, they can cause pain due to inflammation or the accumulation of fluid.

These infections can manifest as either acute, characterized by intense but brief discomfort, or chronic, where symptoms persist or recur frequently. Chronic infections pose a risk of damaging the middle and inner ear, potentially leading to lasting consequences.

Explore further to understand the causes, symptoms, and available treatments for ear infections.

Table of Contents

1. What are the symptoms of ear infections?
2. What causes an ear infection and what increases your risk?
3. Potential complications of an ear infection
4. How are ear infections treated?
5. When to see a doctor
6. How are ear infections diagnosed?
7. How can ear infections be prevented?

What are the symptoms of ear infections?

Common signs of ear infections comprise:

• Mild discomfort or pain within the ear
• Persistent sensation of pressure in the ear
• Drainage resembling pus from the ear
• Hearing impairment

These symptoms may persist or fluctuate over time and can affect one or both ears. Double ear infections, affecting both ears simultaneously, typically induce more severe pain.

In chronic cases, symptoms might be subtler compared to acute episodes.

In children, besides the aforementioned symptoms experienced by adults, additional indicators of an ear infection may include:

• Tugging or rubbing at the ear
• Presence of fever
• Unresponsiveness to certain sounds
• Frequent loss of balance
• Complaints of headaches
• Irritability or restlessness
• Decreased appetite

Typically, ear infections resolve within three days, but in some instances, symptoms may linger for up to a week.

For children under six months old exhibiting fever or other symptoms of an ear infection, medical attention is advisable. Seek prompt medical care if your child’s fever exceeds 102°F (39°C) or if they experience severe ear pain.

What causes an ear infection and what increases your risk?

Viruses or bacteria, notably Streptococcus pneumoniae or Haemophilus influenzae, are common culprits behind ear infections. These infections often arise due to blockages in the Eustachian tubes, leading to the accumulation of fluid in the middle ear. The Eustachian tubes, small passageways connecting the ears to the throat, play a crucial role in regulating pressure.

Factors contributing to Eustachian tube blockage include:

• Allergies
• Common colds
• Sinus infections
• Excessive mucus production
• Smoking
• Fluctuations in air pressure

Additionally, ear infections can stem from infected adenoids, glands situated on the roof of the mouth behind the nose, which help fend off infections. Infections originating from the adenoids can spread to the nearby openings of the Eustachian tubes.

Certain factors heighten the risk of developing ear infections, particularly among young children, who are most susceptible due to their short and narrow Eustachian tubes. Approximately 80% of children experience acute ear infections at some point.

Infants who are bottle-fed tend to have a higher incidence of ear infections compared to those who are breastfed.

Other risk factors include:

• Altitude changes
• Fluctuations in temperature and humidity
• Exposure to cigarette smoke
• Pacifier use
• Recent illness or prior ear infection
• Male gender
• Low birth weight
• Limited access to healthcare
• Attendance at daycare facilities

Potential complications of an ear infection

While many ear infections resolve without complications, it’s essential to be aware of potential complications that can arise, particularly if the infection is left untreated or if it becomes chronic. Here are some potential complications associated with ear infections:

1. Hearing Loss: Persistent fluid buildup in the middle ear can lead to temporary or permanent hearing loss, especially if the infection affects the structures responsible for sound transmission. This is particularly concerning in children, as hearing impairment can interfere with speech and language development.
2. Ruptured Eardrum (Tympanic Membrane Perforation): In severe cases of middle ear infection, increased pressure from fluid buildup can cause the eardrum to rupture. A ruptured eardrum can result in sudden relief from pain and discharge of pus or blood from the ear. While most perforations heal on their own, some may require medical intervention to prevent complications.
3. Chronic Suppurative Otitis Media (CSOM): If an ear infection persists or recurs frequently, it may progress to chronic suppurative otitis media, characterized by persistent drainage of pus from the ear. CSOM can lead to ongoing hearing loss, recurrent infections, and damage to the structures of the middle ear.
4. Mastoiditis: Mastoiditis is a rare but serious complication of middle ear infection that occurs when the infection spreads to the mastoid bone, located behind the ear. Symptoms may include swelling, redness, and tenderness behind the ear, along with fever and ear pain. Mastoiditis requires prompt medical treatment to prevent further complications, such as abscess formation and bone destruction.
5. Facial Nerve Paralysis: In rare cases, severe middle ear infections can lead to inflammation or compression of the facial nerve (cranial nerve VII), resulting in facial weakness or paralysis on the affected side.
6. Labyrinthitis: Labyrinthitis is an inner ear infection that can occur when bacteria or viruses spread from the middle ear to the delicate structures of the inner ear. Symptoms may include vertigo, dizziness, nausea, vomiting, and hearing loss. Prompt treatment is essential to prevent permanent damage to balance and hearing function.
7. Intracranial Complications: In extremely rare cases, untreated or severe ear infections can lead to complications affecting the brain and surrounding structures. These complications may include meningitis (inflammation of the protective membranes covering the brain and spinal cord), brain abscess, or venous sinus thrombosis. Symptoms may include severe headache, neck stiffness, confusion, seizures, and altered consciousness. Intracranial complications require immediate medical attention and may necessitate hospitalization and aggressive treatment with antibiotics or surgery.

