Infection of the Ears (Otitis Media)

Infection of the Ears (Otitis Media)

A typical reason for your child’s visit to the doctor is an ear infection, which is an infection that arises in the region behind the eardrum. Ear infections occur when bacteria or viruses infect the eardrum and trap fluid behind it, causing discomfort and swelling/bulging. Antibiotics, pain relievers, and ear tubes are among the options for treatment.

What is the definition of an ear infection?

Acute otitis media, or a sudden infection in the middle ear, is the medical word for the popularly used term “ear infection” (the space behind the eardrum).

Ear infections may affect anybody, including children and adults, and are one of the most common reasons for young children to visit the doctor.

Ear infections frequently resolve on their own. A drug to ease pain may be recommended by your healthcare practitioner. If your ear infection has not improved or has worsened, your doctor may prescribe antibiotics. Ear infections in children under the age of two frequently necessitate the use of antibiotics.

It’s crucial to see your doctor to ensure that the ear infection has recovered or if you or your kid is experiencing any pain or discomfort. With chronic ear infections, repeated infections, and when fluid builds up behind the eardrum, hearing loss and other significant consequences might arise.

What is the location of the middle ear?

The fragile bones that help in hearing are housed in the middle ear, which is located below the eardrum (tympanic membrane). The hammer (malleus), anvil (incus), and stirrup (ossicles) are these bones (stapes). 

The ear is divided into three sections: outer, middle, and inner.

  • The external ear flap and the ear canal make up the outer ear (external auditory canal).
  • The air-filled region between the eardrum (tympanic membrane) and the inner ear is known as the middle ear. The fragile bones that transfer sound waves from the eardrum to the inner ear are housed in the middle ear. Ear infections are common in this area.
  • The snail-shaped labyrinth in the inner ear transfers sound waves from the middle ear into electrical impulses. These impulses are sent to the brain via the auditory nerve.

Other locations in the vicinity
The eustachian tube connects the middle ear to the upper region of the throat and controls air pressure within it.Adenoids are tiny tissue pads located above the neck, behind the nose, and near the eustachian tubes. Adenoids aid in the battle against infection brought on by bacteria that enter the body through the mouth.

Who is most susceptible to otitis media (inflammation of the middle ear)?

The most frequent childhood disease is a middle ear infection (other than a cold). Ear infections are most frequent in children aged 3 months to 3 years, and they can last up to 8 years. Repeated ear infections affect around a quarter of all children.
Adults can have ear infections as well, although they aren’t as common as they are in children.
Ear infections can be caused by a variety of circumstances, including:

  • Ear infections are more common in infants and young children (between the ages of 6 months and 2 years).
  • Family history of ear infections: Ear infections can run in families.
  • Colds: Having a cold raises the likelihood of developing an ear infection.
  • Allergies increase the adenoids by causing inflammation (swelling) of the nasal passages and upper respiratory tract. The eustachian tube can be blocked by enlarged adenoids, preventing ear fluids from draining. This causes fluid to build up in the middle ear, resulting in pressure, discomfort, and infection.
  • Chronic illnesses: People with chronic (long-term) illnesses, particularly those with immune weakness and chronic respiratory diseases such cystic fibrosis and asthma, are more susceptible to get ear infections.
  • Ethnicity: Ear infections are more common among Native Americans and Hispanic youngsters than in other ethnic groups.

An ear infection is caused by a number of factors.

Bacteria and viruses can cause ear infections. An ear infection frequently follows a cold or other respiratory infection. Through the eustachian tube (one in each ear), microorganisms or viruses enter the middle ear. The middle ear is connected to the back of the throat via this tube. The eustachian tube can also enlarge as a result of germs or viruses. The tube can get clogged as a result of the swelling, causing fluids to pool up in the middle ear instead of being able to drain out.

The fact that children’s eustachian tubes are shorter and have a lower slope than adults exacerbates the situation. Because of this physical difference, these tubes are more likely to clog and drain. A virus or bacterium can infect the confined fluid, resulting in discomfort.
Thesaurus of medical terms and circumstances
Because these phrases may be used by your healthcare professional, it’s vital to have a basic awareness of them:

  • Acute otitis media (middle ear infection): This is the same ear infection as was mentioned earlier. An ear infection that occurs suddenly, frequently in conjunction with or shortly after a cold or other respiratory infection. The bacterium or virus infects and traps fluid behind the eardrum, resulting in discomfort, eardrum swelling/bulging, and the phrase “ear infection.” Ear infections can start quickly and disappear in a few days (acute otitis media), or they can recur often and for lengthy periods of time (chronic otitis media) (chronic middle ear infections).
  • Otitis media with effusion is a complication that can occur after an acute case of otitis media. The signs and symptoms of acute otitis media go away. Although there is no active infection, the fluid is still present. The trapped fluid can cause temporary and moderate hearing loss, as well as increase the risk of an ear infection. A clog in the eustachian tube, which is unrelated to the ear infection, is another cause of this illness.
  • Chronic suppurative otitis media: This is an ear infection that refuses to go away despite therapy. This can eventually result in a hole in the eardrum.

