Overview

An Ear Infection (sometimes called acute otitis media) is a middle-ear infection, the air-filled area behind the eardrum that includes the tiny vibrating bones of the ear. Kids are more likely to get ear infections than adults.

Since ear infections often clear up on their own, treatment may start with pain control and monitoring of the problem. Antibiotics are often used to break down the infection. Many individuals are predisposed to multiple ear infections. This can cause issues with hearing, and other severe complications.

Symptoms of Ear Infection

The signs and symptoms of ear infection are typically fast.

Children

Signs and symptoms common in children include:

• Ear pain, especially when lying down
• Tugging or pulling at an ear
• Trouble sleeping
• Crying more than usual
• Fussiness
• Trouble hearing or responding to sounds
• Loss of balance
• High fever (100 F) (38 C)
• Drainage of fluid from the ear
• Headache
• Loss of appetite

Adults

Common signs and symptoms in adults include:

• Ear pain
• Drainage of fluid from the ear
• Trouble hearing

When to see a doctor

Signs and symptoms of an ear infection may indicate several conditions. Having a correct diagnosis and prompt care is important. Call a doctor for your child, if:

• Symptoms last for more than a day
• Symptoms are present in a child less than 6 months of age
• Ear pain is severe
• Your infant or toddler is sleepless or irritable after a cold or other upper respiratory infection
• You observe a discharge of fluid, pus or bloody fluid from the ear
• Your child or baby becomes sleepless or irritable after a cold or other upper respiratory infection
• Note fluid, pus, or bloody fluid discharge from the ear

Causes

A bacterium or virus in the middle ear triggers an ear infection. This infection also results from another disease such as cold, flu, or allergy, which causes the nasal passage, throat, and eustachian tubes to cough and swelling.

Risk factors

Risk factors for ear infections may include:

Age: Children aged 6 months to 2 years are more vulnerable to ear infections due to the size and shape of their eustachian tubes and because their immune systems still continue to grow.

Group Child Care: Children who are cared for in group environments are more likely to develop colds and ear infections than children who live at home. During social environments, the children are exposed to more diseases, such as a common cold.

Infant Feeding: Babies who drink from a bottle, particularly when lying down, appear to have more ear infections than babies who are breast-fed do.

Seasonal Factors: Infections with the ears are most common in fall and winter. Persons with seasonal allergies can be at higher risk of ear infections when there is a high pollen count.

Low Air Quality: Tobacco smoke exposure, or high air pollution rates, can increase the risk of ear infections.

Alaska Native Heritage: Among the Alaska Natives, ear infections are more popular.

Cleft Palate: Differences in bone structure and muscles in children with cleft palates can make draining of the Eustachian tube more difficult.

Complications

Most of the ear infections will not cause problems in the long run. Ear infections which occur over and over again can lead to serious complications:

Impaired Hearing: Mild hearing loss that comes and goes with an ear infection is relatively normal, but it typically gets better after the infection clears. Ear infections that occur regularly, or fluid in the middle ear, which may lead to more severe hearing loss. If the eardrum or other middle ear structures get permanent damage, permanent hearing loss can occur.

Speech or developmental delays: If the hearing in infants and toddlers is temporarily or permanently impaired, they can experience delays in voice, social, and developmental abilities.

Spread of infection: Untreated infections or infections which do not respond well to treatment may spread to surrounding tissues. Mastoid infection, the bony protrusion behind the ear, is called mastoiditis. This infection may result in bone damage and pus-filled cyst formation. Extreme middle ear infections seldom spread to other skull tissues like the brain or the membranes around the brain (meningitis).

•    Tearing of the eardrum. Most eardrum tears heal within 72 hours. In some cases, surgical repair is needed.

Prevention

The following tips will reduce the risk that ear infections can develop:

•    Prevent common colds and other illnesses. Teach your children to regularly and thoroughly wash their faces, and not share utensils for eating and drinking. Teach your kids to cough or sneeze within their arm’s crook. Reduce the amount of time your child spends in community child care where appropriate. A child care environment that has fewer kids will improve. Consider holding your child home away from childcare or school while you are sick.

•    Avoid secondhand smoke. Make sure that no one smokes in your home. Away from home, stay in smoke-free environments.

•    Breast-feed your kids. Breast-feed your baby for a minimum of six months if possible. Breast milk contains antibodies which can be protective against ear infections.

•    Holding your baby in an upright position while you are bottle feeding. Stop putting a bottle in the mouth of your infant when lying down. Don’t bring the baby bottles into the crib.

•    Talk to your doctor about vaccinations. Ask your doctor about what vaccinations are appropriate for your child. Infections with seasonal flu, pneumococcal and other bacterial vaccines may help prevent ear infections.