While the majority of ear infections resolve with appropriate medical care, it’s essential to monitor symptoms closely and seek prompt treatment if complications are suspected. Early intervention can help prevent long-term consequences and promote optimal recovery.

How are ear infections treated?

Although most mild ear infections resolve on their own, you can alleviate symptoms with the following treatments:

Home Remedies:

• Apply a warm cloth to the affected ear.
• Take over-the-counter pain relievers like ibuprofen (Advil) or acetaminophen (Tylenol).
• Use over-the-counter or prescription ear drops for pain relief.
• Consider over-the-counter decongestants such as pseudoephedrine (Sudafed).
• Refrain from sleeping on the affected ear.

Medical Intervention:

If symptoms worsen or persist, consulting a doctor is advisable. They may prescribe antibiotics for bacterial infections, chronic cases, or those showing no improvement.

It’s crucial to note that antibiotics are ineffective against viral infections.

Treatment for Children:

Doctors often adopt a cautious approach with children to prevent overuse of antibiotics, which can contribute to antibiotic resistance.

In some cases, a doctor may prescribe antibiotics if symptoms are severe or if there’s no improvement after 2 to 3 days. Alternatively, they might issue a prescription but advise waiting to observe if symptoms improve within that timeframe.

Completing the entire antibiotic course is essential. Typically, a 7- or 10-day prescription of amoxicillin is prescribed.

It’s important not to administer aspirin to children without medical guidance, as it can increase the risk of Reyes’ syndrome, a rare condition causing brain and liver damage.

Surgical Options:

If standard medical treatments fail to resolve the infection or if recurrent infections occur frequently, surgery may be considered.

Ear tube placement is a common procedure to facilitate fluid drainage. These tubes are surgically inserted into the eardrums and eventually fall out as the holes heal. Occasionally, surgical closure of these holes may be necessary.

Another surgical option is myringotomy, where a small hole is made in the eardrum to drain fluid and alleviate pain. The incision typically heals within a few days.

In cases involving enlarged adenoids, surgical removal may be recommended.

When to see a doctor

The Centers for Disease Control and Prevention (CDC) suggests seeking medical attention for your child if they experience:

• A fever exceeding 102.2°F
• Presence of pus, discharge, or fluid leakage from the ear
• Deteriorating symptoms
• Symptoms persisting beyond 2 to 3 days
• Hearing impairment
• Any other worrying symptoms

For adults, it’s advisable to consult a doctor if symptoms persist beyond 2 or 3 days, or if there is severe pain or a fever.

How are ear infections diagnosed?

During a medical evaluation, a healthcare provider will assess your symptoms and conduct an examination of your ears employing a tool known as an otoscope, which incorporates a light and magnifying lens. This examination might uncover:

• Redness, presence of air bubbles, or fluid resembling pus within the middle ear
• Drainage of fluid from the middle ear
• Perforation of the eardrum
• Bulging or collapsed eardrum

While this examination is typically not painful, some children might find it uncomfortable.

Additional tests that may be conducted include:

• Fluid sample: In advanced cases, your doctor might collect a sample of the fluid from your ear to test for the presence of specific antibiotic-resistant bacteria.
• Computed tomography (CT) scan: This imaging test can be ordered to assess whether the infection has spread beyond the middle ear.
• Blood tests: These tests can evaluate your immune function.
• Tympanometry: This procedure enables doctors to gauge how effectively your eardrum responds to variations in air pressure within the ear.
• Acoustic reflectometry: This test measures the extent to which sound is reflected back from your eardrum, offering an indirect assessment of fluid accumulation in the ear.
• Hearing test: Particularly for individuals with chronic ear infections, a hearing test may be necessary to assess any potential hearing impairment.

How can ear infections be prevented?

To minimize the risk of ear infections, consider implementing the following practices:

• Maintain good hand hygiene by washing your hands frequently.
• Steer clear of excessively crowded environments, especially during cold and flu seasons.
• If possible, avoid the use of pacifiers with infants and young children.
• Opt for breastfeeding as it can help boost the infant’s immunity.
• Avoid exposure to secondhand smoke, which can increase susceptibility to infections.
• Ensure that immunizations are kept up to date to strengthen the body’s defenses.

Ear infections typically arise from bacterial or viral presence in the middle ear, situated behind the eardrum. While most infections resolve within approximately 3 days, severe cases may necessitate antibiotic treatment.

Children are most commonly affected by ear infections. Seeking medical attention is crucial if severe pain, fever exceeding 102.2°F, ear drainage, or other troubling symptoms develop in you or your child.