What are the signs and symptoms of otitis media (inflammation of the middle ear)?

An ear infection can cause the following symptoms:

  • Ear discomfort is a noticeable symptom in older children and adults. Look for indicators of pain in infants who are too young to communicate, such as touching or pulling ears, screaming more than usual, sleeping problems, or appearing fussy/irritable.
  • Appetite loss: This is more common in young children, especially during bottle feedings. As the youngster swallows, the pressure in the middle ear shifts, producing increased pain and a decreased willingness to eat.
  • Irritability can be caused by any type of persistent discomfort.
  • Poor sleep: When the youngster is resting down, the pressure in the ear may grow, making the pain worse.
  • Ear infections can induce fevers ranging from 100°F (38°C) to 104°F. With an ear infection, 50% of youngsters will develop a fever.
  • The ear’s drainage system: Other than earwax, a yellow, brown, or white fluid may ooze from the ear. This might indicate a punctured eardrum (broken).
  • Hearing loss: Middle ear bones link to nerves that convey electrical impulses (as sound) to the brain. The flow of electrical signals through the inner ear bones is slowed by fluid behind the eardrums.

How can you know if you have an ear infection?

Exam of the ears

An otoscope will be used by your healthcare practitioner to examine your or your child’s ear. The hue of a healthy eardrum is pinkish grey and transparent (clear). The eardrum may be inflamed, enlarged, or red if an infection is present.

A pneumatic otoscope, which blasts a tiny quantity of air at the eardrum, can also be used to look for fluid in the middle ear. The eardrum should shift back and forth as a result of this. If there is fluid inside the ear, the eardrum will not move as freely.

Tympanometry is another test that use air pressure to look for fluid in the middle ear. This is not a hearing test. If you or your kid has had long-term or recurrent ear infections, or fluid in the middle ears that is not draining, your healthcare practitioner may arrange a hearing test by an audiologist to detect probable hearing loss.

Additional examinations

Your healthcare practitioner will also use a stethoscope to listen to your breathing and inspect your throat and nasal tract for symptoms of upper respiratory infections.

What is the treatment for an ear infection?

how can i treat an ear infection myself ?

how do you treat an ear infection without antibiotics ?

what is the best antibiotic for an ear infection ?

Treatment for ear infections is determined by the patient’s age, the severity of the illness, the form of the infection (is it a first-time, continuous, or repeated infection), and whether or not fluid persists in the middle ear for an extended length of time.

Your doctor will prescribe drugs to help you or your kid deal with pain and fever. Whether the ear infection is moderate, your healthcare practitioner may decide to wait a few days to see if the infection goes away on its own before giving an antibiotic.


If bacteria is suspected as the source of the ear infection, antibiotics may be recommended. Whether your kid is older, your healthcare practitioner may want to wait up to three days before giving antibiotics to see if the illness clears up on its own. Antibiotics may be begun immediately away if your or your child’s ear infection is severe. Based on your child’s age, the severity of their infection, and their fever, the American Academy of Pediatrics has suggested when to administer antibiotics and when to consider waiting.

If your doctor recommends an antibiotic, follow the directions carefully. After a few days of therapy, you or your kid will begin to feel better. Even if you’re feeling better and the pain has subsided, don’t stop taking the prescription until you’ve been ordered to. If you don’t finish the medicine, the infection may return. If your child’s antibiotic is a liquid, make sure to use a measuring spoon intended for liquid drugs to ensure that you provide the correct dosage.

Antibiotic eardrops and, in rare cases, a suctioning equipment are used to drain fluids from a hole or tear in your eardrum caused by a severe illness or a continuing infection (chronic suppurative otitis media). Your healthcare practitioner will provide you with precise instructions.

Pain-relieving medications

Earache or fever can be relieved with over-the-counter acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). Eardrops that relieve pain can also be administered. Within a few hours, these drugs typically start to relieve pain. Your doctor will prescribe pain relievers for you or your kid and provide you any further advice you need.

