What is Ear infection?

Ear infections can also occur in adults, although they are much less common than in children.

Ear infection – acute

Suspected ear infections are one of the most common reasons parents take their children to their health care provider. The most common type of ear infection is called otitis media. It is caused by swelling and infection of the middle ear. The middle ear is located just behind the eardrum.

An acute ear infection starts over a short period and is painful. Ear infections that last a long time or come and go are called chronic ear infections.

Causes

The eustachian tube runs from the middle of each ear to the back of the throat. Normally, this tube drains fluid that is made in the middle ear. If this tube gets blocked, fluid can build up. This can lead to infection.

  • Ear infections are common in infants and children because their eustachian tubes are easily clogged.
  • Ear infections can also occur in adults, although they are much less common than in children.

Anything that causes the eustachian tubes to become swollen or blocked may lead to more fluid buildup in the middle ear behind the eardrum. Some causes are:

  • Allergies
  • Colds and sinus infections
  • Excess mucus and saliva produced during teething
  • Infected or overgrown adenoids (lymph tissue in the upper part of the throat)
  • Tobacco smoke

Ear infections are also more likely in children who spend a lot of time drinking from a sippy cup or bottle while lying on their back. Milk may enter the eustachian tube, which may increase the risk of an ear infection. Getting water in the ears will not cause an acute ear infection unless the eardrum has a hole in it.

Other risk factors for acute ear infections include:

  • Attending day care (especially centers with more than 6 children)
  • Changes in altitude or climate
  • Cold climate
  • Exposure to smoke
  • Family history of ear infections
  • Not being breastfed
  • Pacifier use
  • Recent ear infection
  • Recent illness of any type (because illness lowers the body’s resistance to infection)
  • Birth defect, leading to deficiency in eustachian tube function

Symptoms

In infants, often the main sign of an ear infection is acting irritable or crying that cannot be soothed. Many infants and children with an acute ear infection have a fever or trouble sleeping. Tugging on the ear is not always a sign that the child has an ear infection.

Symptoms of an acute ear infection in older children or adults include:

  • Ear pain
  • Fullness in the ear
  • Feeling of general illness
  • Nasal congestion
  • Cough
  • Lethargy
  • Vomiting
  • Diarrhea
  • Hearing loss in the affected ear
  • Drainage of fluid from the ear
  • Loss of appetite

The ear infection may start shortly after a cold. Sudden drainage of yellow or green fluid from the ear may mean the eardrum has ruptured.

All acute ear infections involve fluid behind the eardrum. At home, you can use an electronic ear monitor to check for this fluid. You can buy this device at a drugstore. You still need to see your child’s provider to confirm an ear infection.

Exams and Tests

Your provider will take your medical history and ask about symptoms.

Your provider will look inside the ears using an instrument called an otoscope. This exam may show:

  • Areas of marked redness
  • Bulging of the tympanic membrane (eardrum)
  • Discharge from the ear
  • Air bubbles or fluid behind the eardrum
  • A hole (perforation) in the eardrum

Your provider might recommend a hearing test if you or your child has a history of ear infections.

Treatment

Some ear infections clear on their own without antibiotics. Treating the pain and allowing the body time to heal itself is often all that is needed:

  • Apply a warm cloth or warm water bottle to the affected ear.
  • Use over-the-counter pain relief drops for ears. Or, ask your provider about prescription eardrops to relieve pain.
  • Take over-the-counter medicines such as ibuprofen or acetaminophen for pain or fever. Do not give aspirin to children.

All children younger than 6 months with a fever or symptoms of an ear infection should see their provider. Children who are older than 6 months may be watched at home if they do not have:

  • A fever higher than 102°F (38.9°C)
  • More severe pain or other symptoms
  • Other medical problems

If there is no improvement or if symptoms get worse, schedule an appointment with your provider to determine whether antibiotics are needed.

ANTIBIOTICS

A virus or bacteria can cause ear infections. Antibiotics will not help an infection that is caused by a virus. Most providers don’t prescribe antibiotics for every ear infection. However, all children younger than 6 months with an ear infection are treated with antibiotics.

Your provider is more likely to prescribe antibiotics if your child:

  • Is under age 2 years
  • Has a fever
  • Appears sick
  • Does not improve in 24 to 48 hours

If antibiotics are prescribed, it is important to take them as directed and to take all of the medicines. Do not stop the medicine when symptoms go away. If the antibiotics do not seem to be working within 48 to 72 hours, contact your provider. You may need to switch to a different antibiotic.

Side effects of antibiotics may include nausea, vomiting, and diarrhea. Serious allergic reactions are rare, but may also occur.

Some children have repeat ear infections that seem to go away between episodes. They may receive a smaller, daily dose of antibiotics to prevent new infections.

 

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