Children should never be given aspirin. Reye’s Syndrome is a life-threatening illness caused by aspirin.

Earaches are more painful at night. Pain can also be relieved by applying a warm compress to the outside of the ear. (This is not a good idea for babies.)

Tubes in the ears (tympanostomy tubes)

Ear infections can be persistent (chronic), recurrent, or the fluid in the middle ear might linger for months after the infection has resolved (otitis media with effusion). By the age of five, almost all children will have had an ear infection, and some children may have ear infections on a regular basis. Pain within the ear, a feeling of fullness in the ear, muted hearing, fever, nausea, vomiting, Diarrhea, weeping, irritability, and pulling at the ears are all indicators of an ear infection in a kid (especially in very young children). If your kid has had a history of ear infections (three or more in six months or four in a year), or ear infections that did not respond to medications,

You may be a candidate for ear tubes if you’ve had hearing loss due to fluid accumulation behind the eardrum. Ear tubes can give instant relief and are occasionally advised for young children who are still learning to speak and communicate. This outpatient surgical treatment, known as a myringotomy with tube implantation, may be referred to an ENT expert. A thin metal or plastic tube is placed via a tiny incision (cut) in the eardrum during the surgery.

The tube permits fluid to drain and allows air into the middle ear. The treatment is quick — around 10 minutes — and has a minimal risk of complications. This tube is often left in situ for six to twelve months. It usually falls out on its own, but your doctor can also remove it. Until the hole in the eardrum heals fully and closes, the outer ear must be kept dry and clear of unclean water, such as lake water.

What are the risks of ear fluid accumulation or recurrent or chronic ear infections?

The majority of ear infections do not result in long-term difficulties, but when they occur, issues can include:

  • Hearing loss: During an ear infection, some modest, transient hearing loss (muffling/distortion of sound) is common. Infections that recur, as well as damage to internal structures in the ear caused by a buildup of fluid, can result in more substantial hearing loss.
  • Speech and language development are delayed because children need to hear in order to learn language and develop speech. Hearing loss or muffled hearing for any period of time can considerably slow or obstruct growth.
  • Tear in the eardrum: Pressure from a long-term accumulation of fluid in the middle ear can cause a tear in the eardrum. A tiny rip in the eardrum occurs in around 5% to 10% of children who have an ear infection. Surgery may be required if the tear does not heal on its own. Do not put anything into your ear canal if you have ear leakage or discharge. If the object accidentally comes into contact with the eardrum, this can be harmful.
  • Infection spreads outside the ear if it does not go away on its own, is left untreated, or is not entirely cured with therapy. The neighboring mastoid bone may be harmed by infection (bone behind the ear). Infection can spread to the membranes that surround the brain and spinal cord (meninges) and produce meningitis in rare cases.

What can I do to keep myself and my child from getting ear infections?

Here are some tips to help you or your kid avoid ear infections:

Please don’t smoke. Secondhand smoking has been linked to an increased risk of ear infections in studies. Make sure no one smokes in the house, car, or day care facility, especially if children are present.

Allergic reactions can be controlled. Allergies can induce inflammation and mucus, which can clog the eustachian tube and increase the risk of ear infections.

Colds should be avoided at all costs. During the first year of life, limit your child’s exposure to colds. Toys, snacks, drinking glasses, and utensils should not be shared. Hands should be washed often. The majority of ear infections begin with a cold. If at all possible, avoid using large day care centers throughout the first year.

Your infant should be breastfed. Breastfeed your infant for the first six to twelve months of his or her existence. Ear infections are reduced by antibodies found in breast milk.

Baby should be fed from a bottle at an upright angle. If you’re bottle-feeding, keep your infant upright (head higher than stomach). Formula and other fluids may leak back into the eustachian tubes if you feed in the horizontal posture. 

Allowing a baby to hold his or her own bottle might result in milk draining into the middle ear. This issue may be avoided by weaning your infant off a bottle between the ages of nine and twelve months.

Keep an eye out for snoring or mouth breathing. Large adenoids can induce constant snoring or breathing through the mouth. Ear infections may be exacerbated by several factors. An otolaryngologist examination, as well as surgery to remove the adenoids (adenoidectomy), may be required.

Vaccinate yourself. Check your child’s vaccinations, particularly the annual influenza vaccine (flu shot) for children aged 6 months and above. Inquire about pneumococcal, meningitis, and other immunizations with your doctor. Ear infections can be avoided by avoiding viral and other illnesses